Anterior uveitis as a side effect of topical brimonidine

yPURPOSE: To report anterior uveitis as a late side-effect of topical brimo nidine tartrate 0.2% (Alphagan; Allergan Inc., Irvine, California). METHODS: Four patients aged 79 to 91 (mean, 83) years, who developed acute anterior uveitis while using topical brimonidine for chronic glaucoma, were clinically evaluated for causes of uveitis, When the inflammation had comp letely cleared, topical brimonidine was recommenced in one eye only to dete rmine causality, RESULTS: All four patients developed acute granulomatous anterior uveitis, which resolved rapidly on stopping brimonidine and receiving treatment with topical corticosteroids. The uveitis occurred 11 to 15 (mean, 13.8) months after commencement of brimonidine 0.2% twice daily. None of the patients h ad a previous history of uveitis, and no other identifiable cause of uveiti s was found. In all patients, on rechallenge with brimonidine instilled twi ce daily to one eye, uveitis recurred within 3 weeks in that eye only, CONCLUSIONS: These findings suggest that brimonidine can cause anterior uve itis as a late side effect, The inflammation settles rapidly on stopping th e medication and on using topical corticosteroids and recurs on rechallenge with brimonidine. (C) 2000 by Elsevier Science Inc, All rights reserved.