Keratoconjunctivitis atopic

Although there are five types of hypersensitivity responses, two of these, types 1 and 1 play a significant role in the pathophysiology of allergic eye disease. The ocular manifestations include seasonal allergic conjunctivitis (SAC), giant papillary conjunctivitis (GPC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis, contact dermatitis, and urticaria. These are discussed in Chapter 27. 

Figure 25-25 Papillary response of upper tarsal conjunctiva in a patient with atopic keratoconjunctivitis.

AKC = atopic keratoconjunctivitis FDA = U.S. Food and Drug Administration GI = gastrointestinal GPC = giant papillary conjrmctivitis OTC = over the cormter VKC = vernal keratoconjunctivitis URI = upper respiratory infection MAOI = monoamine oxidase inhibitor... 

AKC = atopic keratoconjunctivitis F = female GPC = giant papillary conjrmctivitis Ig = Itnmrmoglobulin M = Male n/a = not applicable OU prmctate keratopathy VKC = vernal keratoconjrmctivitis. 

AKC = atopic keratoconjunctivitis GPC = giant papUlary conjunctivitis NSAIDs = nonsteroidal anti-inflammatory drugs OTC = over the counter VKC = vernal keratoconjunctivitis. 

Topical corticosteroids are used in cases of exacerbation and should be applied sparingly to the affected area. Hydrocortisone 1% twice a day or dexamethasone 0.1% applied to the periorbital area helps to relieve symptoms during these periods. Secondary infection manifested as blepharitis or keratoconjimctivitis should be treated with topical ophthalmic antibiotic ointments such as bacitracin or erythromycin.Topical antihistamines, NSAIDs, or mast cell stabilizers can be used to control itching, and topical steroids are sometimes required to treat severe keratoconjunctivitis associated with the atopic response. Because of side effects, steroids are not indicated for longterm use. 

Akpek EK, Dart JK, Watson S, et al.A randomized trial of topical cyclosporin 0.05% in topical steroid-resistant atopic keratoconjunctivitis. Ophthalmol 2004 111 476-482. 

Hingorani M, Moodaley L, Calder VL, et al. A randomized, placebo-controUed trial of topical cyclosporine A in steroid-dependent atopic keratoconjunctivitis. Ophthalmology 1998 105 1715-1720. 

Hoang-Xuan T, Prisant O, Hannouche D, Robin H. Systemic cyclosporine A in severe atopic keratoconjunctivitis. Ophthalmology 1997 104 1300-1305. 

Power WJ, Tugal-Tutkun 1, Foster CS. Long-term foUow-up of patients with atopic keratoconjunctivitis. Ophthalmology 1998 105 637-642. 

Takano Y, Fukagawa K, Miyake-Kashima M, et al. Dramatic healing of an allergic corneal ulcer persistent for 6 months by amniotic membrane patching in a patient with atopic keratoconjunctivitis. Cornea 2004 23 723-725. 

Patients with AD can also present with eyelid dermatitis, nipple dermatitis, and cheilitis of the lips. Eyelid dermatitis and chronic blepharitis are commonly associated with AD, and can result in visual impairment from corneal scarring. Other ocular complications include atopic keratoconjunctivitis, vernal conjunctivitis, and keratoconus. ... 

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