A medical history and physical examination are crucial to properly diagnosing atopic keratoconjunctivitis. A diagnosis of atopic keratoconjunctivitis is more likely if a patient has a family history of atopic disease (inherited allergy-related disease) in one or both parents. Other atopic disorders in the patient (for example, asthma or allergic rhinitis) also are indicators of atopic keratoconjunctivitis.

Healthcare professionals usually can recognize atopic keratoconjunctivitis from its appearance. Doctors will first anesthetize the eye and then use scrapings of the conjunctiva (a membrane that covers the white of the eye and inside of eyelids) or collect secretions and discharge to check for the presence of eosinophils. This is a type of white blood cell that releases some of the major chemical mediators (the substances that cause inflammation of airways) during an asthma attack. 

Treatment of atopic keratoconjunctivitis takes several forms. Antihistamine creams are used to provide temporary relief of eye symptoms. Corticosteroid creams are often used for limited periods to treat the dermatitis of the outer eyelid. Long term use of corticosteroids is not recommended. Patients must be careful to avoid getting this medication into the eye itself.

Antibiotics may be prescribed to treat bacterial infections that sometimes develop. Cromolyn sodium eyedrops are used to treat inflammation of the conjunctiva. Cold compresses and saline irrigation may also provide relief from symptoms.

In addition, patients may be advised to wear cotton gloves at night to prevent unintentional damage to the eye caused by rubbing or scratching during sleep.

Patients with a history of atopic keratoconjunctivitis are urged to avoid allergens that trigger symptoms. Avoidance is the only successful prevention technique for those with atopic keratoconjunctivitis.

Allergy shots (immunotherapy) are generally not considered a good option for treating atopic keratoconjunctivitis. It is often difficult for a patient to build a tolerance to all of the allergens that trigger symptoms. In addition, some evidence suggests that the conjunctiva is not as responsive to desensitization treatments as the skin or the lungs.

Patients in the later stages of atopic keratoconjunctivitis may require surgery to address complications. For instance, patients with cataracts may require intraocular lens implantation.