Rhinitis, Allergic

<bold>Figure 35.2</bold> Back pressure to blood circulation around the eyes leads to dark areas under the eyes in the child with allergic rhinitis.

1.11. A: Viral conjunctivitis is associated with an acute follicular reaction. In follicles, vessels course on the surface from the periphery of the lesions toward the center rather than emerging in the center, as is the case in papillae.

1.11.C: In severe adenoviral conjunctivitis, the patient may have lid ecchymoses in addition to subconjunctival hemorrhages.

1.12. D: Giant papillary conjunctivitis is characterized by papillae of the superior tarsus, which are thought to be caused by an allergic reaction to the coating on foreign bodies such as contact lenses or exposed sutures.

1.14. Acute bacterial conjunctivitis with mild lid swelling, conjunctival injection, and discharge along the lid margin.

FIG. 2.6. A: Conjunctivitis. B: Chemosis. C: Facial swelling caused by an allergic reaction.

FIG. 15.10. Allergic conjunctivitis with lid edema and conjunctival infection.

FIG. 15.11. Allergic conjunctivitis with chemosis. Note the swollen conjunctiva extending up to the border of the cornea.

<bold>Figure 19-2</bold> Boggy inferior turbinates seen with allergic rhinitis. (Courtesy of Paul S. Matz, MD.)

Back pressure to the blood circulation around the eye orbit from allergic rhinitis may lead to dark areas under the eyes (allergic shiners). The frequent rubbing of the nose in an upward direction can lead to a peculiar horizontal crease (Dennie's line).

1.15. A: Hyperacute gonococcal conjunctivitis, with copious mucopurulent discharge and lid swelling.