Atopic Keratoconjunctivitis (AKC) Workup

Updated: Feb 03, 2023
  • Author: Anne Chang-Godinich, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Approach Considerations

No specific laboratory testing is necessary for atopic keratoconjunctivitis (AKC). Although serum immunoglobulin E (IgE) levels are usually elevated during exacerbations, skin testing is not helpful. However, conjunctival biopsy can help to differentiate atopic keratoconjunctivitis from cicatricial pemphigoid.


Conjunctival Biopsy and Histology

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

Confocal microscopy studies of the cornea show lower density of basal epithelial cells, thickening of stromal nerves, and severe inflammatory cells in proximity to nerve fibers. [3]