title: Japanese guideline for allergic conjunctival diseases.
abstract: The definition, classification, pathogenesis, test methods, clinical findings, criteria for diagnosis, and therapies of allergic conjunctival disease are summarized based on the Guidelines for Clinical Management of Allergic Conjunctival Disease (Second Edition) revised in 2010. Allergic conjunctival disease is defined as "a conjunctival inflammatory disease associated with a Type I allergy accompanied by some subjective or objective symptoms." Allergic conjunctival disease is classified into allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. Representative subjective symptoms include ocular itching, hyperemia, and lacrimation, whereas objective symptoms include conjunctival hyperemia, swelling, folliculosis, and papillae. Patients with vernal keratoconjunctivitis, which is characterized by conjunctival proliferative changes called giant papilla accompanied by varying extents of corneal lesion, such as corneal erosion and shield ulcer, complain of foreign body sensation, ocular pain, and photophobia. In the diagnosis of allergic conjunctival diseases, it is required that type I allergic diathesis is present, along with subjective and objective symptoms accompanying allergic inflammation. The diagnosis is ensured by proving a type I allergic reaction in the conjunctiva. Given that the first-line drug for the treatment of allergic conjunctival disease is an antiallergic eye drop, a steroid eye drop will be selected in accordance with the severity. In the treatment of vernal keratoconjunctivitis, an immunosuppressive eye drop will be concomitantly used with the above mentioned drugs.
authors.affiliation: Department of Ophthalmology, Tokyo Women's Medical University, School of Medicine, Japan. takamura@oph.twmu.ac.jp
authors.forename: Etsuko
authors.initials: E
authors.lastname: Takamura
authors.forename: Eiichi
authors.initials: E
authors.lastname: Uchio
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ebihara
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Ohno
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Shigeki
authors.initials: S
authors.lastname: Okamoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Kumagai
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.forename: Jun
authors.initials: J
authors.lastname: Shoji
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Kenichi
authors.initials: K
authors.lastname: Namba
authors.forename: Kazumi
authors.initials: K
authors.lastname: Fukagawa
authors.forename: Atsuki
authors.initials: A
authors.lastname: Fukushima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujishima
mesh_terms: D003229:Conjunctival Diseases / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D006967:Hypersensitivity / Q000150:complications*; D007564:Japan; D056990:Post-Exposure Prophylaxis