Allergic Eye disease is common in People who suffer from Asthma, allergic rhinitis and atopic dermatitis.
Symptoms of allergic eye disease include:
Itching, Tearing, redness, discharge.
Itching is most important symptom for allergy eye disease.
Sometimes can be accompanied photophobia and visual loss. Such cases are corelated corneal inflammation and injury.
Allergic eye disease can be several types:
Allergic Conjunctivitis is the most common form.
it have seasonal variability. More common during spring or summer. But some cases can be perennial.
Allergic conjunctivitis is associated with hay fever, which include combination of symptoms:
Runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes.
Clinical signs include conjunctival hyperemia and edema (chemosis),
It has sudden and marked onset.


Vernal keratoconjunctivitis
Mostly occur in late childhood and early adulthood.
It is associated spring Season.
Symptoms include:
Photophobia, Thick mucus discharge, tearing, blurning sensation in the eyes, foreign body sensation and pain. Blurred vision.
Bilateral eye involvement and presence of giant cobblestone-like papillae on the upper tarsal conjunctiva (conjunctiva lining the upper eyelid) are nearly universal findings in patients with vernal keratoconjunctivitis.


Treatment:
In mild cases topical mast cell stabilizers or topical antihistamines are effective.
Mast cell stabilizers requires more time to be effective.
Mast Cell stabilizers:
Nedocromil sodium 2% solution (Alocril) – 1 drop twice a day.
Or more cheaper version, Cromolyn sodium 4% solution (Crolom), 1 drop 4-6 times a day.
Combined antihistamines and mast cell stabilizers:
Ketotifen fumarate 0.025% solution (Zaditor). 1 drop 4 times a day.




Topical vasoconstrictors, such as ephedrine, naphazoline, tetrahydrozoline, and phenylephrine,
are available as over-the-counter medications but not typically used, because of limited efficacy, rebound hyperemia, and follicular conjunctivitis.
Systemic antihistamines can be used. For example loratadine 10 mg daily. If atopic keratoconjunctivitis is prolonged.
In any allergic conjunctivitis, specific allergens may be avoidable.





Treatment of acute exacerbations:




Topical corticosteroids are essential to control acute exacerbations of both vernal and atopic keratoconjunctivitis.
Dexamethasone sodium phosphate 0.1% solution. 1 or 2 drops as often as indicated by
severity; use every hour during the day and every 2 hours during the night in severe inflammation; taper off as inflammation decreases.
Fluorometholone 0.25% suspension - 1 drop two to four times daily.
Prednisolone sodium phosphate 1% solution (various) - 1–2 drops two to four times daily.
This corticosteroids can have serious side effects. So, their usage should be monitored by ophthalmologists.
Corticosteroid induced side effects include: Glaucoma, exacerbations of herpes simplex keratitis,
The lowest potency corticosteroid that controls ocular inflammation should be used. Topical cyclosporine or tacrolimus is also effective.
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