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Background: This study aimed to measure the effects of persistent corneal subepithelial infiltrates associated with epidemic keratoconjunctivitis on corneal densitometry and total corneal higher order aberrations (HOAs), and to compare these measurements with the data obtained from their fellow unaffected healthy eyes., Methods: This prospective cross-sectional study included those who had persistent subepithelial infiltrates in only the affected eyes for at least three months and clinically normal fellow unaffected eyes. Corneal densitometry was measured with the densitometry software of the Pentacam HR-Scheimpflug corneal topographer over a 12 mm diameter of cornea. Further, total corneal HOAs including coma (Z[1,3], Z[3,-1]), trefoil (Z[3], Z[3,-3]), spherical aberration, higher order root mean square (HO-RMS), and total RMS in the Zernike analysis were analysed by the same Pentacam HR device., Results: Forty-six eyes of 23 participants were analysed in this study. The mean corneal densitometry values were statistically significantly higher in all annular concentric areas (0-2, 2-6, 6-10, and 10-12 mm) of the anterior and central corneal layers in the eyes with subepithelial infiltrates when compared to normal fellow eyes (p < 0.05, for each one). Additionally, there were statistically significant differences between the eyes with subepithelial infiltrates and normal fellow eyes with regard to coma, trefoil, HO-RMS, and total RMS in the Zernike analysis (p < 0.05, for each one)., Conclusion: This study quantitatively demonstrated that persistent corneal subepithelial infiltrates associated with epidemic keratoconjunctivitis decrease corneal transparency and corneal optical quality in affected eyes., (© 2018 Optometry Australia.)

Purpose of Review: The purpose of the present review is to provide an overview on the clinical features and long-term complications of severe ocular allergies, with a special focus on the corneal involvement observed in these diseases, which may impair vision permanently. Furthermore, different treatment options are discussed based on the sight-threatening effects of corticosteroid use., Recent Findings: Recent data on the demographics, clinical and immunologic features of vernal and atopic keratoconjunctivitis are presented and discussed, and the evidence of a lack of literature addressing the issue of visual outcome in allergic diseases is underlined. The efficacy and possible long-term complications of their treatments are described, including visual impairment., Summary: Diagnosis and treatment of patients with severe ocular allergy is a challenge for ophthalmologists due to the long-term corneal complications and the potential side-effects of topical corticosteroids that may induce cataract formation and glaucoma, and impair vision permanently. The review describes old and new concepts of management and possible complications such as severe, vision-threatening forms of allergic ocular disease. An update on their management and long-term complications may help clinicians to establish a common agreement on treatment options and researchers to design future studies based on similar outcomes, including visual acuity.