Features:
(1) recurrent eye irritation with excessive production of tears and the formation of mucus strands
(2) recurrent attempts by the patient to "fish" for and remove the strands, which may temporarily reduce the irritation
(3) inflammation and damage to the conjunctivitis, especially along the nasal bulbar (medial) aspect
(4) damage to the cornea with keratitis in severe cases
(5) improvement following therapy to reduce ocular tear irritation, address causes of eye irritation and discontinuation of attempts to manually remove mucus strands
Methods of removing mucus strands:
(1) between the fingers
(2) applicator tip
(3) tweezers
The damage to the conjunctivitis can be demonstrated by increased rose bengal staining.
Treatment may include:
(1) antihistamine eye drops with mast cell stabilizer
(2) ocular mucolytic agent (N-acetylcystine)
(3) olopatadine or other agent to reduce mucus production
(4) frequent lubrication with artificial tears
(5) avoidance of environmental conditions associated with excessive tear drying or use of eye protection (dry air, hot wind, etc.)
(6) removal of contact lens until conjunctivitis completely resolved
