Executive summary: Japanese guidelines for allergic conjunctival diseases 2021

Allergol Int. 2022 Oct;71(4):459-471. doi: 10.1016/j.alit.2022.07.005. Epub 2022 Sep 10.


Allergic conjunctival disease (ACD) is an inflammatory disease of the conjunctiva that is mainly caused by type I hypersensitivity response to allergens and accompanied by subjective symptoms and other findings induced by antigens. ACD is classified as allergic conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and giant papillary conjunctivitis. This article summarizes the third edition of the Japanese guidelines for allergic conjunctival diseases published in 2021 and outlines the diagnosis, pathogenesis, and treatment of ACD. Since the introduction of immunosuppressive eye drops, the treatment strategies for severe ACDs have significantly changed. To clarify the recommended standard treatment protocols for ACD, the advantages and disadvantages of these treatments were assessed using clinical questions, with a focus on the use of steroids and immunosuppressive drugs. This knowledge will assist healthcare providers and patients in taking an active role in medical decision making.

Keywords: Allergic conjunctivitis; Atopic keratoconjunctivitis; Cyclosporine; Tacrolimus; Vernal keratoconjunctivitis.

Publication types

  • Review

MeSH terms

  • Allergens / therapeutic use
  • Conjunctiva
  • Conjunctival Diseases* / diagnosis
  • Conjunctivitis, Allergic* / drug therapy
  • Conjunctivitis, Allergic* / therapy
  • Humans
  • Japan / epidemiology
  • Ophthalmic Solutions / therapeutic use


  • Allergens
  • Ophthalmic Solutions