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World Allergy Forum: Ocular Allergy

Clinical Presentation of Allergic Eye Disease

Roger J. Buckley MA FRCS FRCOphth

Allergic disease of the eye may be no more than a minor inconvenience to some, but it can produce a debilitating, sight-threatening clinical picture in others. The target tissue is the conjunctiva, a mucous membrane; in the more severe varieties of disease, the non-keratinising epithelium of the cornea becomes involved also.

Six basic clinical conditions are recognised:

  • Acute Allergic Conjunctivitis (AAC)

  • Seasonal Allergic Conjunctivitis (SAC)

  • Perennial Allergic Conjunctivitis (PAC)

  • Vernal Keratoconjunctivitis (VKC)

  • Atopic Keratoconjunctivitis (AKC)

  • Contact Lens-Associated Papillary Conjunctivitis (Giant Papillary Conjunctivitis, GPC)

The first three of these, and the last, do not involve the cornea, and are unlikely to require the use of topical steroid. A clinical profile, and management guidelines, will be given for each condition.

All clinicians concerned with allergic disease should be aware of possible ocular manifestations, and will probably wish to use simple methods of management. Such are the potential dangers of ocular steroid therapy that only ophthalmologists should treat allergic conditions requiring this form of management.


  1. Hingorani M, Calder VL, Jolly G, Buckley RJ, Lightman SL. Eosinophil surface antigen expression and cytokine production vary in different ocular allergic diseases. J Allergy Clin Immunol 1998; 102: 821-830

  2. Buckley RJ. Allergic Eye Disease a clinical challenge. Clin Exp Allergy 1998; 28(suppl): 39-43

  3. Bleik JH, Tabbara KF. Topical cyclosporin in vernal keratoconjunctivitis. Ophthalmology 1991; 98: 1679-1684

  4. Buckley RJ. Vernal Keratoconjunctivitis. Int Ophthalmol Clinics 1988; 28(4): 303-308

  5. Buckley RJ. Diagnosis and Treatment of Allergic Eye Disease (Editorial). Clin Exp Allergy 1992; 22: 887-888


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