Correspondence Address:
Ashok Kumar Dubey
H-20, Kailash Colony, New Delhi - 48
India

Full Text

Sir,

I read with great interest the article titled 'Bimatoprost in the treatment of eyelash universalis alopecia areata' by Vila et al. [1] Authors have rightly highlighted the potential use of an established adverse effect of prostaglandin analogs, normally used for glaucoma management. However, I wish to make the following observations.

The authors have mentioned that none of the patients enrolled had developed glaucoma, which normally should not have been expected from a drug which is used to treat glaucoma. They also have mentioned the incidence of conjunctivitis in some patients. In the context of prostaglandin induced redness in the eyes, which is quite common and an established adverse effect, the term 'conjunctival hyperemia' should be preferred to 'conjunctivitis', because inflammation is not significant in the patients treated with bimatoprost. [2]

One uncommon cosmetic problem of loss of orbital fat pad and deepening of the lid sulcus has been reported to be associated with the use of topical bimatoprost. Though no such incidence was seen in this study, the physicians should be watchful for this adverse effect, which can prove counterproductive cosmetically. [3]

The authors have rightly excluded the patients with any other eye problem in the study. Patients with history of cataract operation should especially be excluded because bimatoprost use in a pseudophakic or aphakic eye can lead to cystoid macular edema. [4]

Finally, since the authors have followed up the patients in the study, shouldn't it have been called a prospective study?

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