J Korean Ophthalmol Soc.  2020 Jun;61(6):694-698. 10.3341/jkos.2020.61.6.694.

Brimonidine-induced Atypical Conjunctivitis with Chronic Granulomatous Anterior Uveitis

• Park IK
• Chun YS

• KMID: 2502979
• DOI: http://doi.org/10.3341/jkos.2020.61.6.694

Abstract

Purpose
To report a case of chronic granulomatous anterior uveitis which occurred after 2-year use of eye drops containing brimonidine.
Case summary
A 82-year-old patient with intermittent angle-closure glaucoma had been using 1% brinzolamide/0.2% brimonidine fixed combination eye drops for two years. Bilateral eyelid edema, conjunctival injection, glare, and mucous discharge occurred one month prior, but did not improve, regardless of artificial tears and anti-allergy drug treatment. Mutton fat keratic precipitates, conjunctival injection, and diffuse conjunctiva hypertrophy at the palpebral and bulbar conjunctiva, multiple follicles, and papillary hypertrophy were observed in the slit lamp examination. Based on the diagnosis of chronic granulomatous anterior uveitis with allergic conjunctivitis caused by brimonidine, only an artificial tear preparation was used after the drug was stopped. Anterior uveitis and conjunctivitis improved rapidly and disappeared completely within one month.
Conclusions
Brimonidine-induced chronic granulomatous anterior uveitis is a very rare disease, but it can be easily and quickly treated just by withdrawal of the drug. In the case of long-term use of brimonidine, it is essential to diagnose the possible side effects of the drug and to avoid unnecessary investigations and interventions.

Keyword

Allergic conjunctivitis; Brimonidine; Granulomatous uveitis