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Conjunctivitis caused by toxic substances
Last reviewed: 07.07.2025
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Over-the-counter ophthalmic decongestants can be used to self-treat eye redness and discomfort. These medications typically contain vasoconstrictors (such as naphazoline and phenylephrine) with or without antihistamines, but inappropriate use of the medications can cause conjunctival irritation, burning, foreign body sensation, and hyperemia. The diagnosis of toxic conjunctivitis is made after other causes of conjunctivitis have been excluded.
[ Symptoms of toxic conjunctivitis
- Generalized conjunctival hyperemia is the most common symptom that occurs after discontinuation of vasoconstrictor and nasal medications. Hyperemia is usually associated with papillary lesions on the superior and inferior tarsal conjunctiva;
- follicular conjunctivitis as a manifestation, most likely, of a toxic effect is less common and more often occurs in the lower conjunctival fornix;
- Blepharoconjunctivitis occurs due to hypersensitivity, is rarely a general symptom, and is characterized by swelling and hyperemia of the eyelids and conjunctiva.
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Treatment of toxic conjunctivitis
Treatment of toxic conjunctivitis involves discontinuing topical treatment. The patient should be advised of the possibility of temporary worsening and subsequent improvement. Regression of follicular conjunctivitis may take several weeks, especially if the drops have been used for a long time. In these cases, topical steroids may shorten the recovery time. A short course of topical corticosteroids for blepharoconjunctivitis may also be effective.