A 45-year-old man presented with the complaints of frequent change in glass prescriptions over the past 5 years. Erythema, dryness, and scaling were noted over both eyelids and the face. [ncbi.nlm.nih.gov]

In conclusion, AKC presents with a spectrum of mild to severe inflammatory manifestations. [openarchive.ki.se]

It affects around 10%–20% of the population, with hay fever, allergic asthma, and atopic dermatitis being the most common presentations. [jcrsmed.org]

• Falling

  Vernal keratoconjunctivitis typically reappears each spring and subsides in the fall and winter. Many children outgrow the condition by early adulthood. [merckmanuals.com]

  Allergic association is noted by a somewhat bimodal of spring and fall onset of symptoms. No genetic studies have been performed to date. References Liu G Keane-Myers A, Miyazaki D, Tai A, Ono SJ. [worldallergy.org]

  These poor responders to antihistamine therapy appear to fall into two groups: chronic allergics and seasonal allergics. [oraclinical.com]

• Burning Pain

  Allergic diseases that affect the eyes, also called ocular allergies, are a heterogeneous group of diseases that present a wide spectrum of symptoms: redness, itching, burning, pain and even intolerance to light (photophobia). [sylentis.com]

• Nausea

  […] is most pronounced in a ring at the limbus (the border of the cornea and the sclera ) Photophobia (light sensitivity) Severe foreign body sensation that prevents the patient from keeping the eye open Corneal opacity Fixed pupil Severe headache with nausea [dermnetnz.org]

• Dermatitis

  Topical immunomodulators such as tacrolimus have revolutionized the treatment of atopic dermatitis. [ncbi.nlm.nih.gov]

  In Atopic Dermatitis & Eczematous Disorders, the authors discuss all clinical aspects and treatment of atopic dermatitis and other eczema variants, including: Seborrheic dermatitis Nummular eczema Stasis dermatitis Exfoliative erythroderma HIV-related [books.google.com]

• Ulcer

  Recurrent or persistent corneal erosions and ulcerations are typical complications of atopic keratoconjunctivitis. [ncbi.nlm.nih.gov]

• Eczema

  Both treatments were effective in reducing signs and symptoms of eyelid eczema, with a near superior benefit for tacrolimus in terms of eczema (total skin score) signs (P=0.05). [ncbi.nlm.nih.gov]

  In study II, treatment of eyelid eczema with either tacrolimus ointment or potent steroid ointment was analysed, with the objective to evaluate possible ocular effects. [openarchive.ki.se]

  I believe that this Handbook of Atopic Eczema Since atopic eczema first emerged as a disease entity in will not only enhance our ability to treat our patients, but the early decades of this century, it has been the subject will also stimulate our efforts [books.google.com]

• Pruritus

  […] thinning, infection, keratoconus, and vision loss Atopic keratoconjunctivitis: eyelid tightening, loss of eyelashes, cataracts Giant papillary conjunctivitis : eyelid inflammation and ptosis Clinical features History of allergy, asthma, or eczema Itching (pruritus [pathologyoutlines.com]

  It also exerts mast-cell stabilizing and anti-inflammatory effects. [1] Non-steroidal anti-inflammatory drug (NSAIDs) NSAIDs inhibit the synthesis of prostaglandin D2 and prostaglandin E2 and reduce the conjunctival hyperemia and the pruritus. [explainmedicine.com]

  Patients present with symptoms of pruritus, burning sensation of lids, and lacrimation. It is usually a bilateral disease with majority of the patients having associated lid lesions such as eczema, blepharitis, trichiasis, and meibomitis. [jcrsmed.org]

  The antihistamine is effective for the acute onset and reduces pruritus. These are generally not for continuous long term use, and several preparations are used in courses of limited duration. [aimu.us]

• Photophobia

  It was found that medrysone (1%) significantly improved the symptoms of itching, watering, photophobia and hyperaemia, while sodium cromoglycate (2%) was found to be ineffective. [ncbi.nlm.nih.gov]

  Symptoms include: Intense itching Tearing of the eyes The production of ropy mucus The feeling that there is something in the eye Photophobia Examination reveals red eyes with swollen eyelids. [news-medical.net]

• Lacrimation

  Eye tear system anatomy, (Description) a. tear gland / lacrimal gland, b. superior lacrimal punctum, c. superior lacrimal canal, d. tear sac / lacrimal sac, e. inferior lacrimal punctum, f. inferior lacrimal canal, g. nasolacrimal canal. [emedicine.medscape.com]

  Lacrimal duct An endoscopic procedure for silicone tube placement and other surgical procedures are performed for nasolacrimal duct obstructions. [h.u-tokyo.ac.jp]

  Symptoms include itching, lacrimation, discharge, and conjunctival hyperemia. Diagnosis is clinical. Treatment is with topical antihistamines and mast cell stabilizers. [merckmanuals.com]

  Epidemic keratoconjunctivitis v t e Diseases of the human eye ( H00–H59 360–379 ) Adnexa Eyelid Inflammation Stye Chalazion Blepharitis Entropion Ectropion Lagophthalmos Blepharochalasis Ptosis Blepharophimosis Xanthelasma Eyelash Trichiasis Madarosis Lacrimal [en.wikipedia.org]

• Conjunctival Disease

  Evaluation of the relative percentages of inflammatory cells in brush cytology samples is a useful method of assessing disease activity in allergic conjunctival disease. [ncbi.nlm.nih.gov]

  Atopic keratoconjunctivitis (AKC) is a chronic allergic inflammatory disease that is at the severe end of a spectrum of allergic conjunctival diseases. [ingentaconnect.com]

  Japanese guideline for allergic conjunctival diseases. Allergol Int. 2011;60(2): 191-203. 2 Bonini S, Sacchetti M, Mantelli F, Lambiase A. Clinical grading of vernal keratoconjunctivitis. [cehjournal.org]

  Keywords Atopic dermatitis Atopic keratoconjunctivitis Kocuria keratitis Shield ulcer Background Atopic keratoconjunctivitis (AKC) is a severe chronic allergic conjunctival disease often associated with atopic facial dermatitis. [aacijournal.biomedcentral.com]

• Excessive Tearing

  Methods: The patient complained of bilateral red, itchy eyes, decreased vision, photophobia, difficulty opening the eyelids upon awakening, palpebral edema, excessive tearing, along with yellowish mucous discharge. [ncbi.nlm.nih.gov]

  Associated symptoms include: Redness Chemosis Eyelid swelling A clear discharge due to excessive tear production Mucous discharge A burning sensation Dark circles under the eyes, known as allergic shiners Photophobia The itching may cause repeated rubbing [news-medical.net]

  Multiple causes can produce either inadequate tear production or abnormal tear film constitution, resulting in excessively fast evaporation or premature destruction of the tear film. [emedicine.medscape.com]

• Visual Impairment

  impairment Anopsia Hemianopsia binasal bitemporal homonymous Quadrantanopia subjective Asthenopia Hemeralopia Photophobia Scintillating scotoma Pupil Anisocoria Argyll Robertson pupil Marcus Gunn pupil Adie syndrome Miosis Mydriasis Cycloplegia Parinaud's [en.wikipedia.org]

  Discussion VKC is a chronic, seasonally exacerbated allergic inflammation of the ocular surface involving the tarsal and/or the bulbar conjunctiva. [5] VKC is not a blinding disease but visual impairment is common if the cornea is involved. [tjmrjournal.org]

  AKC like vernal keratoconjunctivitis, is a severe inflammatory disease, which may involve cornea and can cause permanent visual impairment. The highest incidence of visual loss is therefore, found in AKC, the most chronic of these disorders. [aimu.us]

[…] tear breakup time (TBUT) The Schirmer test Tear meniscus height Quantification of tear components through analysis of tear proteins Impression cytology to monitor progression of ocular surface changes Additional tests that may be used in a research workup [emedicine.medscape.com]

Cyclosporin A is effective in the treatment of atopic dermatitis and keratoconjunctivitis. [ncbi.nlm.nih.gov]

CONCLUSIONS: Adequate topical immunomodulation using topical calcineurin inhibitors may eliminate the need for steroids and favorably alter the long-term prognosis of patients with AKC. [ncbi.nlm.nih.gov]

Prognosis The prognosis and outcomes in AKC depend on whether the condition was treated and managed promptly or whether it progresses. [myvmc.com]

Conclusion Clinicians should be aware of Kocuria keratitis as a corneal complication of AKC, and that rapid diagnosis of Kocuria keratitis may improve visual prognosis. [aacijournal.biomedcentral.com]

Prognosis Atopic keratoconjunctivitis (AKC) may result in decreased vision or blindness from corneal complications, such as chronic superficial punctate keratitis, persistent epithelial defects, corneal scarring or thinning, keratoconus, cataracts, and [emedicine.medscape.com]

“It is important to make this distinction because the prognosis is different. Vernal keratoconjunctivitis stops in adulthood, while atopic vernal keratoconjunctivitis is a lifelong disease. [eurotimes.org]

Differentiating Features in Acute Conjunctivitis Etiology Discharge/Cell Type Eyelid Edema Node Involvement Itching Bacterial Purulent/polymorphonuclear leukocytes Moderate Usually none None Viral Clear/mononuclear cells Minimal Often present None Allergic [merckmanuals.com]

(Etiology) Atopic Keratoconjunctivitis is caused by exposure to external agents or particles that cause an allergic inflammatory response. [dovemed.com]

Etiology The International Dry Eye WorkShop (DEWS) developed a 3-part classification of dry eye based on etiology, mechanisms, and disease stage. [1] This classification system distinguishes 2 main categories (or causes) of dry eye states, as follows: [emedicine.medscape.com]

Patients with asthma, hay fever or animal allergies may be at greater risk for GPC; its etiology may be immunological, where contact lens deposits act as allergens. [oraclinical.com]

[…] study designs should include adequate randomisation and concealment of allocation; masking of participants, personnel and outcome assessors; adequate follow-up periods and minimisation of attrition bias; and comparison groups with similar clinical and epidemiologic [ncbi.nlm.nih.gov]

Epidemiologic studies have consistently demonstrated strong associations between rhinitis and asthma. [psoriasiseczema.com.au]

The epidemiology of allergic eye diseases is reported in eye clinic based studies observing the proportion of all patients seen who have an allergic eye disease. [worldallergy.org]

The epidemiology of ocular and nasal allergy in the United States, 1988-1994. Journal of Allergy and Clinical Immunology. 2010;126(4):778-783. ↑ Bielory B and Bielory L. Atopic dermatitis and keratoconjunctivitis. [eyewiki.aao.org]

Diagnosis: Atopic Keratoconjunctivitis Epidemiology Males > Females Predominately presents between the late teenage years and the fifth decade of life[1] Spontaneous resolution in elderly Associated with atopic dermatitis in 95% of cases[2] Associated [webeye.ophth.uiowa.edu]

We hypothesized that S. aureus-secreted enterotoxins (SE) are involved in the pathophysiology of atopic keratoconjunctivitis (AKC). [ncbi.nlm.nih.gov]

The pathophysiology of AKC has not been fully elucidated, and the triggers are still unknown. Corticosteroids are very effective in controlling the acute symptoms of AKC. [clinicaltrials.gov]

Despite much current research interest, the pathophysiology of these disorders and their optimum treatment remain uncertain. [books.google.com]

Prevent aggravation of the condition by staying out of the sun, keeping away from dust and smoke. [dovemed.com]

More information Atopic Keratoconjunctivitis (AKC) Prevention The general principle for preventing all allergies is to avoid the triggers. [myvmc.com]

Pediatric AKC requires appropriate and aggressive treatment to prevent sight-threatening corneal complications. Systemic immunosuppressant should be considered when traditional topical anti-inflammatory therapies have failed. [ncbi.nlm.nih.gov]

The investigators hypothesize that cyclosporine A can be used as a mainstay treatment of AKC to control signs and symptoms over a long period of time and also prevent the progression of this disease. [clinicaltrials.gov]