Contact Dermatoconjunctivitis
- Allergic reaction in lid and surrounding facial skin to applied medications, cosmetics, garden plants
- Neomycin ointment used to treat red eye causes this in 10% of patients
- Red, thickened, coarse lid skin
- Tender, weepy periocular skin
- Conjunctiva often spared, but may show mild engorgement of vessels
- Manifestations appear within day or two of applying offending agent and disappear within days after stopped
- Blepharitis, stye, orbital cellulitis, viral conjunctivitis, BUT...
- Blepharitis is chronic and confined to lid margins
- Stye displays focal swelling and marked tenderness of lid
- Orbital cellulitis displays smooth swelling of lids
- Viral conjunctivitis displays more conjunctival inflammation but little or no inflammation of facial skin around lids
- Elicit history of recent application of new topical medication or lid cosmetic or exposure to plant material
- Stop exposure if you identify offending agent
- Prescribe topical 1% hydrocortisone cream if manifestations bothersome
- Consult ophthalmologist if signs do not disappear within 3 days
- Corticosteroid cream application reduces manifestations and makes them resolve more quickly
- Condition does not persist if exposure to agent eliminated
- Permanent damage rare