May 2005
Volume 46, Issue 13
ARVO Annual Meeting Abstract  |   May 2005
Managing Symptoms of Allergy and Dry Eye in Patients With Keratoconus
Author Affiliations & Notes
  • C.V. Sundarraj
    Opthalmology Department, UPMC Eye Center, Eye and Ear Institute, Univ. of Pittsburgh School of Medicine, Pittsburgh, PA
  • G.N. Foulks
    Opthalmology Department, University of Louisville, Louisville, KY
  • Footnotes
    Commercial Relationships  C.V. Sundarraj, None; G.N. Foulks, None.
  • Footnotes
    Support  unrestricted research grants from RPB and Eye and Ear Foundation, Pittsburgh, PA.
Investigative Ophthalmology & Visual Science May 2005, Vol.46, 941. doi:
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      C.V. Sundarraj, G.N. Foulks; Managing Symptoms of Allergy and Dry Eye in Patients With Keratoconus . Invest. Ophthalmol. Vis. Sci. 2005;46(13):941.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract: : Purpose: Although many of the keratoconus patients successfully wear rigid gas permeable (RGP) lenses for several years without any discomfort, recently we have noticed an increased number of keratoconus patients whose allergic symptoms of itching, redness, tearing, chemosis in combination with strings of mucous need intervention. Differentiation between dry eye patients and those who suffer from allergy is important for management of allergy and dry eye keratocounus patients. Methods: Patients with allergic symptoms were distinguished from dry eye patients by meibomian gland function, tear break up time, fluroescein staining and Schirmer test. We have reported (CLES, 2004) the advantages of piggy back lenses in combination with RGP lenses for keratoconus and post corneal transplant surgery (PK) patients in maintaining the best visual acuity.Recently, (ICER, 2004) we reported the use of Restasis, ( Cyclosporine A, 0.05%) in some of the piggy back contact lens wearers who exhibit dry eye syndrome. Treatment with Patanol (olopadine)or Alamast(pemirolast sodium) twice a day , prior to insertion of the contact lenses and after removalof the lenses at the end of the day reduces the allergy symptoms and extends visual comfort. Results: Among the ten keratoconus patients, five with allergy were treated with mast cell stabilizers. Three of the keratoconus post–PK patients have mild seasonal allergies and benefit from this treatment.Specialized contact lenses such as Proclear and Focus Night & Day which have been used as piggy back lenses in some of these patients have decreased allergy symptoms. Conclusions: The combination use of Patanol and Alamast, the mast cell stabilizers in the allergypatients is very useful in management of allergy among the keratoconus patients. The long term care of the post PK patients depends upon the proper testing to diagnose the allergy from dry eye patients.

Keywords: keratoconus • cornea: tears/tear film/dry eye • contact lens 

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