3. Allergic Conjunctivitis : Causes POLLEN PET DANDER POLLUTION DUST MITES MOLDS

4. Seasonal Allergic Conjunctivitis (SAC) Exposure to seasonal allergens like pollen Perennial Allergic Conjunctivitis (PAC) Continuous exposure to persistent allergens such as house dust mites Mild form of allergy Vernal keratoconjunctivitis (VKC) Due to severe hot conditions , more common in men . Itchy eyes , with mucous strands seen in the morning after sleep. Increase in goblet cells ( special type of cells in conjunctiva) Giant Papillary Conjunctivitis (GPC) Results from trauma caused by contact lens edges, or post- operative sutures . Allergic Conjunctivitis : Types

5. Allergic Conjunctivitis : Signs and Symptoms Itching : Is the hall mark of allergy Redness Teary, watery eyes Stinging and burning sensation Feeling of grittiness and discomfort Photophobia (extra-sensitivity to light) Lid Swelling

6. Allergic Conjunctivitis : Manifestation

7. Allergens Ocular Surface Allergen binds with IgE on mast cell Leads to mast cell activation Preformed Mediators Histamine Chymase Tryptase Proteases Itching , Redness , Swelling Degradation of neighboring cells Inflammatory cells accumulation Newly Formed Mediators Prostaglandins Leukotrienes Platelet-activating factors Cytokines (TNF) Chemokines (IL-8) Redness, swelling Infiltration of eosinophils & neutrophils Calcium enters the cells Mast cell degranulation Release of Mediators

12. “ The goal of treatment for allergic conjunctivitis is to effectively resolve clinical signs and symptoms, and improve quality of life.” – Jose Güell, MD

13. Allergic Conjunctivitis Conventional Medical Management Overview

14. Drug Categories : Indications For prophylaxis , prevention of allergy loading doses are administered, also along with antihistaminic agents Sodium cromoglycate , nedocromil Mast Cell Stabilizer For controlling signs and symptoms of allergic conjunctivitis For temporary relief from symptoms Olopatadine , azelastine , Epinastine , ketotifen Dual Acting agents When intensity of itching is higher , antihistamines are preferred. Levocabastine , Emedastine Antihistamines For sever conditions like VKC , manage severe inflammatory conditions Loteprednol Steroids For managing redness Naphazoline Vasoconstrictor Indication Example Drug Category

16. Ocular Allergies : Require Prompt Attention and Action

21. Thank You