CONTACT DERMOCONJUNCTIVITIS

Contact dermoconjunctivitis is an allergic disorder, involving conjunctiva and
skin of lids along with surrounding area of face.

Etiology
It is in fact a delayed hypersensitivity (type IV)
response to prolonged contact with chemicals and
drugs. A few common topical ophthalmic medications

known to produce contact
  dermoconjunctivitis are
atropine, penicillin, neomycin, soframycin and
gentamycin.

Clinical picture
1. Cutaneous involvement is in the form of weeping
eczematous reaction, involving all areas with which
medication comes in contact.
2. Conjunctival response is in the form of
hyperaemia with a generalised papillary response
affecting the lower fornix and lower palpebral
conjunctiva more than the upper.

Diagnosis is made from:

• Typical clinical picture.
• Conjunctival cytology shows a lymphocytic response with masses of eosinophils.
• Skin test to the causative allergen is positive in most of the cases.

Treatment consists of:
1. Discontinuation of the causative medication,
2. Topical steroid eye drops to relieve symptoms,
and
3. Application of steroid ointment on the involved
skin.