ALLERGIC DISORDERS OF THE EYE

WISTIANI

INTRODUCTION

Approximately 20% population suffers from allergic condition with

environmental
allergens
Allergic conjunctivitis: an allergic reaction that affects the conjunctiva
Characteristics: itchy eyes, watery, red, and/or swollen eyes
2 types: seasonal and perennial allergic conjunctivitis (SAC, PAC)
In Indonesia: PAC (mostly caused by indoor allergens)

ANATOMY OF THE EYE

SIGNS & SYMPTOMS

SEASONAL & PERENNIAL ALLERGIC CONJUNCTIVITIS

SAC: experience symptoms in spring, summer or fall pollen,
plants
the air
Itching, redness, burning, clear or watery discharge
Allergic shinner
Puffy eyelids, eyes discomfort causes by lights

PAC: year round symptoms

Signs milder than PAC
Caused by rx to dust mites, mold, pet dander,

household

allergens

exposure from

VERNAL KERATOCONJUNCTIVITIS
It can occur year-round, symptoms may worsen seasonally
May accompanied by atopic dermatitis
Symptoms: itching, tearing and production of thick mucus, foreign body

sensation, photophobia
Can impair vision

ATOPIC KERATOCONJUNCTIVITIS

Affects older patients (male) with history of allergic dermatitis

Symptoms similar with vernal keratoconjunctivitis

If untreated may cause scarring of the cornea and its delicate

membrane

Symblepharon

Periorbital:
Dennie-Morgan
folds, Hertoghe
thickening
& tylosis, crusting,
edema, sign
fissures, ptosis,
Eyelids:
blepharitis
Conjunctiva: small-or

medium-sized papillae,
hyperemia, edema,
escessive mucin, and limbal
Trantas dots (clusters of
necrotic eosinophils,
neutrophis, and epithelial
cells)
Lenses: post or ant subcapsular shield-shaped cataracts
Evaluation for degenerative vitreous changes and retinal
detachment

Corneal
shield
ulcer

CONTACT ALLERGIC CONJUNCTIVITIS

Can result from irritation by contact lenses or by the proteins from tears that

bind
to the surface of the lens
Symptoms include: redness, itching, mucus discharge, lens discomfort, foreign

body
sensation

GIANT PAPILLARY CONJUNCTIVITIS

Is severe form of contact allergic cinjunctivitis in which individual fluid

sacs, or
papules, form in the upper lining of the inner eyelid
Symptoms are: itching, puffiness, tearing, mucus discharge, blurred vision,

poor
tolerance for wearing contact lenses

DIAGNOSIS

In coordination with opthalmologist: slit lamp (dilated blood vessels,

conjunctival
swelling, eyelid swelling signs of allergic reaction)
Scrapping conjunctiva: eosinophils
Allergist: identification of environmental allergens avoidance

MEDICAMENTOSA

Antihistamine eyedrops: reduce itching, redness, and swelling associated with eye allergy

Mast cell stabilizer and antihistamine eyedrops: to treat & prevention. Twice/day, quick long-lasting

relief of itching, redness, tearing, and burning

NSAID eyedrops: to relieve itchig

Corticosteroid eyedrops: to treat chronic, severe eye allergy symptoms. Beware chronic usage

ENVIRONMENTAL CONTROL
Dust mite: decrease ambient humidity, wash sheets in hot water once weekly,

allergen impermeable covers for mattresses and pillows, minimize carpeting,

linens,
stuffed animals, etc
Pets: keep pets out of the bedroom at all times, use HEPA filters, bathe the pets

at least once weekly, eliminate water leaks and standing water that encourage
mold growth
Mold: decrease humidity, eliminate water leaks
Outdoor polles like tress, grasses and weeds: use AC, keep windows and doors

closed

THANK YOU