This article is from February 2010 and may contain outdated material. Ocular pruritus is a regular symptom that gets patients to the ophthalmologist’s headquarters. It can be tempting to overlook this seemingly minor concern while assessing patients for potentially vision threatening diseases. It is itchy eyes is a huge issue and source of fussiness for patients, oftentimes affecting the ‘daytoday’ quality of life.
It should be essential to identify the underlying cause, even if a physician’s inclination can be just to treat the symptom with topical mast cell stabilizers or antihistamines. Sounds familiar? By carefully and methodically determining ocular etiology pruritus, the clinician can select an appropriate treatment regimen and provide patients with the relief they seek. Pruritus could be the chief complaint for lots of ocular surface diseases. Atopic vernal keratoconjunctivitis, atopic, keratoconjunctivitis or allergic conjunctivitis dermatitis are an important component of ocular spectrum allergies. Different causes of pruritus comprise dry eye syndrome, contact, blepharitis and even meibomian gland dysfunction lens induced giant papillary conjunctivitis, conjunctivitis or contact dermatoblepharitis.
It’s a well the majority of ocular causes pruritus are immunologically mediated. Just think for a second. The next questions may help narrow the differential.
Thus, an appropriate treatment course is selected, once the diagnosis was made.
Dry eye syndrome. Needless to say, ocular Lubrication surface is an important goal. Initial treatment with artificial tears and with lubricant at bedtime, is acceptable. Some patients may likewise require punctal plugs. I’m sure you heard about this. Anyone who remain symptomatic may need topical cyclosporine A to increase tear production. Meibomian gland dysfunction/blepharitis. Schooling regarding good eyelid hygiene is imperative. Considering the above said. Warm compresses and ‘twice daily’ eyelid scrubs can help open inspissated meibomian glands. Ocular surface lubrication with artificial tears can provide special relief. Then, while some patients will require a course of oral tetracyclines that are then tapered off, shortterm use of a topical antibiotic can be beneficial. Sounds familiar, does it not? Staphylococcal marginal keratitis will oftentimes require topical use corticosteroids to quell the inflammatory response. Well known on AAO.