Atopic keratoconjunctivitis is a form of atopic dermatitis (eczema associated with allergies) that affects the eyelids and conjunctiva (the membrane covering the white of the eye and inner eyelid). This chronic eye allergy can damage the cornea (the eye's outermost layer) and cause permanent vision damage if left untreated.

Most people with atopic keratoconjunctivitis have symptoms of atopic dermatitis elsewhere on their bodies. However, the area around the eyes usually manifests the most severe symptoms, which include red, thickened eyelids, eye itchiness and small papular lesions (solid elevations of skin) that ooze, crust and scale. Excess tearing and extreme sensitivity to light (photophobia) also may occur. In rare cases, Horner-Trantas dots (localized collections of white blood cells known as eosinophils) also may appear at the limbus (junction of the eyeball’s cornea and sclera).

Atopic keratoconjunctivitis typically first appears in the teens through early 20s, but it can occur into middle age. It is more common in males than females. Patients often have a personal history of allergy, especially allergic rhinitis (hay fever), eczema and/or asthma. A family history of multiple allergies is also common.

It is closely related to allergic rhinoconjunctivitis and may coexist with the condition. The biggest difference between the two conditions is that atopic keratoconjunctivitis is chronic and potentially threatens a patient’s sight, whereas allergic rhinoconjunctivitis is rarely sight-threatening and tends to flare up in tandem with a patient’s symptoms of allergic rhinitis.