Allergic conjunctivitis

Background

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

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

Conjunctivitis Types

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
Additional Treatment: Antibiotics Treatment: Hygiene Seasonal

Management

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

Disposition

  • Discharge with ophthalmology follow-up

See Also

References