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Periocular contact dermatitis with use of topical voriconazole 1% in mycotic keratitis
  1. Pranita Sahay,
  2. Mohamed Ibrahime Asif,
  3. Prafulla Kumar Maharana,
  4. Jeewan S Titiyal
  1. Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, New Delhi, India
  1. Correspondence to Dr Prafulla Kumar Maharana, drpraful13{at}


We present two cases of culture-proven fungal keratitis on natamycin treatment which developed periocular erythema, oedema, burning sensation and pruritus within 48 hours of the addition of topical voriconazole. On clinical examination, periocular erythema with induration was noted. A diagnosis of orbital cellulitis was suspected, but the absence of pain and tenderness refuted the diagnosis on clinical grounds. A dermatology consultation was sought, and a diagnosis of periocular contact dermatitis with voriconazole was made. A skin patch test was performed with the same medication; however, it was negative. Topical voriconazole therapy was withdrawn, and the patient was prescribed cold compresses and oral antihistamine medication, to which they responded well.

  • eye
  • ophthalmology
  • dermatology
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  • Contributors PS: has contributed in the manuscript preparation and image acquisition. MIA: has contributed in editing the manuscript and image acquisition. PKM: has contributed to the concept of the manuscript and final editing. JST: has contributed in the final editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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