Eyeglass Dermatitis: Causes
Eyeglass dermatitis is primarily caused by allergic contact dermatitis to frame materials, with plasticizers and UV stabilizers being the most common allergens, followed by metals (particularly nickel), dyes, and various plastic components. 1
Primary Causative Allergens
Most Common Offenders
- Plasticizers and UV stabilizers represent the most frequent allergens in modern eyeglass frames 1, 2
- Nickel remains a major culprit, particularly from varnish applied to frames or from frames that appear silver/gold but contain nickel 2
- Solvent dyes including Solvent Orange 60 (SO60) and Solvent Yellow 14 (SY14) used in plastic temples cause increasing numbers of cases 3
Metal Allergens
- Nickel can leach from frame varnish even when the underlying metal appears to be silver or gold 2
- Palladium found in some titanium frames causes allergic reactions 2
- Chromium and cobalt are also documented allergens in eyewear 4
Plastic Frame Components
- Plastic frames contain complex material combinations including zyl, propionate, nylon, carbon, polycarbonate, optyl, and polyamide, making exact allergen identification challenging 2
- Antioxidants, solvents, rubber components, and waxes used in frame manufacturing can all trigger dermatitis 2, 1
Clinical Recognition Pattern
The American Academy of Ophthalmology identifies eyeglass-related contact dermatitis when patients present with periorbital involvement specifically affecting areas where the frame contacts the face 5. Look for:
- Retroauricular dermatitis (behind the ears where temples rest) 2
- Lesions at exact points of skin contact with nose pads and temple tips 2
- Symptoms including irritation (77.1% of cases) and tearing (50.8% of cases) 6
Important Diagnostic Considerations
Distinguishing Allergy from Irritation
- The clinical question often arises whether lesions result from true allergic contact dermatitis versus mechanical irritation 2
- Patch testing with contact allergens and analysis of softened frame scrapings provides definitive diagnosis 2, 7
- The American College of Allergy, Asthma, and Immunology recommends identifying the causative allergen by reviewing all eyeglass materials 5
Critical Pitfall
- Eye drops and topical cosmetics/skin care products are actually more common causes of eyelid dermatitis than eyeglass frames themselves (54.2% and 24.6% respectively versus 13.1% for cosmetics alone), so always investigate these sources first 6
- Rubbing and manipulation of the periorbital area contributes significantly in 30% of allergic eyelid dermatitis cases 6
Pathophysiology
Contact dermatitis from eyeglasses represents a Type IV delayed hypersensitivity reaction where repeated exposure to allergens in frame materials causes sensitization, followed by inflammatory response upon re-exposure 7. The eyelid skin is particularly vulnerable due to its thin structure and high permeability to allergens 6.