Acute and chronic conjunctivitis due to over-the-counter ophthalmic decongestants.
OBJECTIVE
To describe patterns of conjunctivitis caused by ophthalmic decongestants.


METHODS
Case series.


METHODS
Outpatient eye clinic.


METHODS
We selected patients with conjunctival inflammation who were using nonprescription decongestant eyedrops, who had no other cause for conjunctivitis, and whose conditions improved after discontinuing the incriminated preparations.


METHODS
Clinical characteristics of conjunctival inflammation and time to resolution of symptoms and signs after discontinuing the use of eyedrops.


RESULTS
Seventy patients (137 eyes) were identified. Preparations containing the vasoconstrictors naphazoline, tetrahydrozoline, or phenylephrine were associated with 3 clinical patterns of conjunctivitis: conjunctival hyperemia (50 cases), follicular conjunctivitis (17 cases), and eczematoid blepharoconjunctivitis (3 cases). Decongestants were used daily for a median of 3 years (range, 8 hours to 20 years) prior to presentation. The median time to resolution of symptoms and signs was 4 weeks (range, 1-24 weeks), and patients remained asymptomatic for a median follow-up of 6 months (range, 0-12 years).


CONCLUSIONS
Nonprescription decongestant eyedrops can produce acute and chronic forms of conjunctivitis by pharmacological, toxic, and allergic mechanisms. Once recognized, conjunctival inflammation often takes several weeks to resolve.
Soparkar
C N
CN
Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Tex., USA.
Wilhelmus
K R
KR
Koch
D D
DD
Wallace
G W
GW
Jones
D B
DB
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001762:Blepharitis / Q000139:chemically induced / Q000473:pathology; D002908:Chronic Disease; D003228:Conjunctiva / Q000473:pathology; D003231:Conjunctivitis / Q000139:chemically induced* / Q000473:pathology; D005143:Eyelids / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009278:Naphazoline / Q000009:adverse effects*; D014663:Nasal Decongestants / Q000009:adverse effects*; D004366:Nonprescription Drugs; D009883:Ophthalmic Solutions / Q000009:adverse effects; D010656:Phenylephrine / Q000009:adverse effects*; D014661:Vasoconstriction
D007093:Imidazoles; D014663:Nasal Decongestants; D004366:Nonprescription Drugs; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D009278:Naphazoline; C005810:tetrahydrozoline