Seasonal/Perennial Allergic Conjunctivitis

 Mild allergic conjunctivitis can be treated with an over-the-counter topical

antihistamine/vasoconstrictor agent or with the more effective second-generation topical
histamine H1-receptor antagonists
 The use of topical mast-cell inhibitors can also be helpful in alleviating the symptoms of
allergic rhinitis. Mast-cell inhibitors formulated as a nasal spray and aerosols are also helpful
in alleviating the symptoms of allergic rhinitis and asthma in some patients
 If the condition is frequently recurrent or persistent, mast-cell stabilizers can be used. Many
new medications combine antihistamine activity with mast-cell stabilizing properties and can
be used for either acute or chronic disease
 If the symptoms are not adequately controlled, a brief course (1 to 2 weeks) of topical
corticosteroids with a low side effect profile can be added to the regimen
 In severe cases, topical cyclosporine or tacrolimus can be considered

Vernal/Atopic Conjunctivitis

 General treatment measures for vernal/atopic conjunctivitis include modifying the

environment to minimize exposure to allergens or irritants and using cool compresses and
ocular lubricants. Topical and oral antihistamines and topical mast-cell stabilizers can be
useful to maintain comfort

 For acute exacerbations of vernal/atopic conjunctivitis, topical corticosteroids are usually

necessary to control severe symptoms and signs

 Commercially available 0.05% topical cyclosporine has also been shown to be effective in
more frequent dosing for the treatment of severe vernal/atopic conjunctivitis [I+, Good,
Strong] and it has been shown to be effective in preventing seasonal recurrences.137-141
Use of cyclosporine may allow for reduced use of topical steroids