Allergic conjunctivitis: Difference between revisions

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=Clinical Features=
==Background==
#Itching
*Conjunctivitis due to exposure to an allergen
#Watery discharge
*Chronic allergic conjunctivitis is also called vernal conjunctivitis
#Injected and edematous conjunctiva
#Papillae on inferior conjunctival fornix
#Red, swollen eyelids


=Treatment=
{{Conjunctivitis DDX}}
#Mild: avoid triggers, cool compresses x 15 minutes QID
#Moderate: Histamine-blocking drops (e.g. olopatadine, pemirolast, or ketotifen)
#Severe: referral to opthalmology for possible steroid therapy


=Disposition=
==Clinical Features==
*Outpatient ophthalmology follow-up
[[File:PMC4396420 opth-9-575Fig1.png|thumb|Bilateral allergic contact dermatitis caused by eyedrops (left) and after resolution (right).]]
[[File:PMC3640929 1824-7288-39-18-1.png|thumb|Seasonal allergic conjunctivitis. Inverted eyelid showing mild conjunctival injection and moderate chemosis.]]
[[File:PMC3047907 jaa-3-149f1.png|thumb|Acute allergic conjunctivitis.]]
[[File:PMC3047907 jaa-3-149f2.png|thumb|Chronic allergic conjunctivitis.]]
[[File:PMC3047907 jaa-3-149f8.png|thumb|Contact allergic blepharoconjunctivitis (from eyedrops).]]
*Itching
*Watery discharge
*Injected and [[red eye|edematous conjunctiva]]
*Papillae on inferior conjunctival fornix
*Red, swollen eyelids


=See Also=
==Differential Diagnosis==
{{Unilateral red eye DDX}}
{{Bilateral Red Eyes}}
 
==Evaluation==
{{Clinical diagnosis of conjunctivitis}}
 
==Management==
*'''Mild''': avoid triggers, cool compresses for 15 minutes QID
*'''Moderate''': Histamine-blocking drops (e.g. naphazoline/pheniramine 0.025%/0.3%, olopatadine, pemirolast, or ketotifen)
*'''Severe''': refer to ophthalmology for possible [[Steroids|steroid]] therapy
 
==Disposition==
*Discharge with ophthalmology follow-up
 
==See Also==
*[[Conjunctivitis]]
*[[Conjunctivitis]]
*[[Eye Algorithm (Main)]]
*[[Eye Algorithms (Main)]]


=Source=
==References==
*Mahmood, Narang. Diagnosis and management of acute red eye. Emerg Med Clin N Am 2008;26
<references/>
*Tintinalli


[[Category:Ophtho]]
[[Category:Ophthalmology]]

Latest revision as of 17:14, 4 February 2026

Background

  • Conjunctivitis due to exposure to an allergen
  • Chronic allergic conjunctivitis is also called vernal conjunctivitis

Conjunctivitis Types

Clinical Features

Bilateral allergic contact dermatitis caused by eyedrops (left) and after resolution (right).
Seasonal allergic conjunctivitis. Inverted eyelid showing mild conjunctival injection and moderate chemosis.
Acute allergic conjunctivitis.
Chronic allergic conjunctivitis.
Contact allergic blepharoconjunctivitis (from eyedrops).
  • Itching
  • Watery discharge
  • Injected and edematous conjunctiva
  • Papillae on inferior conjunctival fornix
  • Red, swollen eyelids

Differential Diagnosis

Unilateral red eye

^Emergent diagnoses
^^Critical diagnoses


Bilateral red eyes

Evaluation

Clinical diagnosis of conjunctivitis^

Conjunctivitis
Bacterial Viral Allergic
Bilateral 50% 25% Mostly
Discharge Mucopurulent Clear, Watery Cobblestoning, none
Redness Yes Yes Yes
Pruritis Rarely Rarely Yes
Increased Likelihood Presence of mucopurulent discharge; otitis media Concomitant pharyngitis; an enlarged preauricular node; contact with another person with red eye NA
Additional Treatment: Antibiotics Treatment: Hygiene Seasonal

Management

  • Mild: avoid triggers, cool compresses for 15 minutes QID
  • Moderate: Histamine-blocking drops (e.g. naphazoline/pheniramine 0.025%/0.3%, olopatadine, pemirolast, or ketotifen)
  • Severe: refer to ophthalmology for possible steroid therapy

Disposition

  • Discharge with ophthalmology follow-up

See Also

References