Allergic conjunctivitis natural history, complications and prognosis: Difference between revisions
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{{CMG}} {{AE}} {{Sujaya}} | {{CMG}} {{AE}} {{Sujaya}} | ||
==Overview== | ==Overview== | ||
[[Allergic]] [[conjunctivitis]] is usually a non-progressive [[condition]] with a favorable [[prognosis]], and rare but serious [[complications]]. Most [[symptoms]] are self-limiting, while in some subtypes, a temporal association can be found with the age group and specific [[triggers]]. | |||
[[Complications]] include [[infections]], [[scarring]] and can also damage the [[cornea]] and [[eyelids]]. | |||
Long-term [[prognosis]] is influenced by the recurrence of the attacks and [[side-effects]] of [[treatment]]. | |||
==Natural History== | ==Natural History== | ||
===Simple [[allergic]] [[conjunctivitis]]=== | ===Simple [[allergic]] [[conjunctivitis]]=== | ||
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===[[Vernal]] [[Keratoconjunctivitis]]=== | ===[[Vernal]] [[Keratoconjunctivitis]]=== | ||
Complete resolution without the return of [[symptoms]] after adolescence is observed in a majority of patients. | Complete resolution without the return of [[symptoms]] after adolescence is observed in a majority of patients. | ||
===Atopic Keratoconjunctivitis=== | ===[[Atopic]] [[Keratoconjunctivitis]]=== | ||
Uncommon before adolescence and peaks from 30 to 50 years of age. Most cases coexist with [[atopic]] [[dermatitis]]. | Uncommon before adolescence and peaks from 30 to 50 years of age. Most cases coexist with [[atopic]] [[dermatitis]]. | ||
===Giant Papillary Conjunctivitis=== | ===Giant [[Papillary]] [[Conjunctivitis]]=== | ||
* A temporal relationship with contact lens use may explain the predominance of this variety in teens and young adults. | * A temporal relationship with contact lens use may explain the predominance of this variety in teens and young adults. | ||
* It manifests usually after one to two years of wearing soft contact lenses but varies widely with other ocular foreign bodies<ref name="pmid29846426">{{cite journal| author=Sen E, Celik S, Inanc M, Elgin U, Ozyurt B, Yılmazbas P| title=Seasonal distribution of ocular conditions treated at the emergency room: a 1-year prospective study. | journal=Arq Bras Oftalmol | year= 2018 | volume= 81 | issue= 2 | pages= 116-119 | pmid=29846426 | doi=10.5935/0004-2749.20180026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29846426 }} </ref>. | * It manifests usually after one to two years of wearing soft contact lenses but varies widely with other ocular foreign bodies<ref name="pmid29846426">{{cite journal| author=Sen E, Celik S, Inanc M, Elgin U, Ozyurt B, Yılmazbas P| title=Seasonal distribution of ocular conditions treated at the emergency room: a 1-year prospective study. | journal=Arq Bras Oftalmol | year= 2018 | volume= 81 | issue= 2 | pages= 116-119 | pmid=29846426 | doi=10.5935/0004-2749.20180026 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29846426 }} </ref>. | ||
==Complications== | ==Complications== | ||
In most cases, [[allergic]] [[conjunctivitis]] is a [[benign]] condition. [[Complications]] although rare,can be serious and include: | In most cases, [[allergic]] [[conjunctivitis]] is a [[benign]] condition. [[Complications]] although rare,can be serious and include: | ||
* [[Scarring]] of the [[eye]] in severe cases. | * [[Scarring]] of the [[eye]] in severe cases. | ||
* Progression to [[infective]] [[conjunctivitis]], leading to serious secondary [[infections]]. | * Progression to [[infective]] [[conjunctivitis]], leading to serious secondary [[infections]]. | ||
* [[Corneal]] [[opacification]] and [[ulceration]] in [[VKC]] and [[AKC]] | * [[Corneal]] [[opacification]] and [[ulceration]] in [[VKC]] and [[AKC]<ref name="pmid28493631">{{cite journal| author=Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H | display-authors=etal| title=Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. | journal=Allergy | year= 2017 | volume= 72 | issue= 11 | pages= 1597-1631 | pmid=28493631 | doi=10.1111/all.13201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28493631 }} </ref>] | ||
