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Turkish Journal of Ophthalmology Feb 2021Allergic conjunctivitis is a disease of increasing prevalence that affects both children and adults and causes significant deterioration of their quality of life and... (Review)
Review
Allergic conjunctivitis is a disease of increasing prevalence that affects both children and adults and causes significant deterioration of their quality of life and sometimes irreversible visual damage. There are various forms of the disease, some are allergen-induced such as seasonal and perennial allergic conjunctivitis, giant papillary conjunctivitis, and contact allergic blepharoconjunctivitis, whereas others are not always explained by allergen exposure, such as vernal keratoconjunctivitis and atopic keratoconjunctivitis. We review their clinical course, characteristics, and differential diagnosis, and highlight recent advances in their pathophysiology and treatment.
Topics: Adult; Allergens; Child; Conjunctivitis; Conjunctivitis, Allergic; Humans; Keratoconjunctivitis; Quality of Life
PubMed: 33631915
DOI: 10.4274/tjo.galenos.2020.11456 -
Handbook of Experimental Pharmacology 2022Conjunctivitis is a frequent disease of the eye with the typical clinical sign being the "red eye" and comprises a very heterogeneous group with different causes. In...
Conjunctivitis is a frequent disease of the eye with the typical clinical sign being the "red eye" and comprises a very heterogeneous group with different causes. In general, infectious conjunctivitis must be strictly differentiated from non-infectious conjunctivitis. Allergic conjunctivitis is a subtype of non-infectious conjunctivitis and imposes as an acute, intermittent or chronic, inflammation which is most frequently caused by airborne allergens. The leading clinical sign is chemosis, and patients typically complain about itching. Allergic conjunctivitis is often a reaction to topical and systemic drugs or cosmetics as well as animal hairs from cats and/or dogs. Allergic conjunctivitis is sub-classified into the following forms: seasonal allergic conjunctivitis (also termed: hay fever conjunctivitis), atopic conjunctivitis, vernal conjunctivitis, upper limbal (kerato-) conjunctivitis, and conjunctivitis associated with various oculomucocutaneous syndromes. In each form, there are distinctive features in: clinical appearance, generating agent(s), as well as treatment as listed here.
Topics: Animals; Cats; Conjunctivitis, Allergic; Dogs; Humans
PubMed: 34136960
DOI: 10.1007/164_2021_491 -
Italian Journal of Pediatrics Mar 2013Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and... (Review)
Review
Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and consequently undertreated. Basic and clinical research has provided a better understanding of the cells, mediators, and immunologic events, which occur in ocular allergy. New pharmacological agents have improved the efficacy and safety of ocular allergy treatment. An understanding of the immunologic mechanisms, clinical features, differential diagnosis, and treatment of ocular allergy may be useful to all specialists who deal with these patients. The purpose of this review is to systematically review literature underlining all the forms classified as ocular allergy: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratocongiuntivitis, contact allergy, and giant papillary conjunctivitis.
Topics: Anti-Allergic Agents; Anti-Inflammatory Agents; Conjunctivitis, Allergic; Diagnosis, Differential; Histamine Antagonists; Humans; Keratoconjunctivitis; Treatment Outcome
PubMed: 23497516
DOI: 10.1186/1824-7288-39-18 -
Allergology International : Official... Oct 2020The prevalence of ocular allergies has been increasing worldwide for the past several decades. The geographical distribution and hot spots of rhinoconjunctivitis have... (Review)
Review
The prevalence of ocular allergies has been increasing worldwide for the past several decades. The geographical distribution and hot spots of rhinoconjunctivitis have been documented in a global survey by the International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC indicated that Africa, Latin America, and Japan were notable for their high prevalence of rhinoconjunctivitis. The outcomes of follow-up studies of regional differences and the characteristics of allergic conjunctivitis are summarized in this review. Currently, comorbid diseases and socioeconomic and environmental factors, including climate and air pollution, are proposed to contribute to the regional differences in the prevalence of allergic conjunctivitis. Of them, rhinitis has been shown repeatedly to be significantly associated with allergic conjunctivitis. Their mechanistic aspects on association with the prevalence of systemic allergic diseases have been reviewed by examining the birth cohort or in vitro analyses. A vision threatening form of ocular allergy, vernal keratoconjunctivitis, is prevalent in the African countries and Japan. Of the proposed associated factors, air pollution was shown to contribute not only to aggravating the symptoms but also to the increase in the incidence of its severe forms. Its mechanistic aspects are discussed in this review in the context of comorbid diseases.
Topics: Air Pollution; Conjunctivitis, Allergic; Humans; Prevalence
PubMed: 32654975
DOI: 10.1016/j.alit.2020.06.004 -
Annals of Allergy, Asthma & Immunology... Feb 2020Ocular allergy (OA), interchangeably known as allergic conjunctivitis, is a common immunological hypersensitivity disorder affecting up to 40% of the population. Ocular... (Review)
Review
Ocular allergy (OA), interchangeably known as allergic conjunctivitis, is a common immunological hypersensitivity disorder affecting up to 40% of the population. Ocular allergy has been increasing in frequency, with symptoms of itching, redness, and swelling that significantly impacts an individual's quality of life (QOL). Ocular allergy is an often underdiagnosed and undertreated health problem, because only 10% of patients with OA symptoms seek medical attention, whereas most patients manage with over-the-counter medications and complementary nonpharmacological remedies. The clinical course, duration, severity, and co-morbidities are varied and depend, in part, on the specific ocular tissues that are affected and on immunologic mechanism(s) involved, both local and systemic. It is frequently associated with allergic rhinitis (commonly recognized as allergic rhino conjunctivitis), and with other allergic comorbidities. The predominance of self-management increases the risk of suboptimal therapy that leads to recurrent exacerbations and the potential for development of more chronic conditions that can lead to corneal complications and interference with the visual axis. Multiple, often co-existing causes are seen, and a broad differential diagnosis for OA, increasing the difficulty of arriving at the correct diagnosis(es). Ocular allergy commonly overlaps with other anterior ocular disease disorders, including infectious disorders and dry eye syndromes. Therefore, successful management includes overcoming the challenges of underdiagnosis and even misdiagnosis by a better understanding of the subtleties of an in-depth patient history, ophthalmologic examination techniques, and diagnostic procedures, which are of paramount importance in making an accurate diagnosis of OA. Appropriate cross-referral between specialists (allergists and eyecare specialists) would maximize patient care and outcomes. This would significantly improve OA management and overcome the unmet needs in global health.
Topics: Combined Modality Therapy; Comorbidity; Conjunctivitis, Allergic; Diagnosis, Differential; Disease Management; Humans; Immunoassay; Symptom Assessment
PubMed: 31759180
DOI: 10.1016/j.anai.2019.11.014 -
Romanian Journal of Ophthalmology 2022Allergic rhinitis and allergic conjunctivitis are so frequently associated that the need to coin a new name to describe the simultaneous manifestations generated the... (Review)
Review
Allergic rhinitis and allergic conjunctivitis are so frequently associated that the need to coin a new name to describe the simultaneous manifestations generated the term allergic rhinoconjunctivitis. The significant impact of rhinoconjunctivitis on the quality of life and the wellbeing of the patients is the reason why the medical community shows a great interest to this disease. Another aspect is the financial burden that is not negligible. The anatomical connection between the organs involved facilitates the propagation of the disease. The allergic pathophysiological mechanisms implicated in allergic rhinitis and conjunctivitis also share common features. The diagnosis of rhinoconjunctivitis is based on the concordance between the symptoms, the clinical examination, and the diagnostic tests that should reveal the existence of an allergen specific IgE in vivo or in vitro. Whilst the nasal smear for eosinophils is considered a reliable diagnostic test for allergic rhinitis, the occurrence of eosinophils in the conjunctive is not a trustworthy indicator of allergy. The therapy of allergic rhinoconjunctivitis is based on patient education, pharmacotherapy, and allergen-specific immunotherapy. The local treatment for the allergic rhinitis is primarily based on topical corticosteroids that also manage the ocular symptoms. The first line of treatment of the ocular manifestations is represented by topical antihistamines and mast-cell stabilizers or double action drugs.
Topics: Allergens; Conjunctivitis; Conjunctivitis, Allergic; Humans; Quality of Life; Rhinitis, Allergic
PubMed: 35531453
DOI: 10.22336/rjo.2022.3 -
Der Ophthalmologe : Zeitschrift Der... Nov 2017Seasonal allergic conjunctivitis (SAC) is a frequent disease, which is often associated with allergic rhinitis and subsequently manifested as allergic... (Review)
Review
Seasonal allergic conjunctivitis (SAC) is a frequent disease, which is often associated with allergic rhinitis and subsequently manifested as allergic rhinoconjunctivitis. In contrast to other types of chronic allergic conjunctivitis, the course of SAC is not sight-threatening. Pathogenetically, the underlying cause of SAC is an immunoglobulin E (IgE) mediated, Th2-driven type 1 hypersensitivity reaction. Clinically it presents with itching, light-red conjunctival injection as well as chemosis that exceeds the extent of conjunctival injection. The goals of treatment are relief of acute signs and symptoms, control of the underlying inflammatory process and utilization of preventive options. Dually effective local therapeutics combine the advantages of rapid action with a relatively long-lasting effect by a two-fold active approach. Specific immunotherapy is useful in selected patients.
Topics: Conjunctivitis, Allergic; Diagnosis, Differential; Humans; Immunoglobulin E; Immunotherapy; Th2 Cells
PubMed: 29022093
DOI: 10.1007/s00347-017-0580-1 -
Current Opinion in Allergy and Clinical... Oct