eye disorders
Allergic Conjunctivitis
Symptoms and Signs of Allergic Conjunctivitis
Patients with allergic conjunctivitis report having Bilateral mild to intense ocular itching Conjunctival hyperemia Photosensitivity (photophobia in severe cases) Eyelid edema Watery or stringy discharge Concomitant rhinitis is common. Many patients have other atopic diseases, such as Atopic Dermatitis (Eczema) , Findings characteristically include conjunctival edema and hyperemia and a discharge. The bulbar conjunctiva may appear translucent, bluish, and thickened. Chemosis and a characteristic dermatoblepharitis with hyperemia, edema and lichenification of the medial upper first and then lower eyelid, are common. Chronic itching can lead to chronic eyelid rubbing, periocular hyperpigmentation, and dermatoblepharitis. In people with seasonal and perennial conjunctivitis, fine papillae on the upper tarsal conjunctiva give it a velvety appearance. In more severe forms, larger tarsal conjunctival papillae, conjunctival scarring, corneal neovascularization, and corneal scarring with variable loss of visual acuity can occur. Usually, the palpebral conjunctiva of the upper eyelid is involved, but the bulbar conjunctiva is sometimes affected. In the palpebral form, square, hard, flattened, closely packed, pale pink to grayish cobblestone papillae are present in the upper tarsal conjunctiva. The uninvolved bulbar conjunctiva is milky white. In the bulbar (limbal) form, the circumcorneal conjunctiva becomes hypertrophied and grayish. Discharge may be tenacious and mucoid, containing numerous eosinophils. In 3 to 11% of patients, a Corneal Ulcer develops, causing pain and increased photophobia. Other corneal changes (eg, central plaques) and white limbal deposits of eosinophils (Horner-Trantas dots) may be seen. 