Allergic conjunctivitis - External and Internal Eye
Alerts and Notices
Synopsis
Typical symptoms of allergic conjunctivitis include swollen eyelids, mucoid discharge, and intense ocular itching. Itching is the most commonly reported symptom, and patients may also complain of a feeling of dirt or sand in the eyes. At times, the edema of the eyelids can be quite severe and be associated with scaling and fissure formation of the periocular skin.
Atopic keratoconjunctivitis (AKC), giant papillary conjunctivitis (GPC), and limbal and tarsal vernal keratoconjunctivitis (VKC) are rarer, more severe forms of allergic conjunctivitis. Although GPC may be recurrent, it does not carry as great a risk of long-term corneal damage and vision loss as AKC and VKC. People with other forms of atopic disease are more likely to develop AKC or VKC, often associated with atopic dermatitis and allergic rhinitis, respectively. Some of these forms of allergic conjunctivitis are discussed in more detail elsewhere; this writeup will focus on seasonal and perennial disease.
Codes
ICD10CM:H10.10 – Acute atopic conjunctivitis, unspecified eye
H10.45 – Other chronic allergic conjunctivitis
SNOMEDCT:
473460002 – Allergic Conjunctivitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Viral conjunctivitis
- Bacterial conjunctivitis
- Toxic conjunctivitis
- Contact dermatitis
- Other subtype of severe allergic conjunctivitis – GPC, AKC, or VKC
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:08/25/2019
Last Updated:08/17/2021
Last Updated:08/17/2021
Patient Information for Allergic conjunctivitis - External and Internal Eye
Overview
Allergic conjunctivitis is one type of "pink eye" (conjunctivitis). Conjunctivitis is simply an inflammation of the tissue on the surface of the eye and/or the inside lining of the eyelids. The more common causes of pink eye include:- Infection (viruses, bacteria)
- Inflammatory causes such as chemicals, fumes, dust, and debris
- Allergies
- Injuries
- Oral-genital contact with someone who might be infected with a sexually transmitted disease (STD) such as chlamydia, gonorrhea, or herpes
Who’s At Risk
Allergic conjunctivitis is very common all over the world. Allergic conjunctivitis is often caused by an irritant in the eye(s). Age, sex, ethnicity, and race play no role in who develops pink eye. Failure to do the following increases your chances of getting allergic conjunctivitis:- Follow good hygiene, such as washing hands regularly.
- Use proper eye protection when in conditions that might increase your risk, such as working in dusty or fume-filled areas.
- Avoid allergic influences that might affect you, such as perfumes, weeds, mold, etc.
Signs & Symptoms
The eye is usually pink to red with an irritated appearance. There may or may not be a discharge (tears, mucous, or pus), and there may be sensitivity to bright light. There may be burning, itching, a sandy or gravely feeling, and even pain. Vision might be blurred by the mucous or excess tears in the eye(s). Allergic conjunctivitis typically affects both eyes.Self-Care Guidelines
- If itching is the most irritating feature, apply cold compresses.
- If swelling is bothersome, apply cold compresses.
- If there is a lot of discharge, especially if mucous-like, use warm compresses.
- If there is aching and/or pain, use warm compresses.
- Wash the eyelids very gently and soak off debris; do not pick at it.
- Never rub the eyes, as this can worsen the problem.
When to Seek Medical Care
- Pain is increasing.
- Vision is worsening.
- There is blistering and/or rash on the eyelids.
- Swelling is increasing.
- There is a lot of thick mucous secreting.
- The condition is not getting better within a week.
Treatments
Topical anti-inflammatory and anti-allergy drops may all be prescribed by your doctor. If the conjunctivitis is recurring frequently, it may be related to another disease elsewhere in the body (such as a respiratory disease, an autoimmune disease, or an STD); that disease will need treatment as well.Allergic conjunctivitis - External and Internal Eye