Man with pruritic, edematous eruption of the upper and lower eyelids.
A 53-year-old man presented for medical attention after borrowing his wife’s eye drops. He had some itching in the eyes, and started intraocular installation of these drops twice a day for 3 days before the sudden appearance of swollen, itchy red eyes.
Key point: A pruritic, edematous eruption involving upper and lower lids, bilaterally, suggests that the patient might be allergic to some component of the ophthalmic suspension. The product in question contained neomycin, polymyxin-B, and hydrocortisone. Neomycin is a frequent topical sensitizer.
Treatment: The patient was advised to discontinue the eye drops immediately and was given a 3-week tapering dose of prednisone.
Note: The patient may now have a hypersensitivity to all aminoglycosides, even when administered parenterally.
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