Atopic keratoconjunctivitis (AKC)

Atopic keratoconjunctivitis (AKC) is a chronic and potentially sight-threatening allergic eye disease characterised by inflammation of the ocular surface. The condition typically begins during late adolescence and early adulthood. Most patients have a history of asthma and eczema. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing AKC. It includes options for non-pharmacological management and first aid measures, and outlines when urgent and routine referral may be appropriate.

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What is atopic keratoconjunctivitis?

Atopic keratoconjunctivitis is a chronic (long-lasting) allergic condition of the eyelids and front surface of the eye. It affects many patients who have the skin condition, atopic dermatitis (eczema). 

How is atopic keratoconjunctivitis managed?

Atopic keratoconjunctivitis needs long-term treatment to prevent complications such as scarring of the cornea (the clear window at the front of the eye), which can damage sight. In the early stages of the disease, symptoms (e.g. itching or burning) can be controlled by standard anti-allergy drugs combined with the application of a cool compress to the closed eyes. However, courses of steroid eye drops can be needed when symptoms are more severe. Cases that do not respond to steroids, or need steroid eye drops for long periods, may benefit from ciclosporin or tacrolimus eye drops or ointment. Many cases need to be referred to the ophthalmologist for management, who in turn may refer them to specialists in other allergic diseases.

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Last updated

Atopic Keratoconjunctivitis (AKC)
Version 16
Date of search 08.12.22
Date of revision 23.02.23
Date of publication 29.03.23
Date for review 07.12.24
© The College of Optometrists