Which of the following is an allergy example that can occur with brimonidine allergy?

• A. Follicular conjunctivitis
• B. Contact dermatitis
• C. Conjunctival hyperemia
• D. Dandruff

Answer: (A)

Allergic reactions to topical glaucoma medications often show up as ocular allergy. In brimonidine allergy, the most characteristic example is follicular conjunctivitis, where small nodular follicles form on the palpebral conjunctiva and inferior fornix, usually with itching, tearing, and redness. This reflects a true hypersensitivity reaction at the ocular surface to the drug (or its preservative). Conjunctival hyperemia can occur with eye drops but is a nonspecific irritation rather than a definite allergic response. Contact dermatitis can happen, especially on the eyelids or periocular skin from the drug or preservatives, but it’s a different allergic manifestation and not as diagnostic of ocular surface allergy as follicular conjunctivitis. Dandruff is unrelated to ocular allergy.