Allergic eye disease
Pammal Ashwin
Sunil Shah
2008, Birmingham UK
A seminar for a group of eye professionals
Pictures from the www
We can be allergic to many
things….
Types

Simple allergic

Seasonal allergic

Vernal/Atopic

Giant Papillary
SIMPLE ALLERGIC
CONJUNCTIVITIS
Symptoms





Itching
Redness
Chemosis
Watering
Runny nose
SEASONAL ALLERGIC
CONJUNCTIVITIS
Features




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Symptoms of simple allergic conjunctivitis
Seasonal (hay fever)
Thin watery discharge
No pre-auricular nodes
No corneal involvement
Signs
Mild hyperaemia
 Papillary reaction

VERNAL
CONJUNCTIVITIS
Features



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Young boys
Ropy discharge
Intense itching
Ptosis from lid swelling
Runny nose
Palpebral
Giant papillae
 Shield ulcers

Limbal

Limbitis (Trantas dots)
ATOPIC
CONJUNCTIVITIS
Features
Males
 Atopic history (allergy, eczema, asthma)
 Red, thickened, macerated lids
 Infiltration of tarsal conjunctiva

Complications


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Persistent epithelial defects
Superinfection
Corneal neovascularisation
Cicatrisation
Keratoconus, RD, Cataract
GIANT PAPILLARY
CONJUNCTIVITIS
Features
Foreign material –
palpebral conjunctiva
 SCL
 Prosthesis
 Sutures
Management options
General measures
Allergen avoidance
 Cold compresses
 Stop contact lens wear
 Artificial tears

Anti-histamines
Mast cell stabilisers
 Anti- histamines
 Combined – Olopatadine
 Systemic

Steroids
Topical
 Oral
 Sub-tarsal injection

Ciclosporin
THANK YOU

Questions