Optician India

Welcome to question of the day #36

Why do some patients complain of chronic, low-grade, itchy eyes (that appear ‘white and quiet’ on examination)?

These patients often have ‘worse’ times of the year, typically Spring and Autumn.

They have often been seen with more typical hay fever conjunctivitis signs and symptoms and often have a history of atopia; hay fever, asthma, eczema, psoriasis, or similar problems.

Look carefully for the following features:

a porcelain-like, lustrous conjunctival surface quality

some level of follicular hypertrophy on eversion of lower lids

some level of flat-topped papillae on eversion of upper lids

significant relief 1-2 minutes following instillation of topical anaesthetic

Most common cause is chronic atopic blepharoconjunctivitis.

Management

lubrication and lavage

cool compresses

mast-cell stabilization (1 drop 4-5x daily)

topical non-steroidal anti-inflammatory (1 drop 4-5x daily for 10-14 days)

recommend wash hair and shower before bedtime, change pillowcase often.