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Charles N. S. Soparkar, MD, PhD; Kirk R. Wilhelmus, MD; Douglas D. Koch, MD; Gary W. Wallace, MD; Dan B. Jones, MD

Arch Ophthalmol. 1997;115(1):34-38.

Abstract
Objective
To describe patterns of conjunctivitis caused by ophthalmic decongestants.

Design
Case series.

Setting
Outpatient eye clinic.

Patients
We selected patients with conjunctival inflammation who were using nonprescription decongestant eyedrops, who had no other cause for conjunctivitis, and whose conditions improved after discontinuing the incriminated preparations.

Main Outcome Measures
Clinical characteristics of conjunctival inflammation and time to resolution of symptoms and signs after discontinuing the use of eyedrops.

Results
Seventy patients (137 eyes) were identified. Preparations containing the vasoconstrictors naphazoline, tetrahydrozoline, or phenylephrine were associated with 3 clinical patterns of conjunctivitis: conjunctival hyperemia (50 cases), follicular conjunctivitis (17 cases), and eczematoid blepharoconjunctivitis (3 cases). Decongestants were used daily for a median of 3 years (range, 8 hours to 20 years) prior to presentation. The median time to resolution of symptoms and signs was 4 weeks (range, 1-24 weeks), and patients remained asymptomatic for a median follow-up of 6 months (range, 0-12 years).

Conclusion
Nonprescription decongestant eyedrops can produce acute and chronic forms of conjunctivitis by pharmacological, toxic, and allergic mechanisms. Once recognized, conjunctival inflammation often takes several weeks to resolve.

Author Affiliations
From the Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Tex. The authors have no commercial or proprietary interest in the products discussed in this article.

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