Allergic Eye Disorders

The nosology of the clinical diseases resulting from conjunctival hypersensitivity is controversial. However, the common feature that encompasses all these clinical entities is the assumption that a common type I hypersensitivity mechanism is responsible for their pathophysiology. Mast cells that contain both tryptase and chymase have been found in increased number in allergic eye diseases. Mast cells in patients with eye allergies not only are increased in number, but also show a different distribution. The differential diagnosis of ocular allergic disorders includes infectious causes, chronic forms of conjunctivitis, and miscellaneous disorders including keratoconjunctivitis sicca, acne rosacea, and ocular cicatricial pemphigoid. Giant papillary conjunctivitis, characterized by upper tarsal papillary hypertrophy or “cobblestoning,” is associated with continued use of contact lens and ocular prosthetics. Pruritus and tearing associated with GPC will tend to aggravate during the spring, when pollen counts are high.