Atopic keratoconjunctivitis is a chronic, sight-threatening ocular allergic disease. A structured treatment protocol exists for patients whose condition has not been adequately controlled with topical corticosteroids, cyclosporine, or antiallergy medications.
The protocol covers both topical options for refractory cases and — in carefully selected patients — systemic immunosuppressive strategies, which are reserved for situations where they are truly warranted. The complete sequencing, criteria, and regimen are in the full protocol.
Systemic immunosuppression is rarely warranted, but options include montelukast, aspirin, interferons, and oral T-cell inhibitors, such as cyclosporine and tacrolimus.
Randomized clinical trials have demonstrated the efficacy of topical tacrolimus 0.1% applied conjunctivally in patients who had failed conjunctivitis therapy with topical corticosteroids, cyclosporine, and/or antiallergy medications.