These patients often have ‘worse’ times of the year, typically Spring and Autumn. They have often been seen with more typical hay fever conjunctivitis signs and symptoms and often have a history of atopia; hay fever, asthma, eczema, psoriasis, or similar problems.
Look carefully for the following features:
- a porcelain-like, lustrous conjunctival surface quality
- some level of follicular hypertrophy on eversion of lower lids
- some level of flat-topped papillae on eversion of upper lids
- significant relief 1-2 minutes following instillation of topical anaesthetic
The most common cause is chronic atopic blepharoconjunctivitis.
- lubrication and lavage
- cool compresses
- mast-cell stabilization (1 drop 4-5x daily)
- topical non-steroidal anti-inflammatory (1 drop 4-5x daily for 10-14 days)
- recommend wash hair and shower before bedtime, change pillowcase often.