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Dr. Kaplan's letter was referred to Dr. S. Rodman Irvine, who offers the following reply:
To the Editor:
For the interesting editorial, "Most Missed Diagnoses," I did mention punctate staining of the cornea from hair spray. I have seen this sign only when the spray is accidentally directed into the eye, and then the cause of the punctate staining is unquestionable.More common is the occurrence of conjunctival and lid irritation from use of cosmetics, including hair spray, the new deodorants, hexachlorophene soaps, certain perfumes and toilet waters, after-shave lotions, fingernail polish, and detergents and hair dressing containing metallic compounds to darken gray hair. Often there are a mild dermatitis and conjunctivitis which are promptly relieved when the excitants are eliminated.I am not sure whether these signs and symptoms represent allergic or toxic responses. They are often associated with itching, tearing, redness, and swelling, simulating an atropine contact dermatitis,
Irvine SR. MISSED DIAGNOSES-Reply. Arch Ophthalmol. 1964;71(2):291–292. doi:10.1001/archopht.1964.00970010307033
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