II. Causes: Topicals used on or around the eye
- Eye cosmetics
- Eyeliner, Eyeshadow, or Mascara (shellac)
- Eye makeup remover (cocamidopropyl betaine which is also in hard Contact Lens solution)
- Nail polish (exposed when finger nails touch lids)
- Nickel eyelash curler
- Eye medications
- Ophthalmic Antibiotics
- Eye solutions (resorcinol, Amlexanox, Brimonidine, Levobunolol, NSAIDs, Beta Blockers)
III. Causes: Other
- See Allergic Contact Dermatitis
- See Irritant Contact Dermatitis
- Facial Tissue (with perfumes or dyes)
- Topical irritants or allergens spread to Eyelid via hands
- Nail polish and nail enhancers (methacrylates)
- Hair dye
- Face cream or Foundation
- Skin Lubricants
- Soaps
- Airborne irritants or allergens
- Dust or pollen
- Cleaning solutions or sprays
- Rosins
- Occupational exposures (isothiazolinones, epoxy acrylate, Meropenem)
IV. Symptoms
- Pruritus suggests Allergic Contact Dermatitis
- Burning or stinging suggests Irritant Contact Dermatitis
V. Signs
- Initial: Marked local edema with variable erythema and vessicles
- Later: Scaling
VI. Differential Diagnosis
VII. Management
- Eliminate exposure to contact irritant or allergen
- Topical cold compresses
- Petroleum-based skin Emollient (e.g. vaseline)
-
Topical Corticosteroids (low potency)
- Indicated for moderate to severe Allergic Contact Dermatitis
- Precautions
- Apply only to lid and avoid getting topical into eye
- Topical Corticosteroids may also cause Periorbital Dermatitis
- Do not use longer than 10-14 days
- Preparations: Use twice daily for 5 to 10 days
- Desonide 0.05% cream
- Alclometasone dipropionate 0.05% cream