Contact allergy to β-blocking agents in eyedrops

A patient affected by open-angle glaucoma presented symmetrical eyelid dermatitis during local therapy with β-blocker eyedrops. The patient was patch tested with his personal eyedrops, its single constituents, and alternative β-blocker eyedrops. A positive reaction to his personal eyedrops and levobunolol .25%, .5%, and 1% in water was found. Patch tests with alternative eyedrops containing befunolol and timolol were negative. Treatment with befunolo eyedrops caused relapsing of dermatitis after 4 months. Further patch tests with .25% befunolol eyedrops and befunolol .25%, .5%, and 1% in water showed intense positive reactions. Our case confirms the risk of polysensitization by using β-blocking eyedrops.