This guideline last updated 09/05/2022 10:23:30

Differential diagnosis

• Vernal or Atopic Keratoconjunctivitis
• Acute allergic conjunctivitis
• Contact conjunctivitis
• Conjunctivitis medicamentosa
• Contact Lens-Associated Papillary Conjunctivitis

Possible management by Optometrist

Treatment

• Cool compresses for symptomatic relief
• For acute relief consider PoM topical antihistamine
  • 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
    • Refer to local Pharmacist for oral antihistamine
      • Effective also for other symptoms of hay fever, e.g. allergic rhinitis
• Consider anticipatory use of mast cell stabiliser (slow response)
  • Sodium cromoglicate 2% eye drops 4 times daily

Advice

• Advise against eye rubbing
• Advise avoidance of allergen(s)

Management Category

• Normally no referral
• if conventional therapy fails, referral to an immunologist for consideration of sub-lingual or other form of immunotherapy may be appropriate

Possible management by Ophthalmologist

• Not normally referred