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Clinicopathologic Reports, Case Reports, and Small Case Series
November 1, 2005

Periocular Cutaneous Pigmentary Changes Associated With Bimatoprost Use

Arch Ophthalmol. 2005;123(11):1609-1610. doi:10.1001/archopht.123.11.1609

Topical bimatoprost (Lumigan; Allergan Inc, Irvine, Calif) is a prostamide analog licensed in the United States (2001) and in the United Kingdom (2002) as a second-line treatment modality for glaucoma and ocular hypertension. Unlike with latanoprost, there is little published evidence for any periocular skin pigmentary effects associated with bimatoprost. We herein report 3 cases of bimatoprost-related periorbital skin hyperpigmentation along with a review of the literature and a comparison with published latanoprost effects.

Case 1. A 76-year-old white woman with normal-tension glaucoma in the left eye had been treated with 0.25% timolol eyedrops twice daily for 6 years. She was otherwise well and was receiving no other medication. Because of progressive optic disc damage, her treatment was changed to 0.03% bimatoprost eyedrops nightly in the left eye only. When followed up 2 months later, she commented that the skin around the left eye had become darker, developing an unsightly appearance of a black eye. She had also noticed some transient conjunctival hyperemia. Examination at this stage revealed full, long, and dark eyelashes on the left side that were associated with marked unilateral periorbital skin darkening (Figure). Despite lower intraocular pressure when receiving bimatoprost, her treatment was changed by her request. There was a slight reduction in the cutaneous pigmentation over the following few months.