CONTACT ALLERGY TO BETA-BLOCKERS IN EYE D ROPS - CROSS-SENSITIVITY

Introduction. Beta-blockers in eye-drops are widely used for the treat ment of glaucoma. The potential allergic effect was only recently reco gnized. Case report. A 65-year-old man had been treated with eye-drops containing beta-blockers for bilateral chronic glaucoma for 14 years. During the last two years, he developed eczema localized on the upper and lower eyelids. Allergy screening confirmed the implication of tim olol and befunolol which had been used successively. Later prescriptio n of eye-drops containing carteolol led to recurrence of the eczema. D iscussion. This case of contact allergy with three different beta-bloc kers in the same patient is similar to others reported in the literatu re. All beta-blockers have a similar chemical structure, but it cannot act as a haptene. The proposed hypothesis is a cross-sensitivity whic h develops after primary metabolism to a common aldehyde. The risk of recurrence is high if another beta-blocker eye-drop compound is prescr ibed in a sensitized patient. The risk of side effects in such sensiti zed patients when taking oral beta-blockers is unknown.