Allergic Eye Disease

Question 1

What is the ocular manifestation of hayfever?

Answer 1

Seasonal allergic conjunctivitis

Question 2

What are sight threatening allergic eye disease?

Answer 2

Atopic keratoconjunctivitis and vernal keratoconjunctivitis

Question 3

Which part of the eye does allergic eye diseases normally effect?

Answer 3

The conjunctiva

Question 4

Name the three allergic conjunctivitises

Answer 4

1) SAC
2) PAC
3) AAC

Question 5

What are is another name for giant papillary conjunctivitis?

Answer 5

Contact lens associated papillary conjunctivitis

Question 6

What is contact dermatoconjunctivitis?

Answer 6

Allergic reactions to cosmetics or drugs that are treating another eye disease

Question 7

What are five typical signs or an allergic eye disease?

Answer 7

1) Oedema (chemosis)
2) Pupillae
3) Hypereamia
4) Follicules
5) Mucus discharge

Question 8

What are signs on the lids or allergic eye disease?

Answer 8

1) Oedema
2) Hypereamia
3) Bleph
4) Ptosis

Question 9

What are signs with the keratoconjunctivitis eye disease (to do with the cornea & there are 6)?

Answer 9

1) Keratitis
2) Infiltrates
3) Ulceration
4) Plaques
5) Scarring
6) Trantas dots

Question 10

What is trantas dots?

Answer 10

• infiltrates (degeneration of epithelial cells) around the cornea
• sign of vernal keratoconjunctivits

Question 11

What are the 6 common symptoms of allergic eye disease?

Answer 11

1) Itching
2) Irritation
3) Burning
4) Epiphora
5) Photophobia
6) Blurred vision

Question 12

What are is the aetiology of acute allergic conjunctivitis?

Answer 12

• Self-limiting
• Type 1 hypersensitivity reaction
• Allergens (grass, pollen ect)
• unilateral or bilateral

Question 13

What is the management of acute allergic conjunctivitis?

Answer 13

• Self limiting so resolves within a few hours
• Cool compress for symptomatic relief
• Allergen avoidance
• Topical or oral antihistamines (rare for this disease)

Question 14

What is the medical name for hayfever?

Answer 14

Seasonal allergic rhinitis

Question 15

What is the peak months in hayfever season?

Answer 15

May or June

Question 16

Will tree pollen hayfever suffers get their signs or symptoms earlier or later ?

Answer 16

EARLIER due to the trees blossoming

Question 17

What is the aetiology of seasonal allergic conjunctivitis?

Answer 17

Seasonal allergens

Question 18

What is the aetiology of perennial allergic conjunctivitis?

Answer 18

Allergens like a house dust mite

Question 19

What is a predisposing factor of seasonal/perennial allergic conjunctivitis?

Answer 19

FH

Question 20

Give an example of an acute allergic conjunctivitis reaction.

Answer 20

Bee sting on the eyelid

Question 21

What are signs of seasonal/perennial allergic conjunctivitis ?

Answer 21

• Hypereamia
• Chemosis
• Lid oedema
• Diffuse papillary reaction
• No corneal involvement

Question 22

What is the non-pharmacological management of seasonal/perennial allergic conjunctivitis ?

Answer 22

• Allergen avoidance
• Cool compress
• Artificial tears
• Allergen exclusion

Question 23

what are examples of how to achieve allergen avoidance/exclusion? (there are a fair few)

Answer 23

• Limit outdoor activity,
• use AC
• reduce humidity
• wear protective eyewear
• barrier cover for mattress and pillows
• occlusive glasses
• induced ptosis (only in severe cases)

Question 24

What is some pharmacological management options for seasonal/perennial allergic conjunctivitis?

Answer 24

-Antihistamines
- Mast cell stabilisers (sodium cromoglicate)
- Combination of antihistamines and mast cells stabilisers

Question 25

What is the aetiology of giant papillary conjunctivitis?

Answer 25

- Contact lens wear (mechanically induced) - Exposed sutures - Filtration bleb (trabeculectomy)

Question 26

When are predisposing factors of giant papillary conjunctivitis ?

Answer 26

-History of atopy - Poor lens hygiene (build up of protein deposits

Question 27

What key symptoms of giant papillary conjunctivitis ?

Answer 27

- Mild irritation - Itching - Increased lens awareness

Question 28

What are signs of giant papillary conjunctivitis ?

Answer 28

- Papillae variable in size and position - Tops of papillae stained with Fluorescein - Palpebral conjunctival hyperaemia - Increased mucus discharge - Protein deposits on the contact lens

Question 29

What is the management of giant papillary conjunctivitis ?

Answer 29

- Lens hygiene - Disposable lenses - Mast cell stabilisers

Question 30

What is the aetiology of conjunctivitis medicamentosa?

Answer 30

Can be caused by eye drops or cosmetics applied to the eye lids

Question 31

What are signs of conjunctivitis medicamentosa?

Answer 31

- Lid oedema - Chemosis - Follicular conjunctivitis (not papillae )

Question 32

What are symptoms of conjunctivitis medicamentosa ?

Answer 32

- Burning - Stinging - Epiphora

Question 33

What is the management of conjunctivitis medicamentosa?

Answer 33

- Identify and withdraw allergen - Systemic anti-histamines

Question 34

What is the aetiology of atopic keratoconjunctivitis ?

Answer 34

- VKC for adults - young M px's - perennial (all year)

Question 35

What are predisposing factors of atopic keratoconjunctivitis ?

Answer 35

Atopic history (disorders relating to allergy)like asthma and eczema

Question 36

What are symptoms of atopic keratoconjunctivitis ?

Answer 36

- Itching - Epiphora - Blurred vision - Mucus discharge

Question 37

What are signs of atopic keratoconjunctivitis ?

Answer 37

- Eyelids thickened, crusted - Bleph - Conjucntival hyperaemia - Corneal involvement

Question 38

Where is atopic keratoconjunctivitis managed?

Answer 38

secondary care (can be managed if mild and no corneal involvement)

Question 39

How is atopic keratoconjunctivitis managed?

Answer 39

- Mild= sodium cromoglicate - severe= referred for steroids, immunosuppressants, antibiotic - both= good lid hygiene

Question 40

What is the aetiology of vernal keratoconjunctivitis?

Answer 40

- Allergic disorder for children

Question 41

What are predisposing factors of vernal keratoconjunctivitis ?

Answer 41

1. Onset <10 yrs old 2. Worse in spring 3. Atopic history

Question 42

What are four symptoms of vernal keratoconjunctivitis ?

Answer 42

- Itching - Epiphora - Blurred vision- due to corneal involvement - Photophobia

Question 43

What are signs of vernal keratoconjunctivitis? (there are 9)

Answer 43

- Mucus discharge - Giant papillae - Hypereamia - Trantas dots - Punctate corneal staining - Erosion - Plaque - Scarring of the cornea along visual axis (this is the sight threatening complication)

Question 44

What is the management of vernal keratoconjunctivitis ?

Answer 44

- Cold compress - Mast cell stabilisers (MORE LIKELY MANAGEMENT) - Corticosteroids - Mucolytics (drugs that break down mucus) - Ciclosporin (verkasia)

Question 45

what is a mucolytic?

Answer 45

drugs that breaks down the extensive mucus formed

Question 46

how does ciclosporin work?

Answer 46

Immunosuppressant that works on T-cells

Question 47

what else is conjunctivitis medicamemntosa known as?

Answer 47

contact Dermatoconjunctivitis

Question 48

what is a corneal plaque?

Answer 48

collection of mucus, epithelial cells, lipid, and proteinaceous debris attached to corneal epithelium.