J Korean Ophthalmol Soc.  2017 May;58(5):595-599. 10.3341/jkos.2017.58.5.595.

Ocular Side Effects Induced by 0.25% Alcaftadine Ophthalmic Solution

• Lee JS
• Park JM
• Cho HK
• Kim SJ
• Huh HD
• Park YM

• KMID: 2378632
• DOI: http://doi.org/10.3341/jkos.2017.58.5.595

Abstract

PURPOSE
To report a case series of patients experiencing side effects of 0.25% alcaftadine eye drops and to analyze the possible reasons for the side effects.
CASE SUMMARY
Medical records of 90 patients who had a history of alcaftadine eye drop use were retrospectively analyzed. Eight out of the 90 patients (8.9%) showed ocular side effects that required discontinuation of the alcaftadine eye drops. All eight cases of alcaftadine side effects showed palpebral and bulbar conjunctival injection, watery discharge, and lid swelling. During additional history collection, all patients with alcaftadine side effects confessed of overuse (more than twice/day) of the eye drops. Anticipation for fast symptom relief was the main reason for the alcaftadine overuse. In all side effect cases, patients were asked to stop alcaftadine eye drops and use preservative-free artificial tears and steroid eye drops. After discontinuation of 0.25% alcaftadine eye drops, regression of palpebral and bulbar conjunctival injection and lid swelling was observed.
CONCLUSIONS
Overuse of 0.25% alcaftadine eye drops can induce ocular surface toxicity possibly due to toxicity of drug itself. The possible side effects of overuse of 0.25% alcaftadine eye drops should be fully explained to all patients before use.

Keyword

Alcaftadine; Allergy; Conjunctivitis; Toxicity

MeSH Terms

Conjunctivitis
Humans
Hypersensitivity
Lubricant Eye Drops
Medical Records
Ophthalmic Solutions
Retrospective Studies
Lubricant Eye Drops
Ophthalmic Solutions

Figure

• 

  Figure 1 Slit-lamp results of side effect cases concerning 0.25% Alcaftadine eye drop. Palpebral and bulbar conjunctival injection, watery discharge, lid swelling is observed. OD = oculus dexter; OS = oculus sinister; F = female.

• 

  Figure 2 Two distinctive cases of 0.25% Alcaftadine eye drop side effect. Slit-lamp examination showing lid swelling (A) and conjunctival injection (B, D) with watery discharge (B, E) after use of 0.25% Alcaftadine eye drop. After discontinuation of 0.25% Alcaftadine eye drop, regression in palpebral and bulbar conjunctival injection and lid swelling is observed (C, F).

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