Allergic conjunctivitis

conjunctiva Modified mucous membrane that covers the inner surface of the lids and the globe to the edge of the cornea. Highly vascular tissue. Protects the globe.

Allergic conjunctivitis Definition: allergic inflammation of the conjunctiva. Etiology: 1) transient allergen: pollen 2) persistent allergen: house dust mite

classification Seasonal allergic conjunctivitis Atopic keratoconjunctivitis Vernal keratoconjunctivitis Giant papillary conjunctivitis

Clinical features Itching (hallmark symptom) Photophobia Foreign body sensation Tearing Blepharospasm Watery discharge Mucoid discharge

Clinical features Examination: Red eye (bilateral conjunctival injection) Chemosis Periorbital swelling (lid edema) Mucoid discharge Eye lid eczema

Types of conjunctival reaction Follicles Papillae Giant papillae

Diagnostic workup History: allergic disease (asthma, eczema) use of topical preprations Seasonal history Contact lenses Family history of atopy

Investigations Conjunctival scrape esinophils. Skin prick test. Patch test. Measurement of tear levels of inflamatory mediators (IgE, histamine).

Management

Non specific: cold compresses, mucolytic drops. Topical antihistamine. Oral antihistamine. Mast cell stabilizers. Steroids. Cyclosporins. NSAID.

type history examination treatment Seasonal Conj. Acute, itching VKC Conjunctival injection, chemosis Avoid allergens Antihistamine immunotherapy VKC Chronic, Mucoid discharge GPC Mast cell stab. Topical NSAID Topical antihistamine Topical steroids AKC Pain blurring of vision Watery discharge Lid swelling Cataract, GPC Cold compress Antihistamins Mast cell stab Lenses, FB Foreign body sensation Mechanical ptosis, Cobblestone papillae Steroids antihistamins