This guideline last updated 09/05/2022 10:28:27

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