Atopic Kerato-conjunctivitis (AKC)

Young woman doing optical exam at medical clinic

Atopic Keratoconjunctivitis (AKC) is severe chronic inflammatory eye disease, and is frequently associated with allergic (atopic) diseases like asthma, eczema and hay fever.

AKC occurs most commonly in people between 20 and 50 years of age. AKC is a rare disease, it is estimated there are approximately 120,000 patients with AKC in the US.

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    Atopic Keratoconjunctivitis (AKC)
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    Atopic Keratoconjunctivitis (AKC)

    Atopic keratoconjunctivitis (AKC) is a rare, severe form of eye allergy driven by chronic inflammation of the cornea and conjunctiva, tissues essential for protecting and lubricating the eye.(1) AKC is often linked to a history of atopic disease, such as eczema, asthma, or hay fever.(2) It affects less than 200,000 people in the U.S. and typically begins in late adolescence or early adulthood, with complications most common between the ages of 30 and 50.(3,4) Without effective management, AKC can cause serious eye damage and permanent vision loss.(5)

Q&A

What causes AKC?

AKC is typically caused by an overactive allergic reaction in the eyes, it often occurs alongside conditions like eczema or asthma. In people with AKC the body’s immune system becomes overly sensitive to everyday allergens – like dust or pollen – leading to long-term inflammation and irritation of the eyes.

What are symptoms and complications of AKC?

Hallmark symptoms of AKC include severe itching, redness, and eye discomfort.

If AKC is not properly managed or treated, it can cause scarring or thinning of the cornea, which may lead to blurry vision or even permanent vision loss. It can also make the eyes more vulnerable to infections and chronic pain or discomfort.

How is AKC diagnosed?

Due to limited awareness, AKC is often misdiagnosed as other forms of allergic eye disease or less severe diseases that affect the surface of the eye, which can lead to delayed or improper treatment. 

AKC is usually diagnosed by an eye doctor (ophthalmologist) who examines the eyes and reviews your allergy or eczema history. Sometimes an allergist or dermatologist may also be involved to help identify and manage the allergic triggers.

How is AKC treated?

Currently, there are no FDA-approved therapies for AKC. In the absence of approved treatments, therapies such as topical antihistamines, corticosteroids, immunomodulators, and emerging biologics are used off-label. These therapies demonstrate variable efficacy in treating chronic disease and preventing relapses, and are limited by significant side effects.

What is it like living with AKC?

The persistent and debilitating symptoms of AKC can significantly disrupt daily activities and lead to emotional distress, reducing overall quality of life. The risk of vision loss and infection makes proper diagnosis and treatment crucial.

References

  1. Joseph J. Chen et al., “Atopic Keratoconjunctivitis: A Review,” Journal of the American Academy of Dermatology 70, no. 3 (December 2013): 569–75, https://doi.org/10.1016/j.jaad.2013.10.036.
  2. Brett Bielory and Leonard Bielory, “Atopic Dermatitis and Keratoconjunctivitis,” Immunology and Allergy Clinics of North America 30, no. 3 (August 2010): 323–36, https://doi.org/10.1016/j.iac.2010.06.004.
  3. “Atopic Keratoconjunctivitis,” National Organization for Rare Disorders, May 1, 2025, https://rarediseases.org/mondo-disease/atopic-keratoconjunctivitis/.
  4. Brett Bielory and Leonard Bielory, “Atopic Dermatitis and Keratoconjunctivitis.”
  5. Atopic keratoconjunctivitis - eyewiki, accessed October 7, 2025, https://eyewiki.org/Atopic_Keratoconjunctivitis.