Classification of ocular allergy

Hodges, Marcus; Keane‐Myers, Andrea

doi:10.1097/aci.0b013e3282ef6937

Cited by 22 publications

(19 citation statements)

References 34 publications

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“…Vernal keratoconjunctivitis (VKC) is a common ocular allergic disease affecting children and young adults living in warm humid climates [1][2][3][4]. Punctate keratitis, plaques, sterile corneal ulcers, sub epithelial scarring, and pseudogerontoxon are all forms of corneal damage associated with VKC.…”

Section: Discussionmentioning

confidence: 99%

“…Shield ulcers form when superficial punctate keratitis associated with giant papillae progresses to a macroerosion, leading to breaks in the epithelium. Inflammatory mediators and cellular infiltration also may play a role in the development of shield ulcers [1][2][3][4].…”

Section: Discussionmentioning

confidence: 99%

“…The points occasionally break to form a macroerosion with raised margins. The compacted layer of collected cellular debris and mucus may form a vernal plaque over the shield ulcer [1][2][3][4]. These surface changes in turn may create an environmental milieu favorable for fungal infection, especially in endemic areas like India.…”

Section: Introductionmentioning

confidence: 99%

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Aspergillus keratitis in vernal shield ulcer—a case report and review

et al. 2010

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An unusual case of vernal shield ulcer with superadded fungal keratitis caused by Aspergillus fumigates is reported. A 26-year-old man, a known case of vernal keratoconjunctivitis (VKC) presented with the complaint of diminution of vision in the right eye. Patient was on topical steroids and anti-allergic treatment for the past two months. In the right eye, a shield ulcer with an elevated plaque was seen. Scrapings from the right cornea revealed fungal filaments on a wet KOH mount and culture revealed growth of Aspergillus fumigatus. The patient was diagnosed as VKC with shield ulcer with secondary fungal keratitis. The patient was treated with topical cyclosporine, topical moxifloxacin, topical natamycin, and topical amphotericin eye drops. The patient responded well and finally recovered to a best spectacle-corrected visual acuity of 20/20 at the end of nine months. The chronic ocular surface changes and induced inflammation in VKC, and the instillation of topical steroids for therapy, may create an environmental milieu favorable for fungal keratitis. Microbiological evaluation should be considered, even in cases of suspected sterile keratitis, to prevent possible worsening of an associated infective corneal condition. This warrants patient education, periodic reviews and a very cautious approach to indiscriminate use of topical corticosteroids in cases of VKC with shield ulcer. In the event of any secondary fungal infection, use of steroid sparing topical agent, for example cyclosporine may be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Aspergillus keratitis in vernal shield ulcer—a case report and review

et al. 2010

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“…Vernal keratoconjunctivitis (VKC) is a chronic, bilateral ocular inflammatory process that can cause severe inflammation and visual complications [12]. Male children living in warmer climates such as India, Africa, and some parts of Asia are more likely to be affected.…”

Section: Vernal Keratoconjunctivitismentioning

confidence: 99%

Causes and Management of Red Eye in Pediatric Ophthalmology

Seth

Khan

2011

Curr Allergy Asthma Rep

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“…Different classifications of the ocular allergic diseases have been proposed in the literature (3,(14)(15)(16) . Recently, the International Ocular Inflammation Society proposed a classification based on the type of immune response, dividing the ocular allergic conditions into 3 groups: IgE-mediated (SAC/PAC), IgE and non IgE-mediated (VKC/AKC) and non IgE-mediated (GPC/CBC) (16) .…”

Section: Discussionmentioning

confidence: 99%

Ocular allergy latin american consensus

Santos

Alves

Freitas

et al. 2011

Arq. Bras. Oftalmol.

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Study carried out at the Primeira parte (Questionários): online. Segunda parte (Meeting): OrlandoMiami, USA. Terceira Parte (Análise Estatística): São Paulo (SP), Brazil. ABSTRACTPurpose: To establish current definition, classification and staging, and to develop diagnosis and treatment recommendations for ocular allergy, by using Delphi approach. Methods: Ten Latin American experts on ocular allergy participated in a 4-round Delphi panel approach. Four surveys were constructed and answered by panelists. A two-thirds majority was defined as consensus. Definition, classification, staging and diagnosis and treatment recommendations were the main outcomes.Results: "Ocular allergy" was proposed as the general term to describe ocular allergic diseases. Consensus regarding classification was not reached. Signs and symptoms were considered extremely important for the diagnosis. It was consensus that a staging system should be proposed based on the disease severity. Environmental control, avoidance of allergens and the use of artificial tears were recommended as first line treatment. The secondary treatment should include topical anti-histamines, mast cell stabilizers and multi actions drugs. Topical non-steroidal anti-inflammatory and vasoconstrictors were not recommended. Topical corticosteroids were recommended as third line of treatment for the most severe keratoconjunctivitis. Consensus was not reached regarding the use of systemic corticosteroids or immunosuppressant. Surgical approach and unconventional treatments were not recommended as routine. Conclusion:The task of creating guidelines for ocular allergies showed to be very complex. Many controversial topics remain unsolved. A larger consensus including experts from different groups around the world may be needed to further improve the current recommendations for several aspects of ocular allergy.

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Classification of ocular allergy

Cited by 22 publications

References 34 publications

Aspergillus keratitis in vernal shield ulcer—a case report and review

Aspergillus keratitis in vernal shield ulcer—a case report and review

Causes and Management of Red Eye in Pediatric Ophthalmology

Ocular allergy latin american consensus

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