Ocular allergy: implications for the clinical immunologist.

BACKGROUND

Allergic diseases of the eye are the most common conditions affecting the external ocular adnexa. The most common forms are primarily IgE-mediated and share features in common with other atopic conditions. Mast cell activation and release of mediators, particularly histamine, are central to the pathogenesis of seasonal and perennial allergic conjunctivitis. These conditions are self-limited without the occurrence of ocular surface damage. In contrast, vernal keratoconjunctivitis and atopic keratoconjunctivitis are complex diseases, involving both early- and late-phase allergic responses. They are characterized by severe chronic immune inflammation with T cell infiltration in the conjunctiva and may be sight-threatening.

OBJECTIVES

To provide a brief overview of the ocular allergic conditions and summarize the current knowledge of immunopathogenetic mechanisms involved in initiating and driving these conditions.

DATA SOURCES: English-language articles were sought from a MEDLINE search from 1995. This yielded a number of scientific and review papers exploring recent advances in the understanding of the pathogenesis of the ocular allergic conditions.

CONCLUSIONS

Recent advances in knowledge about the pathogenetic mechanisms involved in ocular allergy have led to a better understanding of treatment options and to the development of new treatment modalities, resulting in improved control of symptoms for patients.