Latanoprost irritation

Topical PGE2 and PGF2qi significantly reduce intraocular pressure for at least 24 hours and are used in the treatment of glaucoma. Derivatives of the isopropyl ester of PGF2qi appear to be the most effective. Transient ocular adverse effects include conjunctival hyperemia, local irritation, intermittent photophobia, and pain in the eye (66-68). Newer derivatives, such as latanoprost, travoprost, and bimatoprost, appear to be better tolerated, with less severe and less frequent adverse effects (69). They reduce intraocular pressure by increasing uveoscleral outflow. 

A 75-year-old woman developed bilateral ocular irritation, swollen eyelids, and reduced visual acuity after using dorzolamide 2% eye-drops tds for 2 days, in addition to long-term latanoprost - - timolol Her best-corrected visual acuity deteriorated from 6/9 right and left, to 6/12 and 6/18 respectively. The eyelids were erythematous and there was bilateral conjunctival injection. The anterior chambers were deep and the intraocular pressure was 22 mmHg in both eyes, with no intraocular inflammation. Fundoscopy showed extensive bilateral choroidal detachment. Dorzolamide was withdrawn and the problem resolved within 2 weeks. 

Adverse reactions to latanoprost have been studied in 115 children who had used latanoprost for a mean of 20 months [42. The reported adverse reactions were eyelash growth (in all eyes exposed for at least 6 months latanoprost was withdrawn in one case), conjunctival hyperemia/irritation ( = 6 two withdrawn), headache (n = 3), and difficulty in focusing iris pigmentation, and sleep disturbances ( = 1 each). 

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