Methods: 93 patients 56 women and 37 men, age range 10-81 y.o., mean age 43 y.o with a clinical picture compatible with ocular allergy were referred to our Allergy Unit by the Department of Ophthalmology at the University Hospital for allergological evaluation, including a thorough history, complete clinical examination as well as laboratory techniques and skin testing.
Patch-testing was performed with the standard series, an ophthalmic series of allergens developed at our unit, as well as additional allergens according to the clinical situation.
Results: Contact allergy was more frequently caused by topical antibiotics and preservatives and occasionally by mydriatic agents and topical drugs for glaucoma. The allergens more frequently implicated were Neomycin (10.7%), Bacitracin (9.6%) Thimerosal 8 (8.5%) Benzalconium chloride 5 (5.3%) Phenylephrine hydrochloride 3 (3.2%) local anesthetics 3 (3.2%) Chloramphenicol (3.1%), Polymyxin (2.1%), Kanamycin (2.1%), Gentamicin (2.1%), Tobramycin (2.1%), Beta-blockers 1 (1.7%), and others (6.1%).
Conclusions: Patients with a clinical picture compatible with ocular allergy should be referred for allergologic evaluation. A comprehensive approach will often provide clues for a presumptive diagnosis and appropriate management. When a contact allergy is found it is mandatory to avoid contact with the precipitating substance. This may simply be a case of stopping or altering an ophthalmic medication. The proper use of ophthalmic preparations should decrease the incidence of allergic contact reactions.