1. Allergic eye disease Pammal Ashwin Sunil Shah 2008, Birmingham UK A seminar for a group of eye professionals Pictures from the www

2. We can be allergic to many things….

4. Types Simple allergic Seasonal allergic Vernal/Atopic Giant Papillary

5. SIMPLE ALLERGIC CONJUNCTIVITIS

6. Symptoms Itching Redness Chemosis Watering Runny nose

7. SEASONAL ALLERGIC CONJUNCTIVITIS

10. Features Symptoms of simple allergic conjunctivitis Seasonal (hay fever) Thin watery discharge No pre-auricular nodes No corneal involvement

11. Signs Mild hyperaemia Papillary reaction

12. VERNAL CONJUNCTIVITIS

13. Features Young boys Ropy discharge Intense itching Ptosis from lid swelling Runny nose

14. Palpebral Giant papillae Shield ulcers

15. Limbal Limbitis (Trantas dots)

16. ATOPIC CONJUNCTIVITIS

17. Features Males Atopic history (allergy, eczema, asthma) Red, thickened, macerated lids Infiltration of tarsal conjunctiva

18. Complications Persistent epithelial defects Superinfection Corneal neovascularisation Cicatrisation Keratoconus, RD, Cataract

19. GIANT PAPILLARY CONJUNCTIVITIS

20. Features Foreign material – palpebral conjunctiva SCL Prosthesis Sutures

21. Management options

22. General measures Allergen avoidance Cold compresses Stop contact lens wear Artificial tears

25. Anti-histamines Mast cell stabilisers Anti- histamines Combined – Olopatadine Systemic

26. Steroids Topical Oral Sub-tarsal injection

27. Ciclosporin

28. THANK YOU Questions