TERM 1: allergic eye disease Flashcards
How can you classify allergic eye disease?
Allergic conjunctivitis:
-seasonal allergic conjunctivitis
-perennial allergic conjunctivitis
-Acute allergic conjunctivitis
Giant papillary conjunctivitis
contact dermatoconjunctivitis
keratoconjunctivitis:
-atopic keratoconjunctivitis
-vernal keratoconjunctivitis
What are the signs of allergic eye disease affecting the conjunctiva?
Oedema (chemosis)
Hyperaemia
Papillae
Follicles
Mucus discharge
What are the signs of allergic eye disease affecting the lids?
Oedema
Hyperaemia
Blepharitis
Ptosis
What are the signs of allergic eye disease affecting the cornea/limbus?
Keratitis
Infiltrates
Ulceration
Plaques
Scarring
Trantas dots
What are the general symptoms of allergic eye disease?
Itching
Irritation
Burning
Epiphora
Photophobia
Blurred vision
What is the aetiology of acute allergic conjunctivitis?
-Self-limiting allergic reaction to an allergen that comes in contact with the lid or conjunctiva
-Type I hypersensitivity reaction
Allergens include grass pollen, animal dander (skin, fur, feathers)
What is a predisposing factor of acute allergic conjunctivitis?
What are the symptoms?
What are the signs?
What is the management?
-atopy
-itching, unilateral if contact response
-lid oedema and erythema
-chemosis
-epiphora
-usually resolves in a few hours
-cool compresses
-allergen avoidance
What is the ocular manifestation of hayfever?
What is perennial allergic conjunctivitis?
Seasonal Allergic Conjunctivitis
causes symptoms throughout the year in response to allergens such as house dust mite or animal dander
What is the aetiology of seasonal/perennial allergic conjunctivitis?
Type I
Seasonal: seasonal allergens
Perennial: allergens such as house dust mite, symptoms throughout the year
What is the predisposing factor of seasonal/perennial allergic conjunctivitis?
What are the symptoms of seasonal/perennial allergic conjunctivitis?
What are the signs?
What is the management?
family history
itching, epiphora
Hyperaemia
Chemosis
Lid oedema
Diffuse papillary reaction
No corneal involvement
Allergen avoidance
Cool compresses
Sodium cromoglicate
Topical and/or systemic antihistamines
What are the non-pharmacological management options for allergic eye disease?
Allergen avoidance
-Limit outdoor activities
-Use air conditioning
-Reduce humidity
-Protective eyewear
-Barrier cover for mattress and pillows
-Remove reservoirs for allergen e.g. carpets
Allergen exclusion
-occlusive glasses
-induced ptosis
Cold compresses
Artificial tears
What are the pharmacological management options for allergic eye disease
Antihistamines (oral and topical)
Mast cell stabilizers
What is the aetiology of giant papillary conjunctivitis?
What are the predisposing factors?
What are the symptoms?
What are the signs?
What is the differential diagnosis?
What is the management?
Contact lens wear (trauma and deposits)
Exposed sutures
Filtration bleb
History of atopy
Poor lens hygiene
Mild irritation
Itching
Increased lens awareness
Papillae, variable in size, variable in position
Tops of papillae may stain with fluorescein
Palpebral conjunctival hyperaemia
Increased mucus discharge
Vernal keratoconjuntivitis
Lens hygiene
Disposable lenses
Mast cell stabilisers
What is the aetiology of contact dermatoconjunctivitis?
What is another name for it?
What are the signs?
What are the symptoms?
What is the management?
May be caused by eyedrops, or cosmetics applied to the eyelids
conjunctivitis medicamentosa
Lid oedema and erythema
Chemosis
Follicular conjunctivitis
Burning
Stinging
Epiphora
Identify and withdraw allergen
Systemic anti-histamines
What is the aetiology of atopic keratoconjunctivitis?
What are the predisposing factors?
What are the symptoms?
What are the signs?
What is the DD?
What is the management?
Adult equivalent of vernal keratoconjunctivitis
Young adult males
Perennial with exacerbations
atopic history (asthma, eczema)
itching, epiphora, blurred vision, mucus discharge
-Eyelids thickened, crusted and fissured
-Blepharitis
-Conjunctival hyperaemia
-Corneal involvement
vernal keratoconjunctivitis
Mild: sodium cromoglicate
Severe: with corneal involvment, steroids/immunosuppressants
Lid hygiene
Antibiotics
