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Ocular toxicity resulting from chemicals in eye drops is common. Preservatives such as benzalkonium chloride (BAC) and related quaternary ammonium salts have been shown to play an important part in these reactions.1 The symptoms can range from mild injection and itching to severe conjunctival reactions. The term pseudopemphigoid has been applied to drug-induced cicatrising conjunctivitis.2–5 We present a patient who developed drug-induced granulomatous cicatrising conjunctivitis secondary to glaucoma drops.
A 60-year-old man presented to the eye clinic for ocular irritation. His ocular history was positive for glaucoma, for which he was using latanoprost (Xalatan, Pfizer, New York, New York, USA), and brimonidine 0.2% (a generic preparation). Examination showed severe conjunctival injection bilaterally, …