Table 4 Ocular examination findings of common ocular comorbidities

Allergic

 Atopic keratoconjunctivitis

Eyelid atopic dermatitis often present

Conjunctival injection and chemosis

Conjunctival scarring

Giant papillae may be present

Infiltration of the limbus (region where the cornea meets the sclera) and cornea [15]

 Vernal keratoconjunctivitis

Tearing, profuse mucous discharge [28]

Bulbar conjunctival injection

Large papillae of superior palpebral conjunctiva, ‘cobblestone-like’

Corneal plaque/shield ulcer

Trantas’ dots (infiltrates at the juncture of the cornea and the sclera)

Corneal neovascularization and scarring

 Atopic dermatitis

Periocular scaly, dry skin

Eyelid thickening

Lash loss

Papillary hypertrophy of palpebral conjunctiva

May be accompanied by conjunctival injection, watery/mucoid discharge [28]

 Demodex-associated conjunctivitis (hypersensitivity to lid mites)

Heavy lash debris (lash collarettes)

Bulbar conjunctival injection, may show papillae

Eyelid hyperemia

Others

 Contact-lens associated papillary conjunctivitis, CLPC (often termed Giant papillary conjunctivitis, GPC)

Mucoid discharge

Excessive movement of contact lenses

Papillary hypertrophy of superior palpebra conjunctiva; if severe: lid swelling, ptosis [28]

Clear cornea

 Anterior blepharitis (staphylococcal, seborrheic)

 Posterior blepharitis (Meibomian gland dysfunction, ocular rosacea)

Lash debris, lid hypertrophy/hyperemia [15]

Conjunctival injection and staining (lissamine green)

Corneal staining (fluorescein)

Evaporative dry eye disease

 Dry eye disease (aqueous deficiency, evaporative)

Inadequate tear volume (low tear meniscus) (aqueous deficiency)

Lash debris, lid hypertrophy/hyperemia, Meibomian gland dysfunction, ocular rosacea (poor tear film stability; evaporative dry eye)

Conjunctival injection [15] and staining (lissamine green)

Conjunctival chalasis (redundancy of the conjunctiva from loss of adherence to the sclera)

Corneal staining (fluorescein)

 Ocular toxicity (due to ophthalmic agents, usually preservatives)

Conjunctival injection

Corneal staining

 Others: e.g. superior limbic keratoconjunctivitis, floppy eyelid syndrome, etc.

Chronic symptoms and signs, some of which may overlap with AC