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Atopic Conjunctivitis - Allergic Conjunctivitis


Overview, Causes, & Risk Factors

Allergic conjunctivitis is swelling and redness of the membrane that lines the eye. It is caused by exposure to foreign matter. The affected part of the eye is called the conjunctiva. The conjunctiva is the mucous membrane layer that covers the white part of the eye.

What are the causes and risks of the condition?

Pollen is often the cause of the problem. Other vegetable proteins, animal proteins, dust and fungus spores can cause it, too. Sometimes the allergic reaction can happen within minutes. Other times the reaction can be delayed for hours or days. This problem seems to affect people who have other allergy problems. These include eczema, asthma, hay fever or hives.

Other common causes of allergic conjunctivitis are exposure to animal hair, such as cat hair, or feathers.

A less common form of allergic conjunctivitis comes from bacteria on the eyelid or skin. The cause is often the staphylococcus bacteria. This type of allergy may lead to styes, which are pimple-like infections of the glands in the eyelid. It may also cause chalazions, which are blockages of the oil glands in the eyelid. Long-term problems related to allergies in the eye rarely occur. However, if uncontrolled, the problem can spread to other parts of the eye, such as the cornea and the space between the cornea and the iris. This can cause inflammation of the iris, which is the colored part of the eye.


Symptoms & Signs

What are the signs and symptoms of the condition?

Usual symptoms include:

  • swelling of the conjunctiva
  • redness
  • itching
  • watery or mucous discharge
  • The condition can also spread to the eyelids. The eyelids, as well, may become red with thickening, dryness and scaling of the skin.


    Diagnosis & Tests

    How is the condition diagnosed?

    People often think they have allergic conjunctivitis because their eyes are red, itchy or watery. These are also symptoms of hay fever. In more complex cases, the doctor uses a microscope to find signs of an allergy. Tiny bumps on the white part of the eye indicate that an allergy is present. This distinguishes it from bacterial or viral conjunctivitis.


    Prevention & Expectations

    What can be done to prevent the condition?

    The problem can be prevented by avoiding the material that causes the allergic reaction. Medications or preservatives in eye drops or contact lens solutions might make some people more sensitive. Air filters and air conditioners can reduce dust and allergens in the air. Avoiding dust and animal hair is also important.

    What are the long-term effects of the condition?

    Usually there are no long-term effects when allergic conjunctivitis is managed properly.

    What are the risks to others?

    This condition cannot be passed to others.


    Treatment & Monitoring

    What are the treatments for the condition?

    Using nonprescription antihistamine eye drops can help some symptoms. In more difficult cases, prescription medications can be used. These are nonsteroidal anti-inflammatory drops such as ketorolac, prescription antihistamine eye drops, such as olopatadine or emedastine, or low-dose steroid drops such as loteprednol or fluorometholone. Oral antihistamines such as diphenhydramine, loratadine, or fexofenadine may also help. Allergy shots may help desensitize some people. These are given by an allergy specialist. Topical anesthetic such as tetracaine drops should not be used. They damage the cornea. Contact lenses become hard to wear during episodes of allergic conjunctivitis. Sometimes cool compresses will ease symptoms.

    What are the side effects of the treatments?

    Antihistamine eye drops should be used sparingly. The drops should be used no more than 4 times a day. If corticosteroid eye drops such as loteprednol or fluorometholone are used, an eye doctor should be seen periodically. Long-term use can carry the risk of a rise in the pressure inside of the eye. It may also lead to cataracts, or a clouding of the lens of the eye.

    What happens after treatment for the condition?

    Since this condition is related to exposure to allergens it is usually chronic, seasonal, and tends to recur. Therefore, at the sign of symptoms, treatment should be started again.

    How is the condition monitored?

    Most people are able to monitor their allergic conjunctivitis independently. If medications are used frequently, periodic checkups with a healthcare provider are advised.


    Attribution

    Author:William Stevens, MD
    Date Written:
    Editor:Keefe, Sandy, RN, MSN
    Edit Date:05/18/00
    Reviewer:Sal Sandoval, MD
    Date Reviewed:08/07/01


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