256 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS headaches. These shadows were interpreted as calcification requiring further study as to the cause. A keen observer who noted that the patient wore a large amount of eye makeup suggested the possibility of an artifact. After the eye makeup was removed the supraorbital shadows disappeared eliminating caclification as a factor in the clinical picture. A survey made subsequently of 25 types of eye shadows showed that many are radio-opaque because of bismuth, magnesium silicate and iron oxide in the formula- tions (53). SUMMARY Subjective irritation, allergic contact dermatitis and irritant (toxic) contact dermatitis are the most common adverse effects associated with eye area cosmetics. Comprehen- sive care requires discontinuance of the causative product, appropriate therapy, and a replacement or alternate product whenever feasible for those who wish to continue wearing eye cosmetics. Chronic conjunctivitis and blepharitis are relatively minor complications. Keratitis resulting in corneal ulceration and impaired vision is the most serious adverse effect encountered. Most cases have been traced to the use of mascara contaminated with P. aeruginosa following trauma to the cornea. Preventative measures that can be taken by the consumer and the cosmetic industry have been described. Permanent conjunctival pigmentation is attributable to the misuse of eyeliner or mascara. Eyeshadow mimicking orbital calcification has Sherlokian connotations. REFERENCES (1) J. Mausner, "Skin reactions vs. units sold: world-wide study," in Proceedings of the 1st annual Arnold Schwartz memorial program.' an international symposium on landin and landin derivatives, L. Greenberg and J, j. Sciarra, Eds. (Long Island University, Arnold and Marie Schwartz College of Pharmacy and Health Sciences, New York, 1981), pp 142-143. (2) U.S. Dept. of Health and Human Services, Public Health Service. Food and Drug Administration, Cosmetic-related injuries.' a device monitoring branch study of NEISS data January 1, 1979 to December 31, 1979, (GPO, Washington, 1981), p 7. (3) Consumers' Assn., London, Reactions of the skin to cosmetic and toiletry products, (Consumers' Assn., London, 1979), pp 84-85. (4) P.J. Frosch, A.M. Kligman, A method for appraising the stinging capacity of topically applied substances,J. Soc. Cosmetic Chem., 28, 197-209 (1977). (5) W. F. Schorr, Eye cosmetics, DermatoL and Allergy, 4, 45-56 (April 1981). (6) N. B. Pedersen, Allergic contact conjunctivitis from merthiolate in soft contact lenses, Contact Derre., 4, 165 (1978). (7) W. G. van Ketel, F. A. Melzer-van Riemsduk, Conjunctivitis due to soft lens solutions, Contact Derre., 6, 321-324 (1980). (8) M. R. Allansmith, "Vernal conjunctivitis," in External Diseases of the Eye, L. A. Wilson, Ed. (Harper & Row, Hagerstown, 1979), pp 83-89. (9) J. A. Blue, Current concepts of allergy of the eye, Annals of Allergy, 33,267-273 (Nov. 1974). (10) A. A. Fisher, Contact Dermatitis, 2nd ed., (Lea & Febiger, Philadelphia, 1973), pp 4-6 230-232. (11) E. Cronin, Contact Dermatitis, (Churchill, Livingstone, Edinburgh, London, and New York, 1980), pp 93-170. (12) J. G. Marks, Jr., M. E. Bishop, W. F. Willis, Allergic contact dermatitis to sculptured nails, Arch. Dermatol., 115,100 (1979). (13) C. G. T. Mathias, H. I. Maibach, A. Irvine, W. Adler, Allergic contact dermatitis to echothiopate iodide and phenylephrine, Arch. Opthalmol. 97, 286-287 (1979).

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