Date of last review: Due to be updated

Differential diagnosis

  • Atopic keratoconjunctivitis

Possible management by Optometrist

Treatment

  • Cold compresses may reduce acute symptoms
  • PoM Olopatadine 1 drop twice daily (8 hourly interval) whilst symptomatic
    • Contraindicated in
      • breastfeeding/pregnancy
      • women of childbearing age not using contraception
      • Caution in dry eye/compromised ocular surface if prolonged use planned 
  • If persistent, consider use of sodium cromoglicate 2% eye drops 4 times daily
  • Low threshold for referral to ophthalmology as significant corneal involvement common

Management Category

  • Urgent referral (within one week) if there is active limbal or corneal involvement:
  • Routine referral for PoM for milder cases (without active limbal or corneal involvement)

Possible management by Ophthalmologist

  • Topical steroids
  • Mucolytics
  • Topical immunosuppression
  • Systemic immunosuppression
  • Debridement/superficial lamellar keratectomy for corneal plaque/shield ulcer