Chronic tarsal conjunctivitis

Area of Science:

• Ophthalmology
• Toxicology
• Dermatology

Background:

• A novel presentation of chronic conjunctivitis unresponsive to standard treatments emerged between 2010 and 2013.
• This condition, characterized by unusual clinical features, was observed in a Primary Care Ophthalmology Service.

Purpose of the Study:

• To investigate a new form of toxic conjunctivitis with distinct clinical and histopathological features.
• To identify potential causes and effective management strategies for this resistant conjunctivitis.

Main Methods:

• Retrospective review of 55 adult female patients' case records.
• Histopathological analysis of conjunctival biopsies from 15 patients.

Main Results:

• Patients presented with bilateral epiphora and stickiness, and tarsal conjunctival papillary reaction, with symptom duration averaging 9 months.
• Histology revealed a superficial stromal lymphocytic infiltrate, predominantly CD3 positive T-lymphocytes, with no follicle formation.
• Prolonged use of eye makeup and facial cosmetic products was a common history; symptoms improved with topical steroids, but signs persisted until allergen withdrawal.

Conclusions:

• The findings suggest a contact allergen-driven chronic conjunctivitis, likely induced by cosmetic products.
• While topical steroids offered symptomatic relief, complete resolution required allergen avoidance, highlighting management challenges.
• Further research is needed to identify specific allergens and understand mucous membrane contact allergies.