1. ALLERGIC CONJUNCTIVITIS
AMIRAH BT JAMALUDIN
NURHIDAYATUL HUSNA BT JOHARI

2. Introduction
Allergic conjunctivitis is an inflammation of the conjunctiva (the membrane covering the white part of the eye) due to allergy.
If something irritates this conjunctiva, eyes may become red and swollen. The eyes also may itch, hurt or watery.
It is also known as “pink eye”.

3. Types of allergic conjunctivitis:
Allergic simple conjunctivitis
Spring catarrh
Phlyctenular kerato-conjunctivitis
Giant papillary conjunctivitis

4. Allergic simple conjunctivitis
Definition : Occurring as the result of exposure to a wide variety of allergens
Simple allergic conjunctivitis often results from exposure to eye medications or contact lens solutions (or their preservatives).
Symptoms:
Itching and tearing in response to antigen exposure.
Signs :
Unilateral or bilateral
Mild to moderate conjunctiva hyperaemia
Chemosis

5. Management:
General measures include:
Avoid allergen where possible
Avoid wearing contact lenses until symptoms and signs resolve
Avoid rubbing the eyes
Cool compresses and preservative-free lubricants may also help
If severe,
Oral or topical anti-histamine
Mast cell stabilizer

6. Phlyctenular conjunctivitis
Definition: Kerato-conjunctivitis produced as an allergy to an endogenous agent.
Aetiology: It is a manifestation of allergy to an endogenous toxin as
Tuberculo-protein
Intestinal parasites
Septic foci as in tonsils and adenoids
Symptoms :
Discomfort and lacrimation
If cornea involved,photophobia and blepharospasm occur

7. Signs : Phlyctens Rounded nodules Size 1-3 mm Grayish in color
Eleveated above the surface
Surrounded by a small area of injection

8. Complications:
(1)Cornea
A-Corneal phlycten
B-Phlyctenular ulcers
C-Phlyctenular pannus
(2)Eczema of lids
(3)Muco-purulent conjunctivitis: due to secondary infection with staph. Aureus
(4)Recurrence: are common if the cause is not removed.
Treatments :
Local cortisone drops and ointment
Atropine if cornea is involved
Fascicular ulcer needs cautery with carbolic + Periotomy & cautery of vessel

9. Spring catarrh (Vernal Conjunctivitis)
Definition : It is a bilateral seasonal conjunctivitis recurring in the warm seasons.
Aetiology : It is an allergy of the conjunctiva to an unknown exogenous factor.
The contributing factors are :
U.V rays
Heat
Dust

10. Incidence :
Age : Children
Sex : boys more
Season : summer (not spring)
Symptoms :
Itching
Photophobia
Lacrimation
Ropy discharge (thread): formed of mucus,eosinophils and epithelial debris so that it is scanty,white and elastic

11. Palpebral type (70%)
Large flat-topped papillae
Bluish white color
Cobble stone arrangement
Fornix always free
Milky white film (ropy discharge)
Bulbar type (10%)
Gelatinous masses (due to thickened epithelium and hyaline degeneration )
Tranta spots (white spots)
Mixed type (20%)
Keratitis superficialis vernalis of Tobgy
Superficial ulcers
Epithelial plaque formation that should be scraped
Weakness of the cornea with higher incidence of Keratoconus and Keratectesia

12. Treatment: -Cold compression for sensation of heat
General:
-Antiallergy drugs (antistine,Benadryl,calcium etc)
Local:
-Dark glasses for photophobia
-Cold compression for sensation of heat
-Frequent washing with cold lotion as 4 % boric acid
-Local antihistaminic as antistine of preisoline drops
-Local vasoconstrictor as adrenaline or privine for hyperaemia
-Local cortisone drops (Dexamethasone 0.1 %) pulse therapy during an attack every 2 hours for 5 days only to guard against its complication (may induce glaucoma)
-Local disodium chromoglycate eye drops to stabilize the mast cells “one month before summer”

13. Giant papillary conjunctivitis
Definition : It is an allergic conjunctivitis characterized by the formation of giant papillae.
It occurs most probably due to mechanical irritation of the palpebral conjunctiva in case of :
-Contact lenses (more with extended wear CL and with lens deposits)
-Artificial eyes
-Prominent suture following surgery
Symptoms :
-Red Eye Mucoid discharge Itching

14. Signs :
Conjunctival hyperaemia
Giant papillae on superior tarsal conjunctiva
Superficial punctuate keratitis
Peripheral corneal subepithelial infilterates
Treatment :
Stops using contact lenses for 2 weeks
Topical mast cell stabilizer (disodium chromoglycate) 4 times daily
Topical steroids for few days only
Use new daily wear lenses after complete cure

15. Thank you Syukran Terima kasih…