Allergic Conjunctivitis


What is Allergic Conjunctivitis?

Allergic Conjunctivitis is a non-infectious  inflammation of the white superficial part of the eye.  Unlike “pink eye” Allergic Conjunctivitis is due to exposure to external allergens in a susceptible individual.  Allergens may be seasonal some examples include ragweed and flower pollen. Some allergens are perennial like dust mites, feathers or animal dander.  There are even times when a patient can develop an allergy to a particular contact lens.

What are some common symptoms of Allergic Conjunctivitis?

Patients with Allergic Conjunctivitis typically present with a red, burning and severely itchy eye.  They often complain of assocaited tearing and sometimes note some mild blurry vision.

Are there different types of Allergic Conjunctivitis?

Yes, Allergic Conjunctivitis can be broken down into 5 broad catagories.

Seasonal Allergic Conjunctivitis: This is the most common type of Allergic Conjunctivitis and effects approximately 20 % of the population.

Perennial Allergic Conjunctivitis: Patients with Perennial Allergic Conjunctivitis typically have an allergy to something in there environment.  Sometimes if the inciting agent is removed the symptoms will resolve.

Vernal Conjunctivitis: typically presents in young males from tropical or temperate climates.  These patients usually have a personal history of systemic allergies, like asthma, allergic rhinitis, or eczema.  This is one of the two Allergic Conjunctivitis that may be vision threatening.

Atopic Keratoconjunctivitis: Patients with Atopic Keratoconjunctivitis always  have a personal history of eczema and atopic dermatitis that effects there eyelids.  Like Vernal Conjunctivitis it can also be vision threatening.

Giant Papillary Conjunctivitis: Is a specific allergic conjunctivitis that occurs in contact lens wearers.  Giant Papillary Conjunctivitis is caused by an allergic reaction to debris that builds up on contact lenses.  Patients often need to avoid contact lenses while undergoing treatment and sometimes need to change to a different type of lenses.

How is Allergic Conjunctivitis treated?

First line treatment for Allergic Conjunctivitis is typically with a mast cell stabilizer antihistamine ophthalmic drop like Pataday, Elestat, Bepreve, or Zaditor.  In more resistant cases your doctor might employ a short course of topical steroids or an oral antihistamine.  In the ideal world however instead of treating the symptoms one would try to avoid the inciting allergen or undergo desensitizing with an allergist. Patients with Giant Papillary Conjunctivitis typically need to go on a contact lens holiday and are treated with topical mast cell stabilizers, antihistamine drops and topical steroids .  Patients with Vernal Conjunctivitis and Atopic Keratoconjunctivitis may benefit from local or systemic immunosuppressive therapy with Cyclosporine treatment.

Is Allergic Conjunctivitis vision threatening?

Seasonal and Perennial Allergic Conjunctivitis is not typically vision threatening but can be quite irritating.  Vernal and Atopic Keratoconjunctivitis can be vision threatening and should be treated by a Fellowship trained Ocular Immunologist and Uveitis export or Cornea Specialist.  Giant Papillary Conjunctivitis can lead to permanent contact lens intolerance if not treated appropriately.

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