title: Abuse of vasoconstrictive eyedrops mimicking an ocular pemphigoid.
abstract: OBJECTIVE
  To describe conjunctival histopathologic alterations induced by excessive chronic astringent use.
  
  
  METHODS
  Report of a case with clinical picture, epicutane test results, histologic workup of conjunctival biopsy using conventional staining, and immunohistochemical markers.
  
  
  RESULTS
  A 45-year-old man using a phenylephrine preparation hourly for years presented with grotesque eye redness, fornix shortening, and scarring of puncta lacrimalia. Direct and indirect immunofluorescence were negative for ocular pemphigoid. Histology revealed signs of chronic inflammation and neovascularization in the conjunctiva. Symptoms resolved after cessation of therapy.
  
  
  CONCLUSIONS
  Chronic abuse of decongestant eyedrops can produce a clinical picture resembling an ocular pemphigoid. Histology suggests that late onset immunoreaction and chronic vasoconstriction cause chronic inflammation and neovascularization, respectively.
authors.affiliation: Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Tappeiner
authors.forename: G-M
authors.initials: GM
authors.lastname: Sarra
authors.forename: M
authors.initials: M
authors.lastname: Abegg
mesh_terms: D003231:Conjunctivitis / Q000139:chemically induced / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004338:Drug Combinations; D006801:Humans; D008297:Male; D008751:Methylene Blue / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D004366:Nonprescription Drugs; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D010390:Pemphigoid, Benign Mucous Membrane / Q000139:chemically induced / Q000175:diagnosis*; D010656:Phenylephrine / Q000008:administration & dosage / Q000009:adverse effects*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000209:etiology; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D004338:Drug Combinations; D004366:Nonprescription Drugs; D009883:Ophthalmic Solutions; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D008751:Methylene Blue