22 EyeWorld Asia-Pacific | March 2025 CATARACT by Ellen Stodola, Editorial Co-Director Allergies Or Intolerance To Materials Used In Cataract Surgery While it is generally uncommon to find true allergies to materials used during cataract surgery, this is a topic that physicians may need to discuss with patients. Two physicians highlighted some of the key concerns they hear from patients and how they approach these concerns to identify real allergies versus intolerance to certain products. Patients often report an allergy to a product or drug used during cataract surgery, said Derek DelMonte, MD. “When I see this, the first thing I ask the patient is what the adverse reaction was. Unfortunately, there is a good deal of misunderstanding about the difference between a true allergy, an intolerance, or simply a normal side effect of a medication, and figuring out which category the stated allergy belongs to will help determine how to address the concern.” “A true allergy to an oral medication is considered a robust, whole-body reaction, a rash, trouble breathing, anaphylactic response,” Dr. DelMonte said. For a topical medication, it would include severe hives, swelling, or redness that can spread with continued use. True allergies usually occur only after an initial exposure, which has allowed the immune system time to build up a reaction, making it very unlikely to get a response after just one dose. Intolerances are much more common and include uncomfortable symptoms that are bothersome but do not elicit the true allergy response. This could include swelling without a rash, nausea/upset stomach, and headaches. These can occur with just one exposure and can sometimes be managed with adjusting the dose or method of administration. There are some side effects which, while considered normal to practitioners, can cause noticeable discomfort for the patient. Examples include dilating agents that decrease reading vision for a time, epinephrine that causes the heart to beat faster, oral steroids that lead to excessive thirst or weight gain, and opioids that cause constipation. While these effects can be bothersome, it means the product is working as intended and is not necessarily something to avoid, he said.
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