* Difficulty in wearing contact lenses due to significant [[ | * Difficulty in wearing contact lenses due to significant [[eyelid]] involvement<ref name="pmid28493631">{{cite journal| author=Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H | display-authors=etal| title=Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. | journal=Allergy | year= 2017 | volume= 72 | issue= 11 | pages= 1597-1631 | pmid=28493631 | doi=10.1111/all.13201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28493631 }} </ref> | ||
==Prognosis== | ==Prognosis<ref name="pmid28493631">{{cite journal| author=Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H | display-authors=etal| title=Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis. | journal=Allergy | year= 2017 | volume= 72 | issue= 11 | pages= 1597-1631 | pmid=28493631 | doi=10.1111/all.13201 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28493631 }} </ref>== | ||
* PAC and SAC demonstrate favorable long-term outcomes but, significant eye discomfort and poor ocular cosmesis may persist as long-term sequelae in many people. | * PAC and SAC demonstrate favorable long-term outcomes but, significant eye discomfort and poor ocular cosmesis may persist as long-term sequelae in many people. | ||
* Recurrences result in [[conjunctivochalasis]], which is a result of ongoing [[limba]] [[conjunctival]] [[chemosis]]. | * Recurrences result in [[conjunctivochalasis]], which is a result of ongoing [[limba]] [[conjunctival]] [[chemosis]]. | ||
Latest revision as of 18:21, 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
Allergic conjunctivitis is usually a non-progressive condition with a favorable prognosis, and rare but serious complications. Most symptoms are self-limiting, while in some subtypes, a temporal association can be found with the age group and specific triggers. Complications include infections, scarring and can also damage the cornea and eyelids. Long-term prognosis is influenced by the recurrence of the attacks and side-effects of treatment.
Natural History
Simple allergic conjunctivitis
Symptoms are often neglected, and resolve in many patients without medical care.
Vernal Keratoconjunctivitis
Complete resolution without the return of symptoms after adolescence is observed in a majority of patients.
Atopic Keratoconjunctivitis
Uncommon before adolescence and peaks from 30 to 50 years of age. Most cases coexist with atopic dermatitis.
Giant Papillary Conjunctivitis
- A temporal relationship with contact lens use may explain the predominance of this variety in teens and young adults.
- It manifests usually after one to two years of wearing soft contact lenses but varies widely with other ocular foreign bodies[1].
Complications
In most cases, allergic conjunctivitis is a benign condition. Complications although rare,can be serious and include:
- Scarring of the eye in severe cases.
- Progression to infective conjunctivitis, leading to serious secondary infections.
- Corneal opacification and ulceration in VKC and [[AKC][2]]
- Difficulty in wearing contact lenses due to significant eyelid involvement[2]
Prognosis[2]
- PAC and SAC demonstrate favorable long-term outcomes but, significant eye discomfort and poor ocular cosmesis may persist as long-term sequelae in many people.
- Recurrences result in conjunctivochalasis, which is a result of ongoing limba conjunctival chemosis.
- The medications may cause adverse reactions like cataracts.
References
- ↑ Sen E, Celik S, Inanc M, Elgin U, Ozyurt B, Yılmazbas P (2018). "Seasonal distribution of ocular conditions treated at the emergency room: a 1-year prospective study". Arq Bras Oftalmol. 81 (2): 116–119. doi:10.5935/0004-2749.20180026. PMID 29846426.
- ↑ 2.0 2.1 2.2 Dhami S, Nurmatov U, Arasi S, Khan T, Asaria M, Zaman H; et al. (2017). "Allergen immunotherapy for allergic rhinoconjunctivitis: A systematic review and meta-analysis". Allergy. 72 (11): 1597–1631. doi:10.1111/all.13201. PMID 28493631.