A 30 y/o motorcycle racer after returning from Europe visits
you asking you for medical advice. He complains of itchy eyes, excessive
tearing, and occasional photophobia and disruption visual loss while racing.
You inspect the eye and note conjunctival hyperemia, chemosis, and papillary
fibrous conjunctivitis upon eversion of the eyelid. Slight entropion is also
observed. Review of systems shows rhinitis and asthma. He states he has experiences
symptoms like this before, especially during the summer. What do you suspect?
What is your tx plan?
This patient has a severe form of allergic eye disease referred to as atopic keratoconjunctivitis. he has atopic instead of vernal keratoconjunctivitis because atopic is a chronic disorder of adulthood whereas vernal occurs late in childhood and early adulthood. vernal is most often present in the spring and presents with cobblestone papillae whereas atopic has entropin and papillary fibrous conjunctivitis with the associated symptoms. this is definetly allergic eye disease because he also has rhinitis and asthma. allergic eye disease may occur seasonally as is seen with his symptoms that occur in the summer. rx: histamine h1-receptor antagonist; antihistamine/mast cell stabilizer; topical nsaid; topical corticosteroids