title: Japanese guidelines for allergic conjunctival diseases 2017.
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 abovementioned drugs.
authors.affiliation: Department of Ophthalmology, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan. Electronic address: takamura.etsuko@twmu.ac.jp.
authors.forename: Etsuko
authors.initials: E
authors.lastname: Takamura
authors.affiliation: Department of Ophthalmology, Fukuoka University, School of Medicine, Fukuoka, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Uchio
authors.affiliation: Department of Ophthalmology, Juntendo University Urayasu Hospital, Chiba, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ebihara
authors.affiliation: Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Ohno
authors.affiliation: Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Okamoto Eye Clinic, Ehime, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Okamoto
authors.affiliation: Kumagai Eye Clinic, Yamaguchi, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kumagai
authors.affiliation: Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.affiliation: Division of Ophthalmology, Department of Visual Sciences, Nihon University, School of Medicine, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Shoji
authors.affiliation: Nakagawa Eye Clinic, Osaka, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Namba
authors.affiliation: Ryogoku Eye Clinic, Tokyo, Japan; Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Fukagawa
authors.affiliation: Department of Ophthalmology, Kochi Medical School, Kochi, Japan.
authors.forename: Atsuki
authors.initials: A
authors.lastname: Fukushima
authors.affiliation: Department of Ophthalmology, Tsurumi University School of Dental Medicine, Kanagawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujishima
mesh_terms: D003131:Combined Modality Therapy; D003229:Conjunctival Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D003937:Diagnosis, Differential; D019468:Disease Management; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D007564:Japan; D010641:Phenotype; D017410:Practice Guidelines as Topic; D011292:Premedication; D012648:Self Care / Q000379:methods
keywords: Allergic conjunctivitis; Antiallergic eye drop; Atopic keratoconjunctivitis; Giant papillary conjunctivitis; Vernal keratoconjunctivitis