Treatment of Allergic Reactions to Glass (Eyeglass) Lenses
The primary treatment for allergic reactions to eyeglass frames is immediate discontinuation of the offending frame material and switching to hypoallergenic alternatives, combined with short-term topical corticosteroids for symptomatic relief. 1
Immediate Management
Discontinue the offending eyeglass frame immediately - this is the definitive treatment, as topical corticosteroids provide only transient clinical resolution and do not prevent recurrences. 1
Symptomatic Relief During Acute Phase
- Apply topical corticosteroids to affected skin areas (retroauricular region, nasal bridge, temporal areas) for short-term symptomatic control 1
- Use cold compresses for additional comfort during the acute inflammatory phase 2
- Consider refrigerated preservative-free artificial tears if ocular surface involvement is present to dilute inflammatory mediators 2
Diagnostic Workup
Perform patch testing (epicutaneous testing) with contact allergens and analysis of softened scrapings from the frames to identify the specific culprit allergen. 1 This is essential because:
- Eyeglass frames contain multiple potential allergens including nickel, palladium, titanium, plasticizers, UV stabilizers, dyes, waxes, and various plastic components 1
- Even silver or gold-appearing frames may contain nickel, and varnish applied to frames can be a nickel source 1
- Plastic frames are particularly complex, containing combinations of zyl, propionate, nylon, carbon, polycarbonate, optyl, and polyamide 1
Definitive Long-Term Solution
Switch to hypoallergenic eyeglass frame materials - this is the only reliable solution to prevent recurrences. 1 Consider:
- Hypoallergenic frames specifically marketed as such 1
- Pure titanium frames (verify no palladium content, as some titanium frames contain palladium which can cause allergic contact dermatitis) 1
- Alternative materials based on patch test results 1
Critical Pitfalls to Avoid
- Do not rely solely on topical corticosteroids - they only provide temporary relief and do not address the underlying cause 1
- Do not assume "titanium" or "gold" frames are safe - verify composition, as these may contain allergenic metals like palladium or nickel 1
- Do not overlook plastic frames as potential culprits - they contain multiple materials that can cause allergic reactions 1
- Suspect eyeglass frame allergy in any patient with retroauricular dermatitis or lesions at points of skin contact with frames 1
When Contact Lens Solutions Are Involved
If the patient is considering contact lenses as an alternative, be aware that contact lens solutions themselves can cause allergic reactions, with 38 documented allergenic chemicals identified in ophthalmic drugs and contact lens solutions. 3 Patch testing should be performed before recommending this alternative. 3