Understanding Conjunctivitis

Spring is just around the corner!  When the trees and grass begin to pollinate, allergy sufferers begin to sneeze, sniffle and itch not just in their nose, but also in their eyes. Eye (or ocular) allergies are common and may be very disabling.  There are four common types of ocular allergies:

  • Seasonal Allergic Conjunctivitis
  • Perennial Allergic Conjunctivitis
  • Atopic Keratoconjunctivitis
  • Vernal Conjunctivitis

Conjunctivitis refers to a part of the eye called the conjunctiva that becomes inflamed when triggered by an allergen. This inflammation may occur when a susceptible person is exposed to environmental allergens such as pollens, molds, house dust mites, animals and insects.

Seasonal Allergic Conjunctivitis
Seasonal Allergic Conjunctivitis is the most common type of allergic conjunctivitis. It is sometimes associated with seasonal allergic rhinitis, also known as seasonal allergies or hayfever.

Symptoms Include:

  • Itching
  • Redness
  • Tearing
  • Watery Discharge

Environmental control measures can be taken to avoid the allergens.

Pollen

  • Close windows and doors
  • Avoid window or attic fans
  • Reduce outdoor exposure to allergens by staying indoors when allergens are at their peak (usually in the morning)
  • Shampoo and shower following outdoor exposure to allergens

Molds

  • Avoid molds that may trigger a reaction by staying away from damp areas such as a basement, avoiding lawn mowing or raking leaves, and minimizing humidifier use

Perennial Allergic Conjunctivitis
Perennial Allergic Conjunctivitis differs from Seasonal Allergic Conjunctivitis because it lasts all year long and is triggered by environmental allergens that survive all throughout the year.

Like Seasonal Allergic Conjunctivitis, it is best to avoid the allergens that cause the allergic reaction.

  • Avoiding dust mites by washing bedding frequently and at a temperature of at least 130 degrees Fahrenheit
  • Using allergen-proof covers for pillows, mattresses, and box springs
  • Avoiding curtains or drapery
  • Removing stuffed toys
  • Avoiding furry animals
  • Using careful sanitation such as eliminating open food or dirty dishes to avoid insects such as cockroaches
  • Avoiding irritants such as tobacco smoke, perfume, potpourri, chalk dust and markers

Atopic Keratoconjunctivitis
This ocular allergy is associated with atopic dermatitis of the eyelid and face. It often occurs in late adolescence or early adulthood, particularly if there is a history of allergic rhinitis or asthma.

Symptoms Include:

  • Red, oozing lesions of skin around the eye
  • Mucous discharge
  • Burning
  • Tearing
  • Corneal ulcer
  • Cataract
  • Photophobia (aversion to light)

Vernal Conjunctivitis
This ocular allergy presents with chronic, bilateral inflammation of the conjunctiva and commonly occurs in the spring or summer. Vernal Conjunctivitis may occur more commonly in boys and if left untreated, the scarring could lead to vision loss. Patients with vernal conjunctivitis often have a history of allergic rhinitis, allergies or asthma. 

Symptoms Include

  • Intense itching
  • Photophobia
  • Blurred vision
  • Stringy, ropy discharge
  • Trantas' dots (small white dots at the limbel conjunctiva)

Treatment
As with all allergic diseases, if you are experiencing symptoms of ocular allergy, you should see your allergist/immunologist or obtain a referral to an ophthalmologist for consultation and/or co-management. Visit the Academy's online referral directory to locate an allergist in your area.

This feature was edited by Stuart A. Friedman, MD, FAAAAI, AAAAI Patients & Consumers Web Editor on 3/18/04.