• Histamine, IL-4 and nitric oxide are important in the pathogenesis.
• Allergic rhinoconjunctivitis: It is the combination of allergic rhinitis and allergic conjunctivitis. The cornea is involved in severe cases.
• Giant papillary conjunctivitis: It is seen in lens wearers. It is a type of vernal conjunctivitis. It is not IgE mediated (no prior sensitization required, it happens on first encounter).
• Atopic conjunctivitis: Allergic Conjunctivitis + Atopic dermatitis combination.
• Contact conjunctivitis: It is the form of contact dermatitis seen in the conjunctiva.
Vernal conjunctivitis
It occurs especially in prepubertal boys in spring and summer. It is a bilateral inflammatory disease. Not IgE-mediated (previously sensitized
Pathology
· Involved in the cornea
• Cobblestone appearance in the upper palpebrae
• Clusters of white eosinophils in the corneoscleral limbus: Trantas points
Conjunctival white spots: Horner's spots
Clinic
• Photophobia
• Itching
• tearing in the eyes
• Mucus containing abundant eosinophils
It destroys the cornea by creating ulceration and scar tissue.
Treatment
• 4% cromolyn sodium
• Topical steroid when necessary
Conjunctivitis with risk of vision loss
• Vernal conjunctivitis
• Atopic conjunctivitis