it is indicated for the reduction of elevated intraocular pressure in patients with open - angle glaucoma or ocular hypertension who are insufficiently responsive to beta - blockers.1 the side effects of topical dorzolamide hydrochloride , such as conjunctivitis , eyelid edema , and eye lid irritation , are well known.2 however , allergic contact dermatitis due to dorzolamide is rare , although it has been commonly used worldwide in patients with glaucoma . a 77-year - old woman presented with ocular discomfort and periorbital eczematous swelling in both eyes ( figure 1a ) . she had no history of atopy or previously known allergy contact dermatitis . at presentation , the intraocular pressure was 17 mmhg in the right eye and 20 mmhg in the left eye . one month earlier , bilateral phacovitrectomy and intravitreal gas tamponade had been performed at our hospital to remove the tractional epiretinal membrane . postoperatively , dorzolamide eyedrops was applied twice a day to manage her intraocular pressure for about a month , by which time an eczema - like periorbital swelling of the both eyes had occurred . she had an erythematous rash on both eyelids , and suffered from severe pruritus and burning sensation . we initially assumed that the patient s symptoms to indicate an early stage of preseptal cellulitis , so treated her with systemic and topical antibiotics . the patient s symptoms nonetheless showed no improvement . when dorzolamide was discontinued , however , the eczematous swelling and itching sensation disappeared within a week ( figure 1b ) . we switched dorzolamide to tafluprost eyedrops ( taflotan , santen pharmaceutical co ltd , osaka , japan ) and performed a patch test . patch testing was carried out according to the international contact dermatitis research group recommendations . using the finn chamber method , the patient was tested for a standard series of allergens , to benzalkonium chloride 0.1% in water and to pure dorzolamide hydrochloride 1% . the duration of occlusion was 1 day and results were read at days 2 and 5 . the patch test with pure dorzolamide was positive , with erythema , edema , and papules at days 2 and 5 , while the patch test with benzalkonium chloride 0.1% was negative . according to the world health organization and the glaucoma foundation , glaucoma affects 67105 million people worldwide.3 maintenance therapy with a topical antiglaucoma drug is crucial to prevent permanent vision loss . however , we used dorzolamide eyedrops instead of latanoprost to manage our patient s intraocular pressure in the early postoperative period . endogenous prostaglandin release induced by postoperative anterior segment inflammation can lead to blood aqueous breakdown , inflammatory mediators reaching the macula , and cystoid macular edema . it is known that long - term use of topical latanoprost causes cystoid macular edema after intraocular surgery.4 based on patch test results , we confirmed the diagnosis of allergic contact dermatitis due to topical dorzolamide drops , and changed the patient s antiglaucoma medication . delaney et al reported 14 cases of periorbital dermatitis caused by topical dorzolamide hydrochloride.5 to the best of our knowledge , this is the first report of allergic contact dermatitis caused by topical dorzolamide hydrochloride in korea . the common adverse effects of topical dorzolamide hydrochloride are tearing , photophobia , conjunctivitis , stinging , blurred vision , punctate epithelial keratitis , and corneal decompensation.2 rarely , allergic contact dermatitis due to dorzolamide may cause pruritic skin eruptions . because of its relative infrequency , dorzolamide - induced contact dermatitis may be misdiagnosed as preseptal cellulitis or chalazion . if the patient have an sensitivity to sulfur drugs , we have to use topical dorzolamide eyedrops with caution after intraocular surgery . even though there are not many reports,611 we have to be aware of the possibility of allergic contact dermatitis due to topical dorzolamide eyedrops . in addition , patients on dorzolamide should be warned of this potential late side effect . in patients who do not respond to treatment for continuous periorbital swelling , it is necessary to differentiate dorzolamide - induced allergic contact dermatitis with careful examination and history - taking .
the side effects of topical dorzolamide hydrochloride , such as conjunctivitis , eyelid edema , and eye lid irritation , are well known . however , allergic contact dermatitis due to dorzolamide is rare , although the product has been commonly used worldwide in patients with glaucoma . to the best of our knowledge , 
 this is the first report of allergic contact dermatitis caused by topical dorzolamide hydrochloride in korea . 
 herein we report a case of allergic contact dermatitis due to topical dorzolamide eyedrops .