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oNormal iris, pupil and visual acuity. oCorneal complications in very advanced stages 201Standard Treatment Guidelines201
Non-Pharmacological Treatment Treatment of allergic conjunctivitis depends on the severity of the condition and age of the patient. In mild cases where the eyes are white,Avoid allergens Cold water compresses for 10 minutes four times a day Pharmacological Treatment Adults and children > 6 years of age: C:Oxymetazoline 0.025% drops 6 hourly a maximum of 7 days If no response within 7 days, use mast cell stabilizers such as: C:Sodium chromoglycate 2% eye drops, instill 6 hourly per day (Doctor initiated) Use may be seasonal (1–3 months) or long term. Children 2–6 years of age: A:Chlorpheniramine (PO) 0.1 mg/kg/dose 6–8 hourly If no response within 7 days use C:Sodium chromoglycate 2% eye drops, instill 6 hourly per day (doctor initiated) oUse may be seasonal (1–3 months) or long term for the prevention of further attack, depending on the patient’s exposure to the allergen.Persistent allergic Conjunctivitis in adults and children of >2 years of age: For long term use: Children 2–6 years A:Cetirizine (PO) 5 mg once daily oUse may be seasonal (1–3 months) or long term Children > 6 years of age and adults: A:Cetirizine (PO) 5 mg once daily oUse may be seasonal (1–3 months) or long term NOTE: Do not give antihistamine to children under 2 years of age as its effectiveness at this age group has not been proven.Referral Refer to eye specialist for further specialized care in case of the following: Moderate to severe allergic conjunctivitis No response Persons wearing contact lenses Children <2 years of age At the specialized centre, the following treatment may be added depending on the patient’s presentation:Short term steroid eye drops (in severe cases with involvement of the cornea, apart from mast cell stabilizers, give D:Dexamethasone 0.1%, 6 hourly for a maximum of 14 days. OR202Standard Treatment Guidelines
D:Prednisolone 0.5%, 6 hourly for a maximum of 14 days. In very severe form of allergic conjunctivitis, give steroid injection D:Triamcinolone acetonide 20 mg, subtenon injection, stat ORD:Methylprednisolone sodium acetate 20mg, subtenon injection, stat 126.96.36.199 Viral Conjunctivitis The commonest causative organism is adenovirus. It may be unilateral but usually bilateral Diagnostic Criteria It may be associated with upper respiratory tract infection Presents with morning crusting and watery eye discharge A burning, sandy or gritty feeling in the eyes Diffuse pink or red conjunctiva due to subconjunctival haemorraghes Photophobia if the cornea is involved Normal visual acuity Preauricular lymphadenopathy It appears in epidemics so there will be history of contact with patients with similar eye condition It is usually is self-limiting but the irritation and discharge get worse on 3 –5 days before getting better and symptoms can persist for 2–3 weeks.