Abstract
Purpose :
To describe the frequently misdiagnosed condition of toxic conjunctivitis from facial cosmetics and to evaluate the effectiveness of a novel combined topical anti-inflammatory treatment.
Methods :
A retrospective review of medical records over a two-year period (2020 - 2022) identified 48 eligible patients, 42 (87%) females and 6 (13%) males with toxic conjunctivitis from facial cosmetic creams. Symptoms comprised of itchy, burning sensation and epiphora. The clinical presentation involves contact dermatitis of the nasal skin of the eyelids, follicular reaction of the palpebral conjunctiva and edema of punctum mucosa with functional stenosis. Treatment consisted of complete cessation of all facial cosmetics and topical use artificial tears with 0,24% Hyaluronic Acid, topical unpreserved hydrocortisone eyedrops 3,35 mg/ml (4 times daily for 2 weeks) and unpreserved ketotifen eyedrops 0,25 mg/ml (twice daily for 4 weeks). Follow up performed in 2, 4 and 6 weeks.
Results :
All patients experienced symptoms for over two months not amenable to various regimens of preserved anti-inflammatory topical treatment. Following our unpreserved combined treatment, 41/48 (85%) patients had full recovery in 4 weeks, whereas 5/48 (15%), although improved, required reaffirming of cosmetic cessation and continued artificial tears and topical ketotifen for two more weeks until complete resolution of symptoms. At the end of 6 weeks, all patients were symptom free with no sign of conjunctival inflammation.
Conclusions :
Toxic conjunctivitis from facial cosmetic creams is a frequent condition, especially in women and is often misdiagnosed as allergic conjunctivitis. Cessation of facial creams is mandatory. Topical unpreserved treatment with HA artificial tears, hydrocortisone eyedrops 3,35 mg/ml and ketotifen eyedrops 0,25 mg/ml offers highly effective anti-inflammatory action with no increase in intraocular pressure or other side effects.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.