Stromal opacity secondary to preservative in dilating drops – A case report and review of literature

Publication date: 2014 Source:Journal of Acute Disease, Volume 3, Issue 1 Author(s): Madhiusudhan , LM Evelyn-Tai , Ishak Siti-Raihan , WH Wan Hazabbah This patient is a 64-year-old man who presented with painless progressive blurring of vision for one year. After a routine fundoscopy preceded by dilatation of both eyes with a drop of topical tropicamide, the left eye was noted to have stromal edema temporally. This was attributed to the preservative (BAC) in the medication. The stromal oedema persisted over the following weeks despite administration of a topical steroid, and was associated with deterioration in visual acuity to 6/30 (PH 6/21). This case reminds us that clinicians should be vigilant during instillation of any preservative-containing drops, even in routine practices like dilatation. Far from being restricted to chronic use of preservative-containing drugs, toxicity with BAC can occur even upon a single application. Ideally, all eyedrops should be single-use topical drug formulations, but in the absence of this option, it is imperative that ophthalmic drug prescription be done with adequate clinical justification.
Source: Journal of Acute Disease - Category: Emergency Medicine Source Type: research