Patch Testing for Eyelid Dermatitis: A Report by the American Academy of Ophthalmology

To review the literature for protocols and results of patch testing for allergic contact dermatitis (ACD) in patients with noninfectious eyelid dermatitis.

A literature search of the PubMed database was conducted last in July 2024. Articles were limited to original research for which an English language abstract was available, and in which detailed data were available for at least 25 patients being tested for noninfectious eyelid dermatitis. Of the 135 articles identified, 17 studies were reviewed in full text and were selected for inclusion and grading. All studies were rated level III.

Multiple allergens may cause ACD. The following allergens with at least 10% positivity were reported in more than 1 study (although the same allergens were not examined in every study): Balsam of Peru (Myroxylon pereirae), cinnamic alcohol, fragrance mixes, gold, methylisothiazolinone, nail care products, neomycin, nickel, and personal care products (broadly defined as any product used by a patient at home).

An ideal patch test panel for eyelid ACD remains to be determined; patients with suspected eyelid ACD benefit from a depth and breadth of patch testing beyond common allergens such as Balsam of Peru, cinnamic alcohol, fragrance mixes, gold, methylisothiazolinone, nail care products, neomycin, and nickel. Future research would benefit from a prospective methodology, greater demographic detail, and postpatching follow-up.

The author(s) have no proprietary or commercial interest in any materials discussed in this article.