Allergies

Question 1

What part of the tear film do goblet cells make?

Answer 1

Mucous layer

Question 2

What part of the tear film do the Accessory glands of krouse and wolfring and the lacrimal gland make?

Answer 2

Aqueous layer

Question 3

In order, anterior to posterior, what are the 5 main structures of the cornea?

Answer 3

• Epithelium (5-7 layers of cells, takes 24-48 hours to regenerate)
• Bowman’s Membrane (strong barrier preventing infections entering the stroma)
• Stroma
• Descemet’s membrane (maintains water levels in the stroma -thickness, clairty, water diffused through descemets from the aqueous humour)
• Endothelium

Question 4

What is the main difference between perenial and seasonal allergic conjunctivitis

Answer 4

Length of course:

• perenial lasts through the year and is from house mites, dust or animal hair
• seasonal will be the likes of pollen, grass etc

Question 5

What groups are most susceptible to Vernal keratoconjunctivitis?

Answer 5

> 25years (children and young adults)
warm dry areas (eg african countries)
Those with hayfever, atopy

Question 6

What are the general symptoms of vernal keratoconjunctivitis?
And what are the symptoms if the cornea is involved?

Answer 6

Intense itching
Stringy discharge

Pain, photophobia and blurred vision

Question 7

What are papillae?

Answer 7

vascularised bumps that are caused by allergies and are close together (cobblestone)

Question 8

What type of dishcharge does atopic keratoconjunctivitis have?

Answer 8

Thick white and stringy … yuck

Question 9

What is symplepharon?

Answer 9

Where the eyelid starts to bind to the sclera and results in conjunctival scarring.

Question 10

Can atopic conjuctivitis affect the cornea?

Answer 10

Yes

• can be severe
• Neovascularisation
• Thinning
• scarring

Question 11

What type of hypersensitivity is acute allergic conjunctivitis?

Answer 11

Type 1 IgE mediated

Question 12

Can allergic conjuctivitis affect the cornea?

Answer 12

No

Question 13

What are the main management steps for ocular allergies?

Answer 13

• Remove allergen if possible
• cold compress
• Saline, eyewashes, artificial tears
• antihistamines (topical or oral)
• topical mast cell stabilisers (for long term allergies)
• Non steroidal anti inflammatory agents (topical or systemic)
• Corticosteroids (topical or systemic) (very last option)