Allergic conjunctivitis physical examination: Difference between revisions
Jump to navigation
Jump to search
| (6 intermediate revisions by 2 users not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | __NOTOC__ | ||
{{Allergic conjunctivitis}} | {{Allergic conjunctivitis}} | ||
{{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== | |||
===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>=== | |||
* 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]]<ref name="pmid1730829">{{cite journal| author=Bielory L, Frohman LP| title=Allergic and immunologic disorders of the eye. | journal=J Allergy Clin Immunol | year= 1992 | volume= 89 | issue= 1 Pt 1 | pages= 1-15 | pmid=1730829 | doi=10.1016/s0091-6749(05)80033-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1730829 }} </ref> | |||
* 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<ref name="pmid18786127">{{cite journal| author=Kumar S| title=Vernal keratoconjunctivitis: a major review. | journal=Acta Ophthalmol | year= 2009 | volume= 87 | issue= 2 | pages= 133-47 | pmid=18786127 | doi=10.1111/j.1755-3768.2008.01347.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18786127 }} </ref>. They tend to disappear when [[symptoms]] abate<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>. | |||
* Shield [[ulcers]] in the superior sectors of the [[cornea]] : [[Noninfectious]], oval-shaped, circumscribed [[epithelial]] [[ulcer]] with underlying [[stromal]] [[opacification]]<ref name="pmid23497516">{{cite journal| author=La Rosa M, Lionetti E, Reibaldi M, Russo A, Longo A, Leonardi S | display-authors=etal| title=Allergic conjunctivitis: a comprehensive review of the literature. | journal=Ital J Pediatr | year= 2013 | volume= 39 | issue= | pages= 18 | pmid=23497516 | doi=10.1186/1824-7288-39-18 | pmc=3640929 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23497516 }} </ref> | |||
===AKC<ref name="pmid20670816">{{cite journal| author=Bielory B, Bielory L| title=Atopic dermatitis and keratoconjunctivitis. | journal=Immunol Allergy Clin North Am | year= 2010 | volume= 30 | issue= 3 | pages= 323-36 | pmid=20670816 | doi=10.1016/j.iac.2010.06.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20670816 }} </ref>=== | |||
* 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<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== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category: | [[Category:Ophthalmology]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Latest revision as of 18:31, 10 September 2022
|
Allergic conjunctivitis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Allergic conjunctivitis physical examination On the Web |
|
American Roentgen Ray Society Images of Allergic conjunctivitis physical examination |
|
Risk calculators and risk factors for Allergic conjunctivitis physical examination |
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.