Allergic conjunctivitis: Management
- Pedram Hamrah, MD
Pedram Hamrah, MD
- New England Eye Center/Tufts Medical Center
- Tufts University School of Medicine
- Reza Dana, MD, MPH, MSc
Reza Dana, MD, MPH, MSc
- Claes Dohlman Professor of Ophthalmology
- Harvard Medical School
Allergic conjunctivitis is caused by airborne allergens contacting the eye, which leads to immunoglobulin E (IgE)-mediated local mast cell degranulation and allergic inflammation. It typically presents as bilateral ocular pruritus, redness, and watery discharge. This topic discusses the management of allergic conjunctivitis. The clinical manifestations, epidemiology, diagnosis, and differential diagnosis are reviewed separately. (See "Allergic conjunctivitis: Clinical manifestations and diagnosis".)
An overview of conjunctivitis and detailed reviews of other types of conjunctivitis are found elsewhere. (See "Conjunctivitis" and "Vernal keratoconjunctivitis" and "Atopic keratoconjunctivitis" and "Giant papillary conjunctivitis" and "Toxic conjunctivitis".)
Basic eye care — There are several general measures that are helpful to most patients with allergic conjunctivitis:
●Patients should not rub their eyes because rubbing can cause mechanical mast cell degranulation and worsening of symptoms.
●Cool compresses can help reduce eyelid and periorbital edema .
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- INITIAL MEASURES
- Basic eye care
- Allergen avoidance
- OVERVIEW OF THERAPIES
- Topical therapies
- - Vasoconstrictor/antihistamine combinations
- - Antihistamines with mast cell-stabilizing properties
- - Mast cell stabilizers
- - Nonsteroidal antiinflammatory drugs
- - Glucocorticoids
- Use of multiple eye drops
- Systemic therapies
- - Oral antihistamines
- TREATMENT FOR SPECIFIC DISORDERS
- Acute allergic conjunctivitis
- - Anticipated exposures
- - Frequent episodes
- Seasonal and perennial allergic conjunctivitis
- - Preferred agents
- - Patients with concomitant rhinitis
- REFRACTORY SYMPTOMS
- Concomitant dry eyes
- Concomitant toxic conjunctivitis
- Need for more aggressive therapy
- SPECIAL POPULATIONS
- Pregnant women
- Young children
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS