Allergic conjunctivitis

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Allergic conjunctivitis
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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.

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Allergic conjunctivitis

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

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classification

• Seasonal allergic conjunctivitis
• Atopic keratoconjunctivitis
• Vernal keratoconjunctivitis
• Giant papillary conjunctivitis

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Clinical features

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

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Clinical features

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

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Types of conjunctival reaction

• Follicles
• Papillae
• Giant papillae

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Diagnostic workup

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

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Investigations

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

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

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type history examination treatment
Seasonal Conj. Acute, itching Conjunctival injection, chemosis Avoid allergens Antihistamine immunotherapy
VKC Chronic, itching 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 Topical steroids
GPC Lenses, FB Foreign body sensation Mechanical ptosis, Cobblestone papillae Mast cell stab. Steroids antihistamins