EpistemisEye itching
Specialty: Ophthalmology.
Why it occurs
- Seasonal or perennial allergic conjunctivitis
- Previous blepharitis of seborrheic or staphylococcal origin
- Evaporative keratoconjunctivitis sicca (meibomian gland dysfunction)
- Eyelid contact dermatitis due to cosmetics or ophthalmic eye drops
- Giant papillary conjunctivitis secondary to wearing contact lenses
- Eyelid infestation by Demodex folliculorum
Initial workup
Slit lamp biomicroscopic examination (upper eyelid eversion required to classify the degree of tarsal conjunctival papillary reaction); Evaluation of the eyelashes for collars of debris or flaking on the eyelid margin; Schirmer test (to assess basal tear secretion); Tear Film Breakup Time (TBUT) with fluorescein staining; Taking an eyelash sample for direct microscopy if Demodex is suspected.
red flags
Severe ocular pruritus that progresses to lancinating orbital pain, massive conjunctival chemosis, profuse purulent yellowish-greenish secretion and inflammation of the eyelid that prevents eye opening, indicating aggressive bacterial superinfection or preseptal cellulitis.
Standard management
- Olopatadine — 0.1% or 0.2% eye drops, 1 drop every 12 or 24 hours in the conjunctival sac; It is a highly effective antihistamine and mast cell stabilizer in allergic conjunctivitis.
- Ketotifen — 0.025% eye drops, 1 drop every 12 hours as an antihistamine alternative
- Ophthalmic hydrocortisone — 1% dermal ointment formula for eczema or eyelid contact dermatitis, apply a thin layer every 12 hours for a period of no more than 7 days
- Ciclosporine (0.05% eye drops, 1 drop every 12 hours in cases of severe refractory dry eye to reduce immune inflammation of the lacrimal gland).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Ophthalmology
- Listed causes
- 6
- Treatment options
- 4