Allergic Conjunctivitis Overview
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Questions and Answers

What is the primary reason patients should trial sodium cromoglycate?

  • It can reduce the need for steroids in treatment. (correct)
  • It requires immediate effect to treat severe disease.
  • Patients always have a significant response to it.
  • It is the only treatment for allergic conjunctivitis.

    • Which symptom is primarily associated with allergic conjunctivitis?

  • Itching or difficulty leaving the eyes alone. (correct)
  • Purulent discharge.
  • Grittiness in the eyes.
  • Gummed eyelids in the morning.

    • How long does it take for sodium cromoglycate to show its effects?

  • Immediate effect.
  • One week.
  • Three weeks. (correct)
  • Six weeks.

    • What is a characteristic feature of viral conjunctivitis?

    <p>Tenderness and swelling of the preauricular nodes.</p> Signup and view all the answers

    When should a patient with conjunctivitis be referred to an ophthalmologist?

    <p>If there is corneal involvement or decreased vision not corrected with a pinhole.</p> Signup and view all the answers

    What are the two main types of allergic conjunctivitis?

    <p>Acute and recurrent/chronic</p> Signup and view all the answers

    Which subtype of recurrent/chronic allergic conjunctivitis is primarily associated with seasonal allergies?

    <p>Vernal keratoconjunctivitis</p> Signup and view all the answers

    What is a key characteristic of acute allergic conjunctivitis?

    <p>Conjunctival swelling or chemosis</p> Signup and view all the answers

    Which statement best describes papillae in recurrent/chronic allergic conjunctivitis?

    <p>They are vascular structures appearing as red swellings.</p> Signup and view all the answers

    How should giant papillary conjunctivitis (GPC) primarily be managed?

    <p>Under the care of an optometrist or ophthalmologist</p> Signup and view all the answers

    Which statement best distinguishes conjunctival papillae from follicles?

    <p>Papillae form in response to inflammation, whereas follicles are lymphatic structures.</p> Signup and view all the answers

    What triggers the development of chemosis in acute allergic conjunctivitis?

    <p>An inflammatory response</p> Signup and view all the answers

    When is referral to a specialist warranted for cases of allergic conjunctivitis?

    <p>If symptoms include severe pain and vision changes</p> Signup and view all the answers

    Which of the following is NOT an allergen avoidance strategy?

    <p>Cool compresses</p> Signup and view all the answers

    What should be done to combat high pollen and dust levels?

    <p>Stay indoors</p> Signup and view all the answers

    Which treatment is specifically indicated for vernal allergies?

    <p>Sodium Cromoglycate</p> Signup and view all the answers

    What is a method for reducing dust mites in the home?

    <p>Exposing furniture to sunlight</p> Signup and view all the answers

    Which option is included in both allergen avoidance and treatment strategies?

    <p>Air conditioning/filtering</p> Signup and view all the answers

    What is recommended for acute allergic reactions?

    <p>Cool compresses</p> Signup and view all the answers

    What behavior is essential immediately after play when allergens are present?

    <p>Hand washing</p> Signup and view all the answers

    Which action may be considered when dealing with severe pet allergies?

    <p>Selling the pet</p> Signup and view all the answers

    What is a common sign of chlamydial conjunctivitis in adults?

    <p>Follicles</p> Signup and view all the answers

    Which condition is characterized by rapid onset and resolution of symptoms after allergen exposure?

    <p>Acute allergic conjunctivitis</p> Signup and view all the answers

    What is the commonest allergic conjunctivitis affecting up to 20% of the population?

    <p>Hayfever conjunctivitis</p> Signup and view all the answers

    What symptom is NOT typically associated with acute allergic conjunctivitis?

    <p>Low grade conjunctival hyperemia</p> Signup and view all the answers

    What treatment is typically recommended for acute allergic conjunctivitis?

    <p>Cool compresses</p> Signup and view all the answers

    What is a general indicator of a medication allergy in conjunctivitis?

    <p>Localized eyelid and skin reaction</p> Signup and view all the answers

    What may trigger seasonal symptoms of conjunctivitis in sensitive individuals?

    <p>Grass and tree pollens</p> Signup and view all the answers

    Which type of conjunctivitis may coincide with a history of asthma or atopic dermatitis?

    <p>Hayfever conjunctivitis</p> Signup and view all the answers

    What is the primary symptom experienced by patients with vernal keratoconjunctivitis (VKC)?

    <p>Intense itching</p> Signup and view all the answers

    Which type of vernal keratoconjunctivitis involves the limbal area primarily?

    <p>Limbal VKC</p> Signup and view all the answers

    In which demographic is vernal keratoconjunctivitis most commonly found?

    <p>Children of Maori descent</p> Signup and view all the answers

    What treatment should be considered for patients with corneal involvement from VKC?

    <p>Urgent referral to an ophthalmologist</p> Signup and view all the answers

    Atopic keratoconjunctivitis (AKC) is primarily associated with which other condition?

    <p>Atopic dermatitis</p> Signup and view all the answers

    Which of the following is NOT a common complication of atopic keratoconjunctivitis?

    <p>Optic neuritis</p> Signup and view all the answers

    What is the purpose of staining the cornea with fluorescein in cases of VKC?

