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Updated: Apr 4, 2026

In Vivo Confocal Microscopy in the Diagnosis and Management of Dry Eye: A Focus on Imaging Protocols and Interpretation

In Vivo Confocal Microscopy in the Diagnosis and Management of Dry Eye: A Focus on Imaging Protocols and Interpretation

Published on: November 11, 2025

Component-resolved diagnostics in vernal conjunctivitis.

Alicia Armentia¹, Beatriz Iglesias², Darío Iglesias³

¹Allergy Unit, Rio Hortega University Hospital, Valladolid, Spain.

Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology

|September 7, 2015

Summary

Component-resolved diagnosis (CRD) offers a more sensitive approach to identifying allergens in vernal conjunctivitis (VC). CRD-guided immunotherapy shows promise for improving clinical outcomes in VC patients.

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Area of Science:

Ophthalmology
Allergology
Immunology

Background:

Conventional allergy diagnostics are inadequate for determining the causes of vernal conjunctivitis (VC).
Identifying specific allergens is crucial for effective VC management.

Purpose of the Study:

To assess IgE-mediated hypersensitivity using component-resolved diagnosis (CRD) in tears and serum of VC patients.
To evaluate the efficacy of specific immunotherapy based on CRD findings for treating VC.

Main Methods:

Evaluated 25 patients with VC, 50 with seasonal allergic conjunctivitis (AC), and 50 healthy controls.
Utilized CRD on tear and serum samples to identify specific allergens.
Administered 1 year of specific immunotherapy to patients with identified triggering allergens.

Main Results:

Identified specific grass pollen allergens (n Lol p 1, n Cyn d 1, groups 4, 5, and 6) in VC patients.
CRD detected triggering allergens in a significant portion of VC patients, unlike conventional tests (prick test, IgE).
Clinical improvement was observed in 13 out of 25 VC patients after 1 year of CRD-guided immunotherapy.

Conclusions:

Component-resolved diagnosis (CRD) is a more sensitive diagnostic tool for VC compared to traditional allergy tests.
CRD-guided specific immunotherapy can lead to significant clinical improvements in patients suffering from vernal conjunctivitis.