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Drug allergy to Anti-glaucoma medications

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Dr. Jyotsna Jareda and Dr. Shreya Jaiswal from Suraj Eye Institute Nagpur discuss the most troublesome complication of anti-glaucoma medications- ocular allergy.

Greetings from suraja institute surajya sciences academy presents the spark casewise we present to you a case of drug allergy to anti-glaucoma medication ocular surface disorder occur due to chronic long-term use of anti-glaucoma medications installation of topical agms for a period of three or more months has been found to cause significant subclinical inflammation

With increased expression of hladr on conjunctival epithelial cells and secretion of pro-inflammatory cytokines by conjunctival cells topical medication related ocular surface disorder result in poorer compliance to treatment compromised surgical results and also decreases the quality of life in glaucoma patients we present to you a patient of primary open-angle

Glaucoma who developed severe drug allergy to brimonidine 0.2 eye drops after installing it for four months a male 63 years of age known case of primary open angle glaucoma presented to us in march 2020 with redness itching foreign body sensation and watering from both eyes for last 5 days which had increased gradually his best corrected visual equity was 6

6 both eyes this is a picture showing lid edema and skin exfoliation suggestive of drug allergy intraocular pressure on goldman afternation tonometer in right eye was 15 millimeters mercury and in left eye was 13 millimeters mercury fundus examination of right eye showed a vertical cup disc ratio of 0.7 is to 1 with inferior rim thinning and left eye showed a

Vertical cup disc ratio of 0.5 is to 1 with healthy neural retinal rim it was our impression that the patient had developed allergy to topical agm he was advised to stop hydrobrimonidine 0.2 percent and was started on carboxymethyl cellulose 0.5 percent eye drops in both eyes for one month periorbital application of lactocalamine lotion and tablet levocetrazine

Monty lucas once daily for two weeks patient was reviewed after two weeks and was symptomatically better the lid edema and congestion had reduced significantly at one month follow-up all signs of allergy had resolved and patient was comfortable intraocular pressure in right eye was 20 millimeters mercury and in left eye was 18 millimeters mercury patient was

Started on preservative-free brahmonidine 0.2 percent and timolol 0.5 combination eye drops and was asked to review after three months discussion the prevalence of ocular surface disease has been reported in 59 of glaucoma cases with higher prevalence in patients using benzyl chromium chloride containing agm drug allergy is one of the most important cause for

Non-compliance to treatment our patient developed severe drug allergy to brimonidine 0.2 percent eye drops after using for four months it has been reported that the allergic reaction which occurs in four point eight to nine percent of patients in primonidine eye drops is usually seen within the first nine months we stopped anti-glaucoma medication for allergy

To subside and started him on lubricating eye drops and antihistaminic tablets systemically and intraocular pressure was monitored energy to agm should be promptly recognized and treated due to bothersome cosmetic adverse reaction some patients may choose to discontinue glaucoma medication on their own this can lead to reduced compliance and hence we need to

Warn the patients regarding possible side effects regular review has also to be explained so as to increase the compliance of the drug thank you

Transcribed from video
Drug allergy to Anti-glaucoma medications By Suraj Eye Institute – India