Atopic keratoconjunctivitis (AKC) is a rare and severe eye condition that causes intense itching on the surface of the eyes, the eyelids, and the skin around the eyes.
Other symptoms of AKC include eye redness, burning, tearing, discharge, and blurred vision.
The condition occurs most commonly in adults ages 20 to 50 years who have an underlying condition called atopic dermatitis (eczema). Males get AKC more often than females.
AKC results from a genetic condition called atopy. Atopy makes you more likely to develop allergic conditions.
Treatment can help control the symptoms of AKC and prevent serious complications, like scarring or ulcers in the eye.
Let’s take a closer look at the symptoms, causes, diagnosis, treatment, and outlook of AKC.
What is the difference between atopic and vernal keratoconjunctivitis?
AKC and vernal keratoconjunctivitis (VKC) are both severe eye conditions that are more common in people with atopy. The conditions are similar, but there are a few key differences:
- AKC usually starts in early adulthood, while VKC usually occurs in childhood.
- AKC usually affects the lower part of the eyes, while VKC affects the upper part of the eyes.
- AKC is longer lasting, while VKC may occur periodically and often resolves by late adolescence.
Differentiating between the two conditions can sometimes be challenging for doctors. For some people, VKC can convert to AKC and require long-term treatment. About 5% of people with AKC have a history of childhood VKC.
Atopic keratoconjunctivitis vs. allergic conjunctivitis
AKC is a type of allergic conjunctivitis. But it’s much more severe and chronic than other types. AKC symptoms tend to occur year-round, while other types of allergic conjunctivitis tend to be seasonal and intermittent.
Atopic keratoconjunctivitis causes
AKC is due to a condition called atopy . Atopy is a group of allergy conditions that result from your immune system overreacting to some harmless trigger in the environment, such as pollen, dust, pet dander, or certain types of food. Atopy is a genetic condition that runs in families.
Risk factors for AKC include:
- being male
- being aged between 20 and 50 years
- having asthma or atopic dermatitis (eczema)
- having a family history of atopic or allergic conditions
Is atopic keratoconjunctivitis a rare condition?
About 95% of AKC cases occur in people with another condition called atopic dermatitis. Globally, atopic dermatitis is estimated to occur in about 2.6% of the population. AKC is estimated to occur in up to 40% of people with atopic dermatitis.
Atopic keratoconjunctivitis symptoms
The symptoms of AKC usually occur in both eyes (bilaterally). In general, it tends to affect the lower eyelids more than the upper eyelids.
Symptoms occur year-round but may worsen in the winter. They may include:
- severe itching
- redness
- swelling
- burning
- watery eyes
- blurred vision
- sensitivity to light
- white discharge
- thick crust on the eyelids
- a feeling like there’s something in your eyes
Potential complications of atopic keratoconjunctivitis
Complications can occur with AKC, especially if you don’t seek treatment for the condition and you persistently or aggressively rub your eyes to alleviate the itching.
Complications may include:
The medications that treat AKC can also cause complications. For example, topical corticosteroids carry a risk of increasing blood pressure in the eye (intraocular pressure). This may lead to another condition called glaucoma. Glaucoma can cause impaired vision or blindness.
When to get medical help
Visit a doctor if you’re experiencing any intense itching, burning, redness, or discharge affecting your eyes.
If you have another atopic condition, like atopic dermatitis, it’s important to schedule regular eye exams with an eye doctor (ophthalmologist).
Atopic keratoconjunctivitis diagnosis
A doctor will conduct a physical examination and ask you about your symptoms and medical and family history. They’ll examine your eyes and eyelids as well as any discharge from your eyes.
It’s important to tell your doctor about your symptoms, including when they started and how often they occur. This will help them differentiate AKC from similar conditions, like VKC and giant papillary conjunctivitis.
Atopic keratoconjunctivitis treatment
Treatment for AKC aims to control symptoms. It usually starts with allergy medications like oral and topical antihistamines . Your doctor may also tell you to apply cold compresses or eye lubricants to help alleviate any itching and inflammation.
If your symptoms persist or become severe, your doctor may prescribe medications like:
Can you prevent atopic keratoconjunctivitis?
AKC is a genetic condition, meaning it’s not possible to prevent it. However, you may be able to reduce your risk of severe symptoms by:
- avoiding known allergens that worsen your AKC symptoms, like pet dander or dust
- wearing sunglasses as an eye barrier
- washing your hands before touching your eyes or putting in contact lenses
- taking any prescribed allergy medications or steroids
Living with atopic keratoconjunctivitis
AKC is a serious and chronic condition that can cause eye damage without treatment. The damage to your eyes can cause decreased vision and blindness. Although the condition most commonly affects adults ages 20 to 50 years, research suggests that the earlier the onset and the longer the duration of AKC, the more serious the eye damage that occurs.
Getting an early diagnosis of AKC, managing any underlying conditions, seeking treatment, and avoiding your allergic triggers can help improve your symptoms and quality of life.
Takeaway
AKC is a rare but serious eye condition. It causes inflammation in the eyelids and the surface of the eyes. This inflammation causes a range of symptoms, like intense itching, redness, and discharge.
AKC is often chronic and persistent, but with treatment, your symptoms may resolve completely.
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