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Allergy Frontiers: Clinical Manifestations pp 25–48Cite as

Allergic Conjunctivitis: Update on Its Pathophysiology and Perspectives for Future Treatment

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Part of the book series: Allergy Frontiers ((ALLERGY,volume 3))

Abstract

The ocular surface mucosa is constantly exposed to allergens and, therefore, highly susceptible for developing allergic reactions. Allergic conjunctivitis is among the most common diseases faced by ophthalmologists and it has been traditionally divided in four categories based on clinical presentation: seasonal and perennial allergic conjunctivitis, the two milder forms, and vernal and atopic keratoconjunctivitis, the two most severe forms often characterized by corneal involvement. Although they may present with different grades of severity, all four classes of allergic conjunctivitis share common symptoms such as ocular redness, itching and tearing, and they are all characterized by inflammatory reaction and eosinophil infiltration of the conjunctiva. However, while seasonal and perennial allergic conjunctivitis are characterized by a well-defined pathogenesis, with a typical type I hypersensitivity reaction, vernal and atopic keratoconjunctivitis feature more complex pathogenetic mechanisms: in the former, specific sensitization is not found in many patients and the disease typically regresses with puberty; in the latter, patients have atopic dermatitis or eczema from childhood, but develop ocular symptoms only later in life. Considering the variety of clinical presentations and the diverse pathophysiology characterizing the different forms of allergic conjunctivitis, several therapeutic options are available and newer therapies with immunomodulatory agents are under consideration in recent and ongoing clinical trials. In this chapter we will describe in detail the pathophysiology of ocular allergy, the mechanisms of action of all the available treatments, and the perspectives for future therapies that have been introduced by recent findings in clinical and basic research studies.

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Authors and Affiliations

  1. Coassin Department of Ophthalmology, University of Rome “ Campus Bio-Medico”, Via Alvaro del Portillo, Rome, 21 - 00128, Italy

    Stefano Bonini, Roberto Sgrulletta & Marco Coassin

  2. University of Naples and Institute of Neurobiology & Molecular Medicine, National Research Council (INMM-CNR) - Rome, Italy

    Sergio Bonini

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  1. Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, Japan

    Ruby Pawankar

  2. Southampton General Hospital, University of Southampton, Tremona Road, Southampton, UK

    Stephen T. Holgate

  3. Childrens's Mercy Hospital and Clinic, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64108, USA

    Lanny J. Rosenwasser

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Bonini, S., Sgrulletta, R., Coassin, M., Bonini, S. (2009). Allergic Conjunctivitis: Update on Its Pathophysiology and Perspectives for Future Treatment. In: Pawankar, R., Holgate, S.T., Rosenwasser, L.J. (eds) Allergy Frontiers: Clinical Manifestations. Allergy Frontiers, vol 3. Springer, Tokyo. https://doi.org/10.1007/978-4-431-88317-3_2

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