Today a patient visited me with this question and we talked about Allergic Conjunctivitis.
These conjunctivitis affect approximately 10% of the world population and the most affected are those patients with other allergic diseases (rhinitis or dermatitis) in whom the frequency of ocular symptoms can be up to 60%.
There are different types of allergic conjunctivitis. Among the most common are Seasonal and Perennial Allergic Conjunctivitis.
What distinguishes Seasonal Allergic Conjunctivitis is that its symptoms are related to the season of the year and the presence of specific circulating aeroallergens, signs and symptoms appear and disappear, depending on exposure to them. It occurs more frequently in spring, summer and early fall, when there is a greater amount of pollen in the environment, especially in areas with a hot, dry and windy climate. The most common causative agents are pollen from trees, grasses, and weeds.
Perennial Allergic Conjunctivitis is generally milder and occurs after exposure to allergens, but allergens are present throughout the year, for example dust mites, animal dander and fungi.
The most frequent symptom is ocular pruritus (itching), conjunctival redness, foreign body sensation, burning and tearing; the discharge is watery at first, becoming serous and thicker in chronic forms.
The diagnosis of Allergic Conjunctivitis is clinical, it is integrated with the symptoms and the findings found in the ophthalmological examination. In some severe or persistent cases, different tests can be performed to search for the etiological agent, such as those aimed at evaluating IgE-mediated hypersensitivity (prick test, specific IgE, diagnosis by components, and conjunctival challenge test), those used to investigate hypersensitivity non-IgE-mediated (patch tests and ROAT repeated administration open test) and special tests (tear cytology, conjunctival scraping, IgE measurement in tears).
Treatment focuses on minimizing and controlling the disease, in addition to explaining to the patient the chronic nature of this condition and the importance of avoiding exposure to triggering factors. It is recommended to use preservative-free artificial tears, cold compresses in case of intense itching, antihistamine eye drops + mast cell stabilizer, and oral antihistamine when accompanied by rhinitis. When discomfort persists, steroid eye drops can be used and immunotherapy with an allergist considered.
My patient’s diagnosis was Mild Seasonal Allergic Conjunctivitis and following my general recommendations plus his medication, he improved a lot.
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