Ocular Allergy

Abstract

Ocular allergies often go untreated and are a challenge to diagnose. They can occur in isolation but frequently occur along with other atopic diseases such as allergic rhinitis, asthma, and atopic dermatitis. There are four major types of ocular allergy: Allergic conjunctivitis (AC) divided into seasonal (SAC) and perennial symptoms (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC), and contact dermatoconjunctivitis (CDC). Diagnosis of ocular allergy is by history, physical examination, and testing for environmental allergens. Ocular pruritus is the most common symptom of ocular allergy. AKC and VKC are more common in males and can lead to vision loss if not treated. Giant papillae, corneal ulceration, and Horner-Trantas dots are characteristic of AKC and VKC. GPC is commonly associated with contact lens use. CDC is due to irritant exposure. Management generally begins with allergen identification and avoidance. Pharmacological options for AC include topical dual-activity agents, oral antihistamines, and topical mast cell stabilizers. Topical steroids should be prescribed with caution. Signs and symptoms of ocular allergy subtypes that impose a threat to vision should be recognized. Clinicians should refer to ophthalmology in severe symptoms or if vision is affected.