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Allergic people often have a double fold below eyes, long eyelashes,
and dark "Shiners" below eyes
Atopic dermatitis/keratoconjunctivis
- Dry thickened, scaling with pigmentation changes mainly on extensor
surfaces
- Hyperemia, chemosis, blepharitis, conjunctivitis, keratoconus
- "Trantas dots" at limbus
- "White dermatographism test": Stroke the skin with a blunt
instrument. Normally you would see erythema and wheal formation, but
in people with atopic dermatitis the erythema is often replaced by
a white line surrounded by an area of blanching
Lower tarsus cobblestones confirms diagnosis
Contact dermatitis
- May be type IV allergy or reaction to physical irritant
- Pruritus (itch) is hallmark
- Eyelids very sensitive due to thin skin
- Scaling and erythematous erruptions of lids
- Chemosis with a papillary or follicular reaction
- May be unilateral or bilateral
- Cosmetics, topical meds and cl solutions main causes
- Crusting vesicles
Eczema
- Eczema is a term used in children when the diagnosis is not
sure to be atopic dermatitis or
- Seborrheic dermatitis
- Blepharoconjunctivitis
Staph hypersensitivity
- Probably type I or type IV (Response over time)
- Phlyctenules
- Node of leukocyte infiltration
Marginal infiltrates
- Neutrophils (Poly's) drawn into peripheral cornea in response
to exotoxins
- Often at inferior limbus
- Inferior cornea SPK
Type I hypersensitivity
- Uticaria
- Superficial wheals and hives
- Angioneurotic edema
- Deep tissue edema
- Itching
Type IV Delayed Hypersensitivity
- Prior exposure sensitizes to allergen in days to years
- Cosmetics, plants, nickel, neomycin, perfumes, "Cain" meds,
sulfonamides
- Itching, initial oozing, erythema dries and scales
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