Which drug combination is linked to lid edema?

• A. Isotretinoin + Sulfonamide antibiotics
• B. Prostaglandins
• C. Tetracycline
• D. Isotretinoin

Answer: (A)

Lid edema from drugs often arises when a medication disrupts the lid margin and surrounding tissues, promoting inflammation and swelling. Isotretinoin, used for severe acne, dries the ocular surfaces and commonly causes blepharitis with lid-margin inflammation, which can manifest as eyelid swelling. Sulfonamide antibiotics can trigger hypersensitivity reactions that include periorbital edema or angioedema in susceptible individuals. When these two are used together, the drying/inflammatory effects of isotretinoin on the lid margin couple with the edema risk from sulfonamides, making lid edema more likely than with other drug classes listed.

Prostaglandin analogs frequently cause conjunctival hyperemia and eyelash changes, but lid edema is not their hallmark. Tetracycline’s notable ocular concerns are different (such as potential for intracranial hypertension and photosensitivity), so they don’t fit the typical lid-edema pattern as well.