Ocular surface as mucosal immune site
Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald in Principles of Mucosal Immunology, 2020
Ocular surface inflammation can occur due to a wide range of causes: infection, chemical or mechanical injury, allergy, and autoimmune responses. This can manifest as conjunctivitis (i.e., inflammation of the conjunctiva), keratitis (inflammation of the cornea), or keratoconjunctivitis if both are involved. In many cases, dysfunction of the ocular mucosal immune system and ocular surface disease can be something of a vicious cycle, so that it becomes difficult to distinguish which came first.
Eczema and the Eye
Donald Rudikoff, Steven R. Cohen, Noah Scheinfeld in Atopic Dermatitis and Eczematous Disorders, 2014
The most common ocular complication of atopic dermatitis is keratoconjunctivitis. In a series of 724 eyes of 362 patients with severe atopic dermatitis, biomicroscopic evidence of conjunctivitis coupled with superficial punctate keratopathy was observed in 67.5% of the patients (Dogru et al. 1999). Typical signs and symptoms of atopic keratoconjunctivitis include redness, pain, itch, photophobia, foreign body sensation, dry eye, and discharge.
Adenovirus
Avindra Nath, Joseph R. Berger in Clinical Neurovirology, 2020
Antigen assays are particularly useful for the detection of the fastidious adenovirus types 40 and 41 in stool samples. Another potential application is in the rapid diagnosis of epidemic diseases such as keratoconjunctivitis (EKC). Direct adenovirus antigen assays can also be used to screen cell cultures before the development of CPE as well as to confirm the presence of adenovirus in cell cultures positive for CPE.
Pharmacotherapeutic management of atopic keratoconjunctivitis
Published in Expert Opinion on Pharmacotherapy, 2020
Ibtesham T Hossain, Priyanka Sanghi, Bita Manzouri
Corneal involvement in atopic keratoconjunctivitis is secondary to chronic inflammation and has a spectrum of severity. Presence of inflammatory mediators, irregular lid margins, and trauma results in punctate keratitis and persistent epithelial defects. Corneal ulceration is also common and can be superimposed by infections that can be difficult to manage particularly in patients on long-term steroids [20]. Recurrent exacerbations and episodes of infection can result in pannus formation and corneal neovascularisation causing loss of vision (see Figure 3). Power et al. [21] conducted a cohort review of 20 patients and found that 70% of patients with atopic keratoconjunctivitis developed keratopathy, 60% developed corneal neovascularisation, and 50% required keratoplasty.
Presentation, diagnosis, and the role of subcutaneous and sublingual immunotherapy in the management of ocular allergy
Published in Clinical and Experimental Optometry, 2021
Amruta Trivedi, Constance Katelaris
Atopic keratoconjunctivitis is severe, chronic, bilateral inflammation of the ocular surface. It is more common in adulthood, and up to 95 per cent of patients have a personal or family history of allergic disease. Atopic dermatitis is the most common associated condition,31 and atopic keratoconjunctivitis is considered the ‘ocular counterpart’ of atopic dermatitis. The eyelids have an eczematous appearance (Figure 2F), and madarosis or loss of eyelashes is often present. Other ocular findings include chemosis of the eyelid skin, with fine sandpaper‐like texture, conjunctival injection, and conjunctival scarring.32 Similar to vernal keratoconjunctivitis, small Trantas dots and papillae may be present. Patients may also develop atopic cataracts and may require cataract surgery at a young age.13 Corneal complications are common, and risk of vision‐threatening herpetic keratitis also increases.20 As seen in allergic conjunctivitis, many patients with atopic keratoconjunctivitis also test positive to aeroallergen sensitivity.
Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2023
Paras P. Shah, Yoav Glidai, Richard Braunstein, Matthew Gorski, Jung Lee, Farihah Anwar, Amelia Schrier, Jules Winokur, Anne S. Steiner
In our practice, several, but not all, subjects had a history of corneal inflammatory diseases (n = 6, Table 1). Three patients had a history of HSV keratitis, while a fourth previously had zoster keratitis. Additionally, two patients had a history of keratoconjunctivitis, collectively representing the cohort of six patients who had reactivation of keratitis. Three patients did not have any history of corneal inflammatory diseases. In addition, our cohort of patients who experienced keratitis in temporal proximity to COVID-19 vaccination was relatively evenly distributed between both LNP-formulated COVID-19 vaccines available in the United States, BNT162b2 and mRNA-1273 (55.6% and 44.4%, respectively). Within our practice, there were no observed cases among recipients of the Ad.26.COV2.S (Johnson & Johnson) vaccine, which instead uses an adenovirus serotype 26 vector encoding the SARS-CoV-2 spike protein.41 CDC data shows that out of over 200 million fully vaccinated Americans, only 8% received the Johnson & Johnson vaccine, while the rest received the Pfizer-BioNTech or Moderna mRNA vaccines.
Related Knowledge Centers
- Adenoviridae
- Allergen
- Atopy
- Conjunctiva
- Conjunctivitis
- Cornea
- Inflammation
- Keratitis
- Dry Eye Syndrome
- Vernal Keratoconjunctivitis