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Atopic keratoconjunctivitis: present day diagnosis
  1. Diyaa Rachdan,
  2. Deepa Rajeswari Anijeet,
  3. Sunil Shah
  1. Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK
  1. Correspondence to Professor Sunil Shah, Birmingham and Midland Eye Centre, City Hospital, Dudley Road, Birmingham B18 7QH, UK; sunilshah{at}doctors.net.uk

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Atopic keratoconjunctivitis (AKC) is a rare but serious chronic allergic eye disease. It can involve the cornea, conjunctiva and the eyelids and ranges in severity from a mild condition to a disease causing blindness.1 Guglielmetti2 defined AKC as: A chronic ocular surface non-infectious inflammatory condition with the following clinical characteristics: (1) Always associated with other atopic conditions, (2) Occurring at any time point in the course of the associated atopic disease, and independent of its degree of severity, (3) Evidence of corneal involvement at some time in the course of the disease.

AKC affects both children and adults,1 ,3 ,4 typically presenting in the late teens and early 20s.2

The disease is bilateral, and patients present with photophobia, blurry vision, itching, burning sensation, red eyes and mucoid discharge.5

Clinically, the eyelids may have severe atopic dermatitis with eczema that can be chronic or relapsing. Staphylococcal blepharitis is also a common finding.3 Conjunctivae are normally chemosed with limbal hyperaemia and small to medium-size papillary reaction of upper and lower palpebral conjunctivae. In severe cases, sub-epithelial conjunctival fibrosis may …

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