Symptoma

Atopic Keratoconjunctivitis

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]

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

  • Loss of Hair

    Alopecia areata is complete loss of hair patches on the hairy areas of the body in association with some ocular manifestations such as cataract, or disorders of the conjunctiva, iris, lens, choroid and retina pigment epithelium. [ncbi.nlm.nih.gov]

  • Noncompliance

    One patient was noncompliant and continued the treatment only for 7 months. During the median treatment period of 21.5 months for the 7 continuing patients, a total of only 2 flare-up episodes were noted requiring topical steroids. [ncbi.nlm.nih.gov]

  • Corneal Edema

    edema with a 8 mm 4 mm epithelial defect in the inferior part of the cornea, covered partially by the lied, that stained positive with fluorescein dyes. [ncbi.nlm.nih.gov]

  • Hypesthesia

    Cornea Corneal disease may be complicated by the late development of corneal hypesthesia in patients with AKC, resulting in a paradoxic reduction in surface symptoms, including itching. [clinicalgate.com]

[…] 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]

Application of tacrolimus 0.03% dermatologic ointment into the lower fornix seems to constitute an interesting alternative treatment for atopic keratoconjunctivitis that is refractory to traditional treatment. [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]

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

– Visual prognosis: Visual prognosis is worse for AKC. – Peri-orbital skin and eyelid: There is increased peri-orbital and eyelid skin involvement in AKC as compared to VKC which generally spare skin. – Papillae: AKC usually presents with micro-papillae [aimu.us]

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

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 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]

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 with [webeye.ophth.uiowa.edu]

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]

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

The possible pathophysiological significance of these findings is discussed. [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]

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]

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]