• Eur J Ophthalmol · Jan 2009

    Case Reports

    Abuse of vasoconstrictive eyedrops mimicking an ocular pemphigoid.

    • C Tappeiner, G-M Sarra, and M Abegg.
    • Department of Ophthalmology, Inselspital, University of Bern, Bern, Switzerland.
    • Eur J Ophthalmol. 2009 Jan 1;19(1):129-32.

    PurposeTo describe conjunctival histopathologic alterations induced by excessive chronic astringent use.MethodsReport of a case with clinical picture, epicutane test results, histologic workup of conjunctival biopsy using conventional staining, and immunohistochemical markers.ResultsA 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.ConclusionsChronic 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.

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