Conjunctival provocation tests and the ocular late phase reaction

Abstract

Atopy refers to hypersensitivities in persons with a hereditary background of allergic diseases. The major, most commonly recognized atopic conditions include eczema (atopic dermatitis), asthma, hay fever, and allergic rhinitis. Atopic ocular disease includes Seasonal Allergic Conjunctivitis (SAC), Perennial Allergic Conjunctivitis (PAC), Vernal Keratoconjunctivitis (VKC), Atopic Keratoconjunctivitis (AKC), and Giant Papillary Conjunctivitis (GPC). SAC and PAC, with or without nasal involvement, comprise the majority of ocular allergic conditions. The immunopathology of seasonal and perennial allergic conjunctivitis and rhinitis has been characterized as an IgE-mediated, mast cell dependent, hypersensitivity response. These conditions are classified as Type I immediate hypersensitivity. This chapter discusses the therapies that are currently available to treat SAC and PAC. VKC and AKC might cause significant complications and lead to loss of vision. Type I hypersensitivity reactions of the ocular surface are involved in AKC and VKC, but are not considered the only pathophysiologic mechanisms in these similar, yet distinct entities.