Ocular allergies are the most frustrating group of eye diseases. The severity may vary from being a very mild discomfort to severe allergy leading to complications. Ocular allergies cause persistent, recurrent discomfort which includes swelling of the eyelids, a thick discharge, redness and severe itching. Severe ocular allergy is characterised by a swollen lid. On eversion of the upper lid, giant nodular swellings can be appreciated. These constantly rub on the cornea and lead to formation of corneal ulcer- a very painful condition. Though initially mild, these ‘shield ulcers’ may develop infection. Such cases require prompt management at a corneal centre with good microbiological services. Even when completely healed, they leave behind white corneal opacities. For patients with chronic, recurrent disease with swelling around the cornea, the cornea might loose its transparency. This is termed as limbal stem cell deficiency (LSCD). This leads to a decrease in vision which is difficult to treat. Hence, the goal of management is to target these diseases at the onset or they might lead to the above mentioned complications. Allergies are at first managed with medications in the form of either eye drops or occasionally oral medications. These suffice in most cases. For patients developing complications, careful examination is essential. Microbiological corneal scraping should be done at the first instance whenever required. For patients developing severe LSCD in both eyes, we have an option of Keratoprosthesis. Dr Rajat has obtained special training in implantation of the Keratoprosthesis and he is one of the very few in the country to perform such surgery.
Note for the patients: Parents are advised to keep a watch that their children do not rub their eyes. At their tender age, cornea is known to change its shape due to the mechanical pressure of the fist and has been implicated to cause complications of corneal shape referred to as keratoconus.