Purpose of review To determine if the late-phase reaction, which commonly occurs in allergic rhinitis and asthma, is also found in ocular allergy. Recent findings Using PubMed, 542 articles were found; 18 articles in the allergy and ophthalmology literature were specifically related to late-phase reaction. Ocular late-phase reaction is clinically seen in 50-100% of allergic rhinoconjunctivitis patients, is associated with progression to systemic atopic disorders that is allergic rhinoconjunctivitis and occurs in several forms including biphasic, multiphasic and a prolonged response. Summary The existing literature demonstrates that an ocular late-phase reaction also exists and has implications in the development severity of disease, change of reactivity and progression of the atopic disease state from a localized target organ, such as the nose or eye, to a more systemic atopic disorder. The existence of the clinically relevant allergic late-phase response is not only limited to the nose, skin and lungs but also includes the eyes. The appreciation that the late-phase response may be clinically very important as there is a continuum of ocular mast-cell activation during the waking hours of the day, a better understanding of its clinical impact may be a more appropriate focus in the development of future treatments.