LE: reactivated corneal ulcer, with upper tarsal papillary reaction

Treatment
Conservative treatment with palpebral hygiene
Cold patches
Mucolytic agent (topical n-acetylcisteine)

To control the “flare-up” of the disease:
“pulses” of topical steroids
artificial tears
topical mast cell stabilizers (olopatadine).

Systemic Treatment:
…depending of ocular and systemic allergic exacerbations:
desloratidine (Aerius)
prednisolone

mometasone cream (Elocom)
nasal mometasone (Nasomet)

inhaled beclometasone (Beclotaide)
inhaled salbutamol (Ventilan)
inhaled salmeterol + fluticasone (Seretaide).

…meanwhile he started:

allergen vaccine (allergen immunotherapy) with a polymerized allergen extract of Dermatophagoides pteronyssinus and maintained strict allergen avoidance.

Images after treatment: 
Amniotic membrane transplantation - 1 month later
Atopic corneal ulcer with decreased inflammation, less neovascularization and decreased hyperaemia
Follow-up: Improvement of the inflammatory process, decreased papillary reaction in the upper tarsal conjunctiva.
Follow-up: Bilateral mild allergic conjunctivitis with minor symptomatology.
Corneal leucomas (RE <<< LE) after keratopathy
Conclusion: 

Prognosis…

Keratopathy with neovascularization is a serious problem, reducing the probability of successful corneal transplants.

References: 

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