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We wish to thank Dr Feibel for his comments regarding the use of apraclonidine as single-dose therapy in patients with documented allergy.We agree with his premise that patients who have had allergic reactions or failed to respond to chronic therapy with apraclonidine may still benefit from prophylactic single-dose therapy. However, we have indeed seen a recurrence of allergic symptoms in response to a single dose of 1% apraclonidine in patients with documented allergy. Some of the patients in our study were rechallenged with just such a single dose, and developed a significant recurrence of the local reaction within 24 hours. Therefore, we feel that patients with a previous history of allergy may be safely given a single-dose application of apraclonidine but should be warned that there is a risk of developing a recurrence of their allergic symptoms. Our favorable experience with the use of cromolyn sodium to
Butler PJ, Alvarado JA. High Incidence of Topical Allergic Reactions to 1% Apraclonidine-Reply. Arch Ophthalmol. 1995;113(12):1579-1580. doi:10.1001/archopht.1995.01100120111030