New York State Medical Treatment Guidelines for Atopic and Vernal Keratoconjunctivitis in workers compensation patients

The guidelines provided by the New York State Workers Compensation Board offer general principles for managing Atopic Keratoconjunctivitis and Vernal Keratoconjunctivitis. These directives aim to assist healthcare professionals in determining appropriate strategies for diagnosing and addressing inflammatory conditions affecting the cornea and conjunctiva in individuals with atopic or vernal allergies, as part of a comprehensive care plan.

Healthcare practitioners specializing in Atopic and Vernal Keratoconjunctivitis can rely on the guidance from the Workers Compensation Board to make well-informed decisions about the most suitable approaches for assessing and treating these specific eye conditions in their patients.

It is crucial to emphasize that these guidelines are not intended to replace clinical judgment or professional expertise. The ultimate decision regarding the management of Atopic and Vernal Keratoconjunctivitis should involve collaboration between the patient and their healthcare provider.


Atopic and Vernal Keratoconjunctivitis

The prognosis for ocular allergies is generally positive, with favorable outcomes expected. However, the prognosis may be less favorable in cases with worsening symptoms, particularly if systemic manifestations such as occupational asthma are present. Anaphylactic symptoms, if observed, necessitate complete removal from exposure, as outlined in the Work-Related Asthma guideline.

The main complication associated with ocular allergies is the development of systemic allergic diseases, especially work-related asthma, as detailed in the Work-Related Asthma guideline. Anaphylaxis is a rare but serious potential complication, particularly in individuals with severe allergies exposed to high levels of allergens.

Regular monitoring, appropriate management, and, when necessary, removal from exposure can contribute to a positive prognosis for individuals with ocular allergies. Understanding and addressing systemic implications are crucial for comprehensive care and improved outcomes.

Follow-up care for ocular allergies varies based on the severity of the case and the response to treatment. Mild cases typically require infrequent follow-ups. In more severe cases, evaluations for concomitant asthma, consideration of exposure modification or removal from work, and immunotherapy may be necessary.

For cases requiring immunotherapy, treatments may be administered every 1-2 weeks over a period ranging from several months to approximately 2 years. This approach aims to address the underlying allergic inflammation and improve the overall condition.

Vernal keratoconjunctivitis, characterized by chronic and severe ocular surface inflammation, is relatively rare. While it is often associated with Th2-lymphocyte-mediated mechanisms, 50% of patients do not exhibit IgE-mediated pathways. Considered the ocular manifestation of atopic dermatitis, it typically begins in childhood and is largely viewed as a nonoccupational condition. Although primarily nonoccupational, occasional cases can occur throughout the United States and Canada, potentially exacerbated by non-specific hyperreactivity to factors like wind, dust, and sunlight.

The evaluation of patients with vernal keratoconjunctivitis is similar to other allergy investigations, as outlined previously. Consequently, treatments recommended for other allergic eye diseases are also applicable to vernal keratoconjunctivitis. The management typically involves addressing the underlying allergic inflammation through measures such as antihistamines, mast cell stabilizers, and, in more severe cases, immunotherapy. Additionally, symptomatic relief may be achieved with lubricating eye drops and avoiding known triggers. Regular follow-ups are essential to monitor the condition’s progression and adjust the treatment plan accordingly.

Skip to content