The correlation between the topical ocular administration of various epinephrine compounds and pigmented deposits of the conjunctiva was first reported by Lowenstein in 1927.1 Subsequently these were observed clinically by other European investigators.3,4 Histologic examination, however, was not performed until 1951.4 In recent months our attention has been drawn to these interesting deposits by the receipt of biopsies obtained from patients presenting with black localized punctate conjunctival deposits. One of these was biopsied as a possible conjunctival foreign body. Another was clinically considered to be a conjunctival melanoma.
The clinical histories, physical findings, and histologic examinations of each of these cases were remarkably similar. The patients had used an epinephrine compound topically for at least one year for open-angle glaucoma. Each case showed small, bilateral, isolated, round lesions in the lower palpebral conjunctiva.
A number of typical cases have been referred from our staff.* Three cases which
CORWIN ME, SPENCER WH. Conjunctival Melanin DepositionsA Side-Effect of Topical Epinephrine Therapy. Arch Ophthalmol. 1963;69(3):317-321. doi:10.1001/archopht.1963.00960040323011