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Author

Mark Ventocilla, OD, FAAO Chief Executive Officer, Elder Eye Care Group, PLC; Chief Executive Officer, Mark Ventocilla, OD, Inc; President, California Eye Wear, Oakwood Optical

Mark Ventocilla, OD, FAAO is a member of the following medical societies: American Academy of Optometry, American Optometric Association

Disclosure: Nothing to disclose.

Coauthor(s)

Marc R Bloomenstein, OD, FAAO Director of Optometric Services, Schwartz Laser Eye Center; Adjunct Assistant Professor, Arizona College of Optometry; Adjunct Assistant Professor, Southern California College of Optometry

Marc R Bloomenstein, OD, FAAO is a member of the following medical societies: International Society of Refractive Surgery, American Academy of Optometry, American Optometric Association, Arizona Optometric Association

Disclosure: Nothing to disclose.

Parag A Majmudar, MD Fellowship Co-Director, Assistant Professor, Department of Ophthalmology, Cornea and Refractive Surgery Service, Rush-Presbyterian-St Luke's Medical Center

Parag A Majmudar, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, International Society of Refractive Surgery, Phi Beta Kappa

Disclosure: Received consulting fee from Allergan for consulting; Received consulting fee from Alcon for consulting; Received consulting fee from Bausch + Lomb for consulting; Received consulting fee from Tear Science for consulting.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Andrew A Dahl, MD, FACS Assistant Professor of Surgery (Ophthalmology), New York College of Medicine (NYCOM); Director of Residency Ophthalmology Training, The Institute for Family Health and Mid-Hudson Family Practice Residency Program; Staff Ophthalmologist, Telluride Medical Center

Andrew A Dahl, MD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Intraocular Lens Society, American Medical Association, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Medical Society of the State of New York, New York State Ophthalmological Society, Outpatient Ophthalmic Surgery Society

Disclosure: Nothing to disclose.

Acknowledgements

Jerre Freeman, MD Founder and Chairman, Memphis Eye and Cataract Associates; Clinical Professor, Department of Ophthalmology, University of Tennessee Health Science Center College of Medicine

Jerre Freeman, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, and Tennessee Medical Association

Disclosure: Nothing to disclose.

Christopher J Rapuano, MD Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director 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, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; RPS Ownership interest Other; EyeGate Pharma Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting; Merck Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Characteristics	VKC	AKC
Age at onset	Generally presents at a younger age than AKC' first decade	Second to third decade
Sex	Males are affected preferentially.	No sex predilection
Seasonal variation	Typically occurs during spring months	Generally perennial
Discharge	Thick mucoid discharge	Watery and clear discharge
Conjunctival scarring	Moderate incidence of conjunctival scarring	Higher incidence of conjunctival scarring
Horner-Trantas dots	Horner-Trantas dots and shield ulcers are commonly seen.	Presence of Horner-Trantas dots is rare.
Corneal neovascularization	Not present, unless secondary to infectious keratitis	Deep corneal neovascularization tends to develop
Presence of eosinophils in conjunctival scraping	Conjunctival scraping reveals eosinophils to a greater degree in VKC than in AKC	Presence of eosinophils is less likely

Characteristics	VKC	AKC
Age at onset	Generally presents at a younger age than AKC' first decade	Second to third decade
Sex	Males are affected preferentially.	No sex predilection
Seasonal variation	Typically occurs during spring months	Generally perennial
Discharge	Thick mucoid discharge	Watery and clear discharge
Conjunctival scarring	Moderate incidence of conjunctival scarring	Higher incidence of conjunctival scarring
Horner-Trantas dots	Horner-Trantas dots and shield ulcers are commonly seen.	Presence of Horner-Trantas dots is rare.
Corneal neovascularization	Not present, unless secondary to infectious keratitis	Deep corneal neovascularization tends to develop
Presence of eosinophils in conjunctival scraping	Conjunctival scraping reveals eosinophils to a greater degree in VKC than in AKC	Presence of eosinophils is less likely

Allergic Conjunctivitis Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

Allergic Conjunctivitis Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

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