Allergic conjunctivitis natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sujaya Chattopadhyay, M.D.[2]

Overview

Allergic conjunctivitis is usually a non-progressive condition with a favorable prognosis, and rare but serious complications. Most symptoms are self-limiting, while in some subtypes, a temporal association can be found with the age group and specific triggers. Complications include infections, scarring and can also damage the cornea and eyelids. Long-term prognosis is influenced by the recurrence of the attacks and side-effects of treatment.

Symptoms are often neglected, and resolve in many patients without medical care.

Complete resolution without the return of symptoms after adolescence is observed in a majority of patients.

Uncommon before adolescence and peaks from 30 to 50 years of age. Most cases coexist with atopic dermatitis.

A temporal relationship with contact lens use may explain the predominance of this variety in teens and young adults.
It manifests usually after one to two years of wearing soft contact lenses but varies widely with other ocular foreign bodies^[1].

In most cases, allergic conjunctivitis is a benign condition. Complications although rare,can be serious and include:

Scarring of the eye in severe cases.
Progression to infective conjunctivitis, leading to serious secondary infections.
Corneal opacification and ulceration in VKC and [[AKC]^[2]]
Difficulty in wearing contact lenses due to significant eyelid involvement^[2]

PAC and SAC demonstrate favorable long-term outcomes but, significant eye discomfort and poor ocular cosmesis may persist as long-term sequelae in many people.
Recurrences result in conjunctivochalasis, which is a result of ongoing limba conjunctival chemosis.
The medications may cause adverse reactions like cataracts.