This 70 year old patient with unilateral ocular hypertension was prescribed a topical prostaglandin F2α analogue to the left eye and reviewed two months later. Although the intraocular pressure was then well controlled, there was considerably increased growth of the eyelashes of the left eye and increased pigmentation. While this is a recognised side effect of topical prostaglandin F2 α analogues, this case illustrates how dramatic this can be and therefore the importance of counselling patients and taking care when this treatment is used unilaterally.

Amir Hamid, junior research fellow, Ophthalmology Department, Worcestershire Royal Hospital, Worcester WR5 1DD, Jasmin Singh, senior house officer, Western Eye Hospital, London NW1 6YE, Stephen R Perry, consultant ophthalmic surgeon, Kidderminster Hospital, Kidderminster, Worcestershire DY11 6RJ