Allergic conjunctivitis: Difference between revisions
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*Conjunctivitis due to exposure to an allergen | *Conjunctivitis due to exposure to an allergen | ||
*Chronic allergic conjunctivitis is also called vernal conjunctivitis | *Chronic allergic conjunctivitis is also called vernal conjunctivitis | ||
{{Conjunctivitis DDX}} | |||
==Clinical Features== | ==Clinical Features== | ||
[[File:PMC4396420 opth-9-575Fig1.png|thumb|Bilateral allergic contact dermatitis caused by eyedrops (left) and after resolution (right).]] | |||
[[File:PMC3640929 1824-7288-39-18-1.png|thumb|Seasonal allergic conjunctivitis. Inverted eyelid showing mild conjunctival injection and moderate chemosis.]] | |||
[[File:PMC3047907 jaa-3-149f1.png|thumb|Acute allergic conjunctivitis.]] | [[File:PMC3047907 jaa-3-149f1.png|thumb|Acute allergic conjunctivitis.]] | ||
[[File:PMC3047907 jaa-3-149f2.png|thumb|Chronic allergic conjunctivitis.]] | [[File:PMC3047907 jaa-3-149f2.png|thumb|Chronic allergic conjunctivitis.]] | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{ | {{Unilateral red eye DDX}} | ||
{{Bilateral Red Eyes}} | |||
==Evaluation== | ==Evaluation== | ||
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==Management== | ==Management== | ||
*'''Mild''': avoid triggers, cool compresses for 15 minutes QID | *'''Mild''': avoid triggers, cool compresses for 15 minutes QID | ||
*'''Moderate''': Histamine-blocking drops (e.g. olopatadine, pemirolast, or ketotifen) | *'''Moderate''': Histamine-blocking drops (e.g. naphazoline/pheniramine 0.025%/0.3%, olopatadine, pemirolast, or ketotifen) | ||
*'''Severe''': refer to ophthalmology for possible [[Steroids|steroid]] therapy | *'''Severe''': refer to ophthalmology for possible [[Steroids|steroid]] therapy | ||
Latest revision as of 17:14, 4 February 2026
Background
- Conjunctivitis due to exposure to an allergen
- Chronic allergic conjunctivitis is also called vernal conjunctivitis
Conjunctivitis Types
Clinical Features
- Itching
- Watery discharge
- Injected and edematous conjunctiva
- Papillae on inferior conjunctival fornix
- Red, swollen eyelids
Differential Diagnosis
Unilateral red eye
- Nontraumatic
- Acute angle-closure glaucoma^
- Anterior uveitis
- Conjunctivitis
- Corneal erosion
- Corneal ulcer^
- Endophthalmitis^
- Episcleritis
- Herpes zoster ophthalmicus
- Inflamed pinguecula
- Inflamed pterygium
- Keratoconjunctivitis
- Keratoconus
- Nontraumatic iritis
- Scleritis^
- Subconjunctival hemorrhage
- Orbital trauma
- Caustic keratoconjunctivitis^^
- Corneal abrasion, Corneal laceration
- Conjunctival hemorrhage
- Conjunctival laceration
- Globe rupture^
- Hemorrhagic chemosis
- Lens dislocation
- Ocular foreign body
- Posterior vitreous detachment
- Retinal detachment
- Retrobulbar hemorrhage
- Traumatic hyphema
- Traumatic iritis
- Traumatic mydriasis
- Traumatic optic neuropathy
- Vitreous detachment
- Vitreous hemorrhage
- Ultraviolet keratitis
^Emergent diagnoses
^^Critical diagnoses
Bilateral red eyes
- Painful
- Painless
Evaluation
Clinical diagnosis of conjunctivitis^
| Bacterial | Viral | Allergic | |
|---|---|---|---|
| Bilateral | 50% | 25% | Mostly |
| Discharge | Mucopurulent | Clear, Watery | Cobblestoning, none |
| Redness | Yes | Yes | Yes |
| Pruritis | Rarely | Rarely | Yes |
| Increased Likelihood | Presence of mucopurulent discharge; otitis media | Concomitant pharyngitis; an enlarged preauricular node; contact with another person with red eye | NA |
| Additional | Treatment: Antibiotics | Treatment: Hygiene | Seasonal |
Management
- Mild: avoid triggers, cool compresses for 15 minutes QID
- Moderate: Histamine-blocking drops (e.g. naphazoline/pheniramine 0.025%/0.3%, olopatadine, pemirolast, or ketotifen)
- Severe: refer to ophthalmology for possible steroid therapy
Disposition
- Discharge with ophthalmology follow-up