Acute Allergic Conjunctivitis

Question 1

Aetiology

Answer 1

When allergen comes into contact with conjunctiva, this can provoke an immediate Type 1 IgE mediated response.
Common in children.
Common allergens are grass pollen and animal dander.

Question 2

Predisposing factors

Answer 2

History of allergies, but can occur without history too

Question 3

Symptoms

Answer 3

Sudden onset of eyelid swelling and itching, unilateral.

Question 4

Signs

Answer 4

Eyelid oedema and erythema
Conjunctival hyperaemia and chemosis which can overhang lid margin
Watery mucoid discharge - mild
No corneal involvement
No papillae

Question 5

Non-pharmacological management

Answer 5

Reassure - symptoms get better in a few hours without treatment.
Cold compresses.
Avoid eye rubbing - mechanical mast cell degranulation

Question 6

Pharmacological

Answer 6

Usually none but you can give lubricants for symptomatic relief.
If recurrent, prophylactic topical MCS (sodium cromoglicate /lodoxamide) or combined AH+MCS (olopatadine / ketotifen) can be given

Question 7

Referral?

Answer 7

Usually none.