Allergic Conjunctivitis

Clinical Description

Condition characterised by conjunctival inflammation caused by airborne allergens.

Signs and Symptoms

• Itchy eyes, Excessive tearing, Watery/non-purulent discharge, Burning/foreign body sensation, Conjunctival hyperaemia (redness/pink eye)
• Eyelid oedema
• Conjunctival papillae ranging from small to large or ‘cobblestone’ on the tarsal conjunctiva (seen on everting eyelid) depending on severity of condition. Usually bilateral, but one eye can be affected more than the other. Associated with other allergic conditions such as allergic rhinitis, asthma.
• A positive family history of atopic disease may be present

Treatment

• Avoid triggers/allergens when identified. Patients should not rub their eyes

Mild disease:

• Cool compresses over the eyelids to reduce oedema
• Artificial tears, Hypromellose or Viscotears 6hourly or 8 hourly

Moderate disease

• Mast cell stabilizers e.g., Sodium Cromoglycate eye drops 6 hourly
• Antihistamines e.g., Olopatadine eye drops

Severe Disease

• Treat as moderate disease with a short course of low potent steroid eye drops such as Fluorometholone eye drops 0.1% EVERY 8HRS, otherwise Dexamethasone eye drops 0.1% 8 hourly may be used

Topical steroids should only be used for a maximum of 2 weeks