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What is AKC (Atopic Keratoconjunctivitis)?


Updated April 27, 2007

What is AKC (Atopic Keratoconjunctivitis)?

The outer layer of the eye (sclera, or white, and cornea) is fibrous and protective. The middle layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory.

Updated April 27, 2007
Atopic keratoconjunctivitis (AKC) is a severe form of eye allergy that can involve the cornea of the eye as well as the inner lining of lower eyelids. AKC usually affects young adults, starting in the late teens to early twenties, and can persist for decades. The majority of people with AKC also have atopic dermatitis, allergic rhinitis and/or asthma. Severe AKC can lead to complications including cataracts, eye infections and blindness.

What are the symptoms of AKC?

The symptoms of AKC are initially very similar to those of allergic conjunctivitis, although much more severe and include more sensitivity to light, blurred vision and a thick, stringy discharge. People with AKC frequently have atopic dermatitis that involves the eyelids and skin around the eyes and face. The inner lining of the eyelids, or conjunctiva, are red and swollen, and may have thickened bumps called papillae. These are most frequently found under the lower lid in AKC.

Symptoms of AKC are typically year-round, but may notice seasonal worsening in the winter and summer months. Common triggers include animal dander, dust and occasionally foods.

What are the complications of AKC?

Because AKC can affect other structures of the eye, such as the cornea, cataracts and scarring can form, and blindness can occur. People with AKC are also at increased risk for infections of the eye, including certain bacterial and herpes infections.

How is AKC diagnosed?

AKC is diagnosed in much the same way as allergic conjunctivitis, although the presence of more severe symptoms and the presence of atopic dermatitis on the face should be a clue of a more severe disease process. An ophthalmologist or optometrist may be needed to confirm the diagnosis of AKC, and assist the primary physician in the treatment of the patient.

How is AKC treated?

Treatment of AKC is very similar to the treatment of atopic conjunctivitis, although corticosteroids may be required more frequently in this disease. An ophthalmologist or optometrist should monitor people using steroid eye drops for any prolonged period of time, as these medications can also lead to severe side effects (such as glaucoma and cataract formation).


    1) Ono SJ, Abelson MB. Allergic conjunctivitis: Update on pathophysiology and prospects for future treatment. J Allergy Clin Immunol. 2005; 115:118-22.
    2) Bielory L. Allergic and Immunologic Disorders of the Eye. Part II: Ocular Allergy. J Allergy Clin Immunol. 2000; 106:1019-32.

DISCLAIMER: The information contained in this site is for educational purposes only, and should not be used as a substitute for personal care by a licensed physician. Please see your physician for diagnosis and treatment of any concerning symptoms or medical condition.

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