Eyedrop-induced allergy: clinical evaluation and diagnostic protocol.
BACKGROUND
In the last few years, adverse reactions to mydriatic eyedrops have been investigated. However, is not still available a standardized protocol, capable of identify the pathogenetic mechanism. In the light of these findings we have evaluated the reliability of a protocol with well established concentration of specific allergens.


METHODS
The diagnostic method includes the application of patch test series Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali (GIRDCA), medicaments, corticosteroids, local anesthetics, main eyedrops' excipients, pure active principles and extemporaneous preparations with mydriatic eyewashes. At the same time, skin prick test with a solution of atropine sulfate at 1 per thousand and an intradermal test with injection of atropine at 0.01 per thousand were carried out.


RESULTS
After patch tests were removed, we detected seven positiveness to the phenylephrine, two to the benzalkonium chloride, one to thiomersal, one to the ethylendiamine and one to the atropine sulfate 1 per thousand. With intradermal tests we obtained three positiveness in patients who reported adverse reactions to atropine.


CONCLUSIONS
Our results show that phenylephrine is frequently responsible for allergic conjunctivitis (53.8%). In the case of atropine, even though the limited number of patients suggests to perform more extensive studies, it emerges that our diagnostic protocol is safe and might be able to screen allergic reactions in the field of ophthalmopathies.
Ventura
M T
MT
Department of Internal Medicine, Immunology and Infectious Diseases, University of Bari Medical School, Policlinico, Bari, Italy. mt.ventura@allergy.uniba.it
Di Corato
R
R
Di Leo
E
E
Foti
C
C
Buquicchio
R
R
Sborgia
C
C
Tursi
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine / Q000009:adverse effects / Q000276:immunology; D001548:Benzalkonium Compounds / Q000009:adverse effects; D003233:Conjunctivitis, Allergic / Q000209:etiology*; D005029:Ethylenediamines / Q000009:adverse effects / Q000276:immunology; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D010328:Patch Tests / Q000379:methods*; D010656:Phenylephrine / Q000009:adverse effects / Q000276:immunology; D012882:Skin Tests; D013849:Thimerosal / Q000009:adverse effects / Q000276:immunology
D001548:Benzalkonium Compounds; D005029:Ethylenediamines; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D013849:Thimerosal; C031234:ethylenediamine; D001285:Atropine