Introduction: Dorzolamide is suspected to alter corneal hydration control. Patients with healthy corneas showed no change in corneal thickness when using dorzolamide compared to other topical glaucoma drugs in clinical studies. Some cases demonstrating corneal decompensation after application of the drug are documented in the literature. All of those had some prior endothelial damage.
Methods: We present a 50 years old primary open angle glaucoma patient who had used dorzolamide three times per day in both eyes with good IOP control and no noticeable side effects for 1 year. He contracted adenovirus keratoconjunctivitis (EKC) and developed subepithelial infiltrates in the course of this disease.
Results: The patient noted marked increase of blurring and decrease of vision 30 minutes after dorzolamide application which lasted for several hours. After discontinuation of the drug these symptoms vanished immediately and subepithelial infiltrates regressed slowly in the ensuing four weeks.
Conclusion: The report suggests that dorzolamide can cause
reversible swelling in the subepithelial stroma in patients with infiltrates
after adenovirus keratoconjunctivitis. The suspected compromised mechanism of
corneal hydration control is in the corneal endothelium. Whether EKC
compromises corneal endothelial factors is not known. Our observation suggests
a rationale for further research into the effects of dorzolamide on corneal
hydration control.