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