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Table 4 Ocular examination findings of common ocular comorbidities

From: A contemporary look at allergic conjunctivitis

Related ocular disease Ocular signs
 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
 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