Allergic eye disease

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Allergic eye disease

• Pammal Ashwin
• Sunil Shah
• 2008, Birmingham UK
• A seminar for a group of eye professionals
• Pictures from the www

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We can be allergic to many things.
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Types

• Simple allergic
• Seasonal allergic
• Vernal/Atopic
• Giant Papillary

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Simple allergic conjunctivitis
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Symptoms

• Itching
• Redness
• Chemosis
• Watering
• Runny nose

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Seasonal allergic conjunctivitis
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Features

• Symptoms of simple allergic conjunctivitis
• Seasonal (hay fever)
• Thin watery discharge
• No pre-auricular nodes
• No corneal involvement

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Signs

• Mild hyperaemia
• Papillary reaction

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Vernal conjunctivitis
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Features

• Young boys
• Ropy discharge
• Intense itching
• Ptosis from lid swelling
• Runny nose

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Palpebral

• Giant papillae
• Shield ulcers

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Limbal

• Limbitis (Trantas dots)

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Atopic conjunctivitis
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Features

• Males
• Atopic history (allergy, eczema, asthma)
• Red, thickened, macerated lids
• Infiltration of tarsal conjunctiva

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Complications

• Persistent epithelial defects
• Superinfection
• Corneal neovascularisation
• Cicatrisation
• Keratoconus, RD, Cataract

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Giant papillary conjunctivitis
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Features

• Foreign material palpebral conjunctiva
• SCL
• Prosthesis
• Sutures

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Management options
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General measures

• Allergen avoidance
• Cold compresses
• Stop contact lens wear
• Artificial tears

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Anti-histamines

• Mast cell stabilisers
• Anti- histamines
• Combined Olopatadine
• Systemic

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Steroids

• Topical
• Oral
• Sub-tarsal injection

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Ciclosporin
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THANK YOU

• Questions