Allergic conjunctivitis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Classification

SAC and PAC

Both seasonal allergic conjunctivitis and perennial allergic conjunctivitis are two acute allergic conjunctival disorders. SAC is the most common ocular allergy. Symptoms of the aforementioned ocular diseases include itching and pink to reddish eye(s). These two eye conditions are mediated by mast cells. Nonspecific measures to ameliorate symptoms include cold compresses, eyewashes with tear substitutes, and avoidance of allergens. Treatment consists of antihistamine, mast cell stabilizers, dual mechanism anti-allergen agents, or topical antihistamines. Corticosteroids are another option, but, considering the side-effects of cataracts and increased intraocular pressure, corticosteroids are reserved for more severe forms of allergic conjunctivitis such as vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC).

VKC and AKC

Both vernal keratoconjunctivitis and atopic keratoconjunctivitis are chronic allergic diseases wherein eosinophils, conjunctival fibroblasts, epithelial cells, mast cells, and TH2 lymphocytes aggravate the biochemistry and histology of theconjunctiva. VKC is a disease of childhood and is prevalent in males living in warm climates. AKC is frequently observed in males between the ages of 30 and 50. VKC and AKC can be treated by medications used to combat allergic conjunctivitis or the use of steroids.

Giant Papillary Conjunctivitis

Giant papillary conjunctivitis is not a true ocular allergic reaction and is caused by repeated mechanical irritation of the conjunctiva. Repeated contact with the conjunctival surface caused by the use of contact lenses is associated with GPC.

Phlyctenular Keratoconjunctivitis

PKC results from a hypersensitivity/inflammatory reaction to bacteria. Common pathogens include Staph. aureus, Mycobacterium tuberculosis, Chlamydia and Candida.