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Allergic Conjunctivitis

Seasonal allergic conjunctivitis (hay fever conjunctivitis)

In spring and summer, there is a type 1 hypersensitivity reaction to airborne allergens such as tree and grass pollen.

It often accompanies allergic rhinitis and asthma.

Eosinophils are seen in cytological examination of the conjunctiva.

Cold compress, steroid and cromaline sodium are used in its treatment.


Vernal keratoconjunctivitis (VKC)

The disease, which is more common in hot climates, increases its severity in spring and summer.

It is common between the ages of 5-20 and in males.

It is the second type of allergic conjunctivitis with the worst prognosis.

The cap shape is the most common. The view on the top lid is called the cobblestone view.

Horner-Trantas spots formed by degenerated cells are seen on them.

In the cornea, punctate epithelial erosions, shield-like ulcers and subepithelial scars can be seen.


Atopic Keratoconjunctivitis (AKC)

It occurs between the ages of 30-50.

Coexistence of atopic dermatitis and asthma is common.

Scars are usually seen on the cornea and conjunctiva.

Shield-like corneal ulcers may be seen.

Symptoms are more severe, chronic and continuous than VKC.

For these reasons, allergic conjunctivitis has the worst prognosis.


Giant papillary conjunctivitis

It is especially seen in those who use intraocular foreign bodies (contact lenses, mechanical prostheses, etc.).

It is a type 1 hypersensitivity reaction.

It resolves completely with removal of the lens and steroid therapy.

It is allergic conjunctivitis with the best prognosis.


Phlyctenular Conjunctivitis 

It is a delayed type hypersensitivity reaction that usually develops against tuberculoproteins.

Flickens (ropes) develop at the base of the limbus, which then ulcerate but heal without scarring. 

Conjunctivitis Summary

Symptom or sign

Bacterial

Chlamydial

Viral

Allergic

Toxic

Itching

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 -

 -

 ++

 -

Bleeding

+

 -

 +

 -

 -

Follicles

 -

 ++

 +

 +

 +

Papillae

 +

 -+

 -

 +

 -

Fake/real dice

 -+

 -

 -+

 -

 -

Lymphoadenopathy (LAP)

 +

 +

 ++

 -

 -

Pannus formation

 -

 +

 -

 -

 -+

Keratitis

 -+

 +

 -+

 -

 -+


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