    <p>To detect corneal dullness or scarring</p> Signup and view all the answers

    What characteristics can be observed in palpebral vernal keratoconjunctivitis?

    <p>Papillae and cobblestone appearance</p> Signup and view all the answers

    What is a key requirement for patch testing to be useful in diagnosing allergic conjunctivitis?

    <p>Symptoms must be recurrent and include non-ocular symptoms.</p> Signup and view all the answers

    What initial treatment may a GP provide for allergic conjunctivitis?

    <p>Simple measures such as artificial tears and cool compresses.</p> Signup and view all the answers

    How long does sodium cromoglycate generally take to work effectively?

    <p>Three weeks.</p> Signup and view all the answers

    Why are steroids not recommended as a first-line treatment for allergic conjunctivitis?

    <p>They can lead to dependency and significant side effects.</p> Signup and view all the answers

    Which treatment is indicated for patients with frequent allergic conjunctivitis symptoms?

    <p>Topical sodium cromoglycate.</p> Signup and view all the answers

    Which of the following is an effective immediate relief method for acute allergic conjunctivitis, particularly in children?

    <p>Cool compresses.</p> Signup and view all the answers

    What is a common issue associated with the failure of sodium cromoglycate therapy?

    <p>It is often stopped before it has had a chance to work.</p> Signup and view all the answers

    When should a patient be referred to an ophthalmologist for allergic conjunctivitis?

    <p>When the patient has VKC or AKC.</p> Signup and view all the answers

    Study Notes

    Allergic Conjunctivitis

    • Allergic conjunctivitis is a common eye problem in general practice.
    • It is often treatable by a general practitioner.

    Types of Allergic Conjunctivitis

    • Two main types: acute and recurrent/chronic.
    • Recurrent/chronic types include drug-induced, hayfever, vernal keratoconjunctivitis (VKC), and atopic conjunctivitis.
    • Giant papillary conjunctivitis (GPC) is a rare type affecting contact lens wearers and those with artificial eyes.

    Chemosis, Papillae, and Follicles

    • Conjunctivitis is inflammation of the conjunctiva.
    • Acute allergic conjunctivitis shows conjunctival swelling (chemosis).
    • Recurrent/chronic allergic conjunctivitis shows papillae, which are vascular structures resembling small red swellings.
    • Follicles are lymphatic structures resembling grains of rice. They are common in children and in adults with chlamydial conjunctivitis.

    Acute Allergic Conjunctivitis

    • A distinctive urticarial reaction, common in children.
    • Marked by intense itching, watering, and swelling of the conjunctiva.
    • Eyelid swelling is also common.
    • Vision is generally normal, and most cases resolve within a few hours.
    • Cool compresses and avoiding rubbing the eyes are advised.

    Recurrent/Chronic Allergic Conjunctivitis

    • Drug-induced conjunctivitis can be caused by topical eye medications and preservatives (e.g., neomycin, brimonidine).
    • Hay fever conjunctivitis is common, with seasonal or perennial symptoms triggered by allergens like pollen, pet dander, or dust mites.
    • Symptoms include itching, tearing, and burning.
    • Other allergic symptoms should be investigated, such as asthma, atopic dermatitis, food or drug allergies, or urticaria-angioedema.
    • Vernal keratoconjunctivitis is a bilateral, seasonal conjunctivitis more common in certain ethnic groups.
    • Symptoms like intense itching, tearing, burning, and photophobia and often corneal involvement.
    • Atopic keratoconjunctivitis (AKC) is the adult equivalent of vernal keratoconjunctivitis, with chronic hypersensitivity to airborne allergens.
    • Corneal involvement is a significant concern for both VKC and AKC.

    Investigations

    • Patch testing is beneficial if symptoms are recurrent and other symptoms exist but is limited.
    • General practitioners can manage most allergic conjunctivitis initially.

    General Practice Treatment

    • Allergen avoidance is important.
    • Simple methods like irrigating the eyes or using cool compresses are helpful.
    • Topical medications like levocabastine (Livostin) or sodium cromoglycate can be used depending on symptoms.
    • Systemic antihistamines are often not helpful for ocular symptoms specifically.

    Distinguishing Allergic from Infective Conjunctivitis

    • Allergic: mainly itch, symptoms evolve during the day.
    • Infective: typically foreign body sensation, worse in the morning, often with a discharge, or pre-auricular lymphadenopathy (especially viral).

    When to Refer

    • Refer patients showing evidence of corneal involvement, decreased vision, or if simple measures fail to resolve the issue.

    Key Points

    • Most allergic conjunctivitis is manageable by general practitioners.
    • Sodium cromoglycate is a helpful treatment but requires time to work effectively.
    • Referral to ophthalmologists is critical in cases with corneal involvement.

    Table 1: Allergen Avoidance Strategies

    (Table information is not included in the summary, as the table does not provide important facts for the study notes)

    Table 2: Treatment Strategies

    (Table information is not included in the summary, as the table does not provide important facts for the study notes)

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    Allergic Conjunctivitis PDF

    Description

    This quiz explores the types, symptoms, and treatments of allergic conjunctivitis. Learn about acute and chronic forms, their distinctions, and the unique features associated with them. Enhance your understanding of how this common eye ailment manifests and is managed in clinical practice.

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