Allergic Eye Disease Flashcards
What is the ocular manifestation of hayfever?
Seasonal allergic conjunctivitis
What are sight threatening allergic eye disease?
Atopic keratoconjunctivitis and vernal keratoconjunctivitis
Which part of the eye does allergic eye diseases normally effect?
The conjunctiva
Name the three allergic conjunctivitises
1) SAC
2) PAC
3) AAC
What are is another name for giant papillary conjunctivitis?
Contact lens associated papillary conjunctivitis
What is contact dermatoconjunctivitis?
Allergic reactions to cosmetics or drugs that are treating another eye disease
What are five typical signs or an allergic eye disease?
1) Oedema (chemosis)
2) Pupillae
3) Hypereamia
4) Follicules
5) Mucus discharge
What are signs on the lids or allergic eye disease?
1) Oedema
2) Hypereamia
3) Bleph
4) Ptosis
What are signs with the keratoconjunctivitis eye disease (to do with the cornea & there are 6)?
1) Keratitis
2) Infiltrates
3) Ulceration
4) Plaques
5) Scarring
6) Trantas dots
What is trantas dots?
- infiltrates (degeneration of epithelial cells) around the cornea
- sign of vernal keratoconjunctivits
What are the 6 common symptoms of allergic eye disease?
1) Itching
2) Irritation
3) Burning
4) Epiphora
5) Photophobia
6) Blurred vision
What are is the aetiology of acute allergic conjunctivitis?
- Self-limiting
- Type 1 hypersensitivity reaction
- Allergens (grass, pollen ect)
- unilateral or bilateral
What is the management of acute allergic conjunctivitis?
- Self limiting so resolves within a few hours
- Cool compress for symptomatic relief
- Allergen avoidance
- Topical or oral antihistamines (rare for this disease)
What is the medical name for hayfever?
Seasonal allergic rhinitis
What is the peak months in hayfever season?
May or June
Will tree pollen hayfever suffers get their signs or symptoms earlier or later ?
EARLIER due to the trees blossoming
What is the aetiology of seasonal allergic conjunctivitis?
Seasonal allergens
What is the aetiology of perennial allergic conjunctivitis?
Allergens like a house dust mite
What is a predisposing factor of seasonal/perennial allergic conjunctivitis?
FH
Give an example of an acute allergic conjunctivitis reaction.
Bee sting on the eyelid
What are signs of seasonal/perennial allergic conjunctivitis ?
- Hypereamia
- Chemosis
- Lid oedema
- Diffuse papillary reaction
- No corneal involvement
What is the non-pharmacological management of seasonal/perennial allergic conjunctivitis ?
- Allergen avoidance
- Cool compress
- Artificial tears
- Allergen exclusion
what are examples of how to achieve allergen avoidance/exclusion? (there are a fair few)
- Limit outdoor activity,
- use AC
- reduce humidity
- wear protective eyewear
- barrier cover for mattress and pillows
- occlusive glasses
- induced ptosis (only in severe cases)
What is some pharmacological management options for seasonal/perennial allergic conjunctivitis?
-Antihistamines
- Mast cell stabilisers (sodium cromoglicate)
- Combination of antihistamines and mast cells stabilisers
What is the aetiology of giant papillary conjunctivitis?
- Contact lens wear (mechanically induced)
- Exposed sutures
- Filtration bleb (trabeculectomy)
When are predisposing factors of giant papillary conjunctivitis ?
-History of atopy
- Poor lens hygiene (build up of protein deposits
What key symptoms of giant papillary conjunctivitis ?
- Mild irritation
- Itching
- Increased lens awareness
What are signs of giant papillary conjunctivitis ?
- Papillae variable in size and position
- Tops of papillae stained with Fluorescein
- Palpebral conjunctival hyperaemia
- Increased mucus discharge
- Protein deposits on the contact lens
What is the management of giant papillary conjunctivitis ?
- Lens hygiene
- Disposable lenses
- Mast cell stabilisers
What is the aetiology of conjunctivitis medicamentosa?
Can be caused by eye drops or cosmetics applied to the eye lids
What are signs of conjunctivitis medicamentosa?
- Lid oedema
- Chemosis
- Follicular conjunctivitis (not papillae )
What are symptoms of conjunctivitis medicamentosa ?
- Burning
- Stinging
- Epiphora
What is the management of conjunctivitis medicamentosa?
- Identify and withdraw allergen
- Systemic anti-histamines
What is the aetiology of atopic keratoconjunctivitis ?
- VKC for adults
- young M px’s
- perennial (all year)
What are predisposing factors of atopic keratoconjunctivitis ?
Atopic history (disorders relating to allergy)like asthma and eczema
What are symptoms of atopic keratoconjunctivitis ?
- Itching
- Epiphora
- Blurred vision
- Mucus discharge
What are signs of atopic keratoconjunctivitis ?
- Eyelids thickened, crusted
- Bleph
- Conjucntival hyperaemia
- Corneal involvement
Where is atopic keratoconjunctivitis managed?
secondary care (can be managed if mild and no corneal involvement)
How is atopic keratoconjunctivitis managed?
- Mild= sodium cromoglicate
- severe= referred for steroids, immunosuppressants, antibiotic
- both= good lid hygiene
What is the aetiology of vernal keratoconjunctivitis?
- Allergic disorder for children
What are predisposing factors of vernal keratoconjunctivitis ?
- Onset <10 yrs old
- Worse in spring
- Atopic history
What are four symptoms of vernal keratoconjunctivitis ?
- Itching
- Epiphora
- Blurred vision- due to corneal involvement
- Photophobia
What are signs of vernal keratoconjunctivitis? (there are 9)
- Mucus discharge
- Giant papillae
- Hypereamia
- Trantas dots
- Punctate corneal staining
- Erosion
- Plaque
- Scarring of the cornea along visual axis (this is the sight threatening complication)
What is the management of vernal keratoconjunctivitis ?
- Cold compress
- Mast cell stabilisers (MORE LIKELY MANAGEMENT)
- Corticosteroids
- Mucolytics (drugs that break down mucus)
- Ciclosporin (verkasia)
what is a mucolytic?
drugs that breaks down the extensive mucus formed
how does ciclosporin work?
Immunosuppressant that works on T-cells
what else is conjunctivitis medicamemntosa known as?
contact Dermatoconjunctivitis
what is a corneal plaque?
collection of mucus, epithelial cells, lipid, and proteinaceous debris attached to corneal epithelium.
