eMedicine Specialties > Ophthalmology > Cornea

Keratoconjunctivitis, Atopic: Differential Diagnoses & Workup

Author: Anne Chang-Godinich, MD, Assistant Clinical Professor, Department of Ophthalmology, Baylor College of Medicine
Coauthor(s): Michael B Raizman, MD, Associate Professor, Department of Ophthalmology, Tufts School of Medicine; Consulting Staff, Ophthalmic Consultants of Boston, Inc
Contributor Information and Disclosures

Updated: Jan 16, 2009

Differential Diagnoses

Blepharitis, Adult
Red Eye Evaluation
Cicatricial Pemphigoid
Trachoma
Conjunctivitis, Allergic
Conjunctivitis, Giant Papillary
Conjunctivitis, Viral

Other Problems to Be Considered

Corneal thinning and perforation
Secondary corneal infection
Steroid-response glaucoma
Vernal conjunctivitis (Large conjunctival papillae are seen under the upper eyelid in palpebral vernal or along the limbus in limbal vernal.)

Workup

Laboratory Studies

  • No specific laboratory testing is mandated.
  • Serum IgE levels are usually elevated during exacerbations; however, skin testing is not helpful.

Procedures

Histologic Findings

Conjunctival biopsy specimens reveal excessive eosinophils, mast cells, and goblet cells. Conjunctival biopsy specimens can also help to histologically differentiate AKC from cicatricial pemphigoid by the presence of basement membrane antibodies or complement components in cicatricial pemphigoid.

More on Keratoconjunctivitis, Atopic

Overview: Keratoconjunctivitis, Atopic
Differential Diagnoses & Workup: Keratoconjunctivitis, Atopic
Treatment & Medication: Keratoconjunctivitis, Atopic
Follow-up: Keratoconjunctivitis, Atopic
Multimedia: Keratoconjunctivitis, Atopic
References

References

  1. Foster CS, Calonge M. Atopic keratoconjunctivitis. Ophthalmology. Aug 1990;97(8):992-1000. [Medline].

  2. Casey R, Abelson MB. Atopic keratoconjunctivitis. Int Ophthalmol Clin. Spring 1997;37(2):111-7. [Medline].

  3. Akpek EK, Dart JK, Watson S, et al. A randomized trial of topical cyclosporin 0.05% in topical steroid-resistant atopic keratoconjunctivitis. Ophthalmology. Mar 2004;111(3):476-82. [Medline].

  4. Hingorani M, Moodaley L, Calder VL, Buckley RJ, Lightman S. A randomized, placebo-controlled trial of topical cyclosporin A in steroid-dependent atopic keratoconjunctivitis. Ophthalmology. Sep 1998;105(9):1715-20. [Medline].

  5. Hoang-Xuan T, Prisant O, Hannouche D, Robin H. Systemic cyclosporine A in severe atopic keratoconjunctivitis. Ophthalmology. Aug 1997;104(8):1300-5. [Medline].

  6. Anzaar F, Gallagher MJ, Bhat P, Arif M, Farooqui S, Foster CS. Use of systemic T-lymphocyte signal transduction inhibitors in the treatment of atopic keratoconjunctivitis. Cornea. Sep 2008;27(8):884-8. [Medline].

  7. Power WJ, Tugal-Tutkun I, Foster CS. Long-term follow-up of patients with atopic keratoconjunctivitis. Ophthalmology. Apr 1998;105(4):637-42. [Medline].

Further Reading

Keywords

atopic keratoconjunctivitis, AKC, bilateral conjunctivitis, atopic dermatitis, allergic conjunctivitis, giant papillary conjunctivitis, vernal keratoconjunctivitis, systemic allergy

Contributor Information and Disclosures

Author

Anne Chang-Godinich, MD, Assistant Clinical Professor, Department of Ophthalmology, Baylor College of Medicine
Anne Chang-Godinich, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Coauthor(s)

Michael B Raizman, MD, Associate Professor, Department of Ophthalmology, Tufts School of Medicine; Consulting Staff, Ophthalmic Consultants of Boston, Inc
Michael B Raizman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Pan-American Association of Ophthalmology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Andrew W Lawton, MD, Medical Director of Neuro-Ophthalmology Service, Section of Ophthalmology, Baptist Eye Center, Baptist Health Medical Center
Andrew W Lawton, MD is a member of the following medical societies: American Academy of Ophthalmology, Arkansas Medical Society, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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