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Allergic conjunctivitis is an inflammation of the conjunctiva caused by a type I allergic reaction. It is characterized by various subjective and objective symptoms. Based on clinical findings and patient history, allergic conjunctival diseases are classified into four types:

1. Allergic conjunctivitis (seasonal or perennial)
2. Atopic keratoconjunctivitis
3. Vernal keratoconjunctivitis (vernal catarrh)
4. Giant papillary conjunctivitis

Common allergens that trigger allergic conjunctivitis include:

• Dust mites
• House dust
• Mold
• Pollen (e.g., cedar, cypress, and other plants)

The hallmark symptom of allergic conjunctivitis is itchy eyes. Other symptoms may include:

• Redness
• Foreign body sensation
• Eye discharge
• Watery eyes

Diagnosing allergic conjunctivitis involves both clinical examination and specific tests:

1. Systemic Allergy Tests:
   ?Blood tests to detect IgE antibodies, which confirm an allergic reaction.
   ?Skin tests using diagnostic allergen extracts.
2. Ocular Allergy Tests:
   ?A conjunctival sample is obtained by gently rubbing the conjunctiva. Special staining techniques are used to detect eosinophils¡ªcells involved in allergic reactions.

During an ophthalmologic examination, the following findings may be observed:

• Hyperemia (redness): This may be more pronounced on the inner surface of the eyelids (eyelid conjunctiva) than the visible white part of the eye.
• Follicles: Small patches of swollen lymphoid tissue caused by inflammation.

In severe cases such as vernal keratoconjunctivitis and atopic keratoconjunctivitis, additional features may include:

• Papillary hypertrophy: Enlarged, cobblestone-like structures on the inner surface of the eyelid.
• Corneal scars: Shield ulcers caused by toxic proteins released from eosinophils, which can lead to pain, vision loss, or permanent corneal opacity.

The mainstay of treatment is eye drop therapy

1. Anti-Allergic Eye Drops: Used for milder forms of allergic conjunctivitis.
2. Steroid Eye Drops: Effective but may cause increased intraocular pressure. Regular check-ups are required during use.
3. Immunosuppressive Eye Drops: Reserved for severe cases (e.g., vernal keratoconjunctivitis or atopic keratoconjunctivitis). These do not raise intraocular pressure but may increase the risk of corneal infections, necessitating frequent ophthalmologic monitoring.