Atopic keratoconjunctivitis (AKC) is a severe, chronic allergic eye disease associated with atopic dermatitis and often asthma or hay fever.
Clinical Picture
Patients experience year‑round itching, redness, mucous discharge, and eyelid skin changes such as thickening and fissuring.
- Conjunctival scarring, symblepharon, and peripheral corneal neovascularisation may develop over time.
- Cataract and retinal detachment risks are increased, partly from chronic inflammation and steroid use.
- Corneal ulcers and keratoconus are recognised complications.
- AKC typically presents in late adolescence or early adulthood and can persist for decades.
Management
Treatment requires long‑term allergy and inflammation control with lubricants, topical antihistamines, mast‑cell stabilisers, and steroid‑sparing immunomodulators such as ciclosporin or tacrolimus.
- Short courses of topical steroids treat acute flares but must be monitored closely.
- Coordination with dermatology helps manage systemic atopy.
- Regular surveillance for glaucoma, cataract, and corneal disease is essential.
- Patient education on lid care and avoiding rubbing reduces mechanical damage.
