Immunogenic Conjunctivitis

  • Chronic conjunctival inflammation of autoimmune cause
  • May be isolated to eye, or...
  • Associated with systemic disorders of immune system such as Graves disease, rheumatoid arthritis, Sjögren syndrome, lupus erythematosus, granulomatous polyangiitis, relapsing polychondritis, polyarteritis nodosa
  • Mild, chronic, diffuse engorgement of conjunctival vessels
  • No discharge
  • Little if any pain
  • Sometimes swelling of lids
  • Systemic autoimmune disease often already identified
  • Chlamydial conjunctivitis, blepharitis, dry eye syndrome, BUT...
  • Chlamydial conjunctivitis usually most prominent in lower conjunctiva
  • Blepharitis causes primary inflammation of lids, not conjunctiva
  • Dry eye syndrome causes loss of glistening reflection from corneal surface and fluorescein staining
  • Refer to ophthalmologist non-urgently as diagnosis difficult
  • Outcome variable
  • Chronic cicatricial pemphigoid, a rare type of immunogenic conjunctivitis, may cause marked scarring of conjunctiva
  • In Graves disease, corticosteroids and other immunomodulatory agents may be effective, but if used chronically will expose patient to dangerous side effects
  • In other systemic autoimmune disorders, ocular response depends on underlying condition