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Pronunciations conjunctivitis corticosteroid eczema episcleritis mucus scleritis trachoma

Allergic conjunctivitis is inflammation of the conjunctiva caused by an allergic reaction.

• Allergic reactions may inflame the conjunctiva.
• Redness, irritation, swelling, and discharge are common.
• Various eye drops may help decrease inflammation.

The conjunctiva contains a large number of cells from the immune system (mast cells) that release chemical substances (mediators) in response to a variety of stimuli (such as pollens or dust mites). These mediators cause inflammation in the eyes, which may be brief or long-lasting. About 20% of people have some degree of allergic conjunctivitis.

Seasonal allergic conjunctivitis and perennial allergic conjunctivitis are the most common types of allergic reaction in the eyes. Seasonal allergic conjunctivitis is often caused by tree or grass pollens, leading to its typical appearance in the spring and early summer. Weed pollens are responsible for symptoms of allergic conjunctivitis in the summer and early fall. Perennial allergic conjunctivitis occurs year-round and is most often caused by dust mites, animal dander, and feathers.

Vernal conjunctivitis is a more serious form of allergic conjunctivitis in which the stimulant (allergen) is not known. The condition is most common among boys, particularly those aged 5 to 20 years who also have eczema, asthma, or seasonal allergies. Vernal conjunctivitis typically reappears each spring and subsides in the fall and winter. Many children outgrow the condition by early adulthood.

Symptoms

People with all forms of allergic conjunctivitis develop intense itching and burning in both eyes. Although usually equal, occasionally one eye may be more affected than the other. The conjunctiva becomes red and sometimes swells, giving the surface of the eyeball a puffy appearance that many people find disturbing. With seasonal and perennial conjunctivitis, there is a large amount of thin, watery discharge. At times the discharge is stringy. Vision is seldom affected. Many people have a runny nose.

With vernal conjunctivitis, the eye discharge is thick and mucuslike. Unlike other types of allergic conjunctivitis, vernal conjunctivitis often affects the cornea, and painful ulcers develop. These ulcers cause deep eye pain with exposure to bright light and sometimes lead to a permanent decrease in vision.

Diagnosis and Treatment

Doctors recognize allergic conjunctivitis by its typical appearance and symptoms. The condition is treated with anti-allergy eye drops. Tear supplements can help reduce symptoms. Drops that combine an antihistamine, such as antazoline or pheniramine Some Trade Names
TUSSIREX
, and a drug that constricts the eye blood vessels, such as naphazoline Some Trade Names
VASOCON
NAPHCON
, may be enough for mild cases. These drugs can be bought without a prescription. If they are ineffective, prescription anti-allergy eye drops may be effective. Nonsteroidal antiinflammatory eye drops have anti-inflammatory properties and help relieve symptoms. Corticosteroid eye drops have more potent anti-inflammatory effects; however, they should not be used for more than a few weeks without close monitoring because they may cause increased pressure in the eyes (glaucoma), cataracts, and an increased risk of eye infections.

Last full review/revision June 2008 by Mitchell H. Friedlaender, MD