Allergic conjunctivitis physical examination: Difference between revisions
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{{CMG}} | {{CMG}} {{AE}} {{Sujaya}} | ||
==Overview== | ==Overview== | ||
[[Conjunctival]] [[hyperemia]] and [[discharge]] are found in the majority of patients on [[clinical]] examination. Specific signs include [[Horner-Tranta's]] dots, shield [[ulcers]] and [[cobblestone]] appearance in [[VKC]], [[sandpaper]] like [[eyelid]] texture in [[AKC]], and giant [[conjunctival]] [[papillae]] in [[GPC]]. | |||
==Physical Examination== | ==Physical Examination== | ||
===SAC and PAC<ref name="pmid21822130">{{cite journal| author=Friedlaender MH| title=Ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2011 | volume= 11 | issue= 5 | pages= 477-82 | pmid=21822130 | doi=10.1097/ACI.0b013e32834a9652 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21822130 }} </ref>=== | ===SAC and PAC<ref name="pmid21822130">{{cite journal| author=Friedlaender MH| title=Ocular allergy. | journal=Curr Opin Allergy Clin Immunol | year= 2011 | volume= 11 | issue= 5 | pages= 477-82 | pmid=21822130 | doi=10.1097/ACI.0b013e32834a9652 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21822130 }} </ref>=== | ||
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===GPC=== | ===GPC=== | ||
* Giant [[papillae]] covering the [[tarsal]] [[conjunctiva]] | * Giant [[papillae]] covering the [[tarsal]] [[conjunctiva]] | ||
Rest of the [[clinical]] findings are similar to VKC without [[corneal]] involvement<ref name="pmid18769199">{{cite journal| author=Elhers WH, Donshik PC| title=Giant papillary conjunctivitis. | journal=Curr Opin Allergy Clin Immunol | year= 2008 | volume= 8 | issue= 5 | pages= 445-9 | pmid=18769199 | doi=10.1097/ACI.0b013e32830e6af0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18769199 }} </ref>. | * Rest of the [[clinical]] findings are similar to VKC without [[corneal]] involvement<ref name="pmid18769199">{{cite journal| author=Elhers WH, Donshik PC| title=Giant papillary conjunctivitis. | journal=Curr Opin Allergy Clin Immunol | year= 2008 | volume= 8 | issue= 5 | pages= 445-9 | pmid=18769199 | doi=10.1097/ACI.0b013e32830e6af0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18769199 }} </ref>. | ||
==References== | ==References== | ||
Latest revision as of 18:31, 10 September 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]
Overview
Conjunctival hyperemia and discharge are found in the majority of patients on clinical examination. Specific signs include Horner-Tranta's dots, shield ulcers and cobblestone appearance in VKC, sandpaper like eyelid texture in AKC, and giant conjunctival papillae in GPC.
Physical Examination
SAC and PAC[1]
- Mild to moderate conjunctival injection
- Conjunctival chemosis, more than expected for a particular degree of redness
VKC
- ‘Cobblestone-like’ giant papillae on flipping the upper tarsal conjunctiva, sometimes with a tenacious mucous discharge[2]
- Central Punctate epithelial keratitis (keratitis epithelialis vernalis of El Tobgy). The dots may coalesce to form a whitish or grayish plaque beneath the epithelium which interfere with vision and lead to central corneal scarring.
- Tranta’s dots: Clumps of necrotic eosinophils, neutrophils, and epithelial cells[3]. They tend to disappear when symptoms abate[1].
- Shield ulcers in the superior sectors of the cornea : Noninfectious, oval-shaped, circumscribed epithelial ulcer with underlying stromal opacification[4]
AKC[5]
- Red, elevated, eczematous lesions on the eyelids, or any place on the body.
- Fine sandpaper-like texture of the eyelid skin
- Conjunctival injection and chemosis with giant papillae
- Conjunctival scarring
- Atopic cataracts
GPC
- Giant papillae covering the tarsal conjunctiva
- Rest of the clinical findings are similar to VKC without corneal involvement[6].
References
- ↑ 1.0 1.1 Friedlaender MH (2011). "Ocular allergy". Curr Opin Allergy Clin Immunol. 11 (5): 477–82. doi:10.1097/ACI.0b013e32834a9652. PMID 21822130.
- ↑ Bielory L, Frohman LP (1992). "Allergic and immunologic disorders of the eye". J Allergy Clin Immunol. 89 (1 Pt 1): 1–15. doi:10.1016/s0091-6749(05)80033-8. PMID 1730829.
- ↑ Kumar S (2009). "Vernal keratoconjunctivitis: a major review". Acta Ophthalmol. 87 (2): 133–47. doi:10.1111/j.1755-3768.2008.01347.x. PMID 18786127.
- ↑ La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S; et al. (2013). "Allergic conjunctivitis: a comprehensive review of the literature". Ital J Pediatr. 39: 18. doi:10.1186/1824-7288-39-18. PMC 3640929. PMID 23497516.
- ↑ Bielory B, Bielory L (2010). "Atopic dermatitis and keratoconjunctivitis". Immunol Allergy Clin North Am. 30 (3): 323–36. doi:10.1016/j.iac.2010.06.004. PMID 20670816.
- ↑ Elhers WH, Donshik PC (2008). "Giant papillary conjunctivitis". Curr Opin Allergy Clin Immunol. 8 (5): 445–9. doi:10.1097/ACI.0b013e32830e6af0. PMID 18769199.