title: Conjunctival provocation test for the diagnosis of ocular hypersensitivity to chlorobutanol.
abstract: OBJECTIVE
  Conjunctival provocation test (CPT) is a useful tool for the determination of the reagent in patients with allergic conjunctivitis. Our aim is to present an unusual reaction of ocular hypersensitivity to chlorobutanol by using this technique.
  
  
  METHODS
  This case describes a 56-year-old woman who presented intense ocular pruritus and conjunctival hyperemia with each instillation of Colircusi Fluotest (Alcon, El Masnou, Spain). Skin tests and CPTs were considered.
  
  
  RESULTS
  Skin tests were all negative. CPTs were performed with commercially available ophthalmic products that were selected for their compositions. Chlorobutanol was presumed as the reagent through elimination. Positive CPT with purified chlorobutanol confirmed this hypothesis.
  
  
  CONCLUSIONS
  CPT performed with commercially available products can be a useful, accessible, and inexpensive technique to orient the diagnosis of suspected ocular hypersensitivity to a pharmacologic component. To our knowledge, this is the first report of ocular hypersensitivity to chlorobutanol.
authors.affiliation: Ophthalmology Research Unit, Santiago Grisolia Department of Ophthalmology, University Hospital Doctor Peset, Valencia, Spain. josegarciam@yahoo.com
authors.forename: José Javier
authors.initials: JJ
authors.lastname: García-Medina
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Medina
authors.forename: Vicente Calixto
authors.initials: VC
authors.lastname: Zanon-Moreno
authors.forename: Gabriel
authors.initials: G
authors.lastname: Scalerandi
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Pinazo-Duran
mesh_terms: D000485:Allergens; D002724:Chlorobutanol; D003228:Conjunctiva / Q000276:immunology; D003233:Conjunctivitis, Allergic / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007159:Immunologic Tests; D008875:Middle Aged; D011310:Preservatives, Pharmaceutical
chemical_list: D000485:Allergens; D011310:Preservatives, Pharmaceutical; D002724:Chlorobutanol