Allergic Disease of the Eye

Abstract

AbstractAllergic eye disease is a bilateral immune-mediated process of the ocular surface that occurs in up to 25 % of the population of developed countries. Four entities are described as having at least in part some portion of their pathogenesis emanating from mast cell activation: seasonal allergic conjunctivitis (SAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), and giant papillary conjunctivitis (GPC). SAC and GPC are non-vision threatening whereas AKC and VKC may lead to vision loss. The severe forms of allergic disease, AKC and VKC have an immune-mediated pathogenesis as well as mast cell activation. GPC is considered iatrogenic due to the presence of an ocular surface foreign body such as contact lens or an exposed suture. Treatment of allergic eye disease may be as simple as administration of artificial tears or topical antihistamines through to as complex as the need for topical or oral steroids as well as immunomodulatory therapy. Contact dermatitis may occur in the periocular region. The periocular form of contact dermatitis is most commonly associated with topical ophthalmic pharmaceutical agents. Antiviral and glaucoma medications are some of the more common medications implicated. In vivo conjunctival provocation testing is an ocular equivalent of skin testing to determine sensitivity to specific antigens. This may be used experimentally to develop a reproducible human model of allergic eye disease and has been utilized to test new pharmaceutical agents.KeywordsAtopic DermatitisAllergic RhinitisAllergic ConjunctivitisContact Lens WearMast Cell StabilizerThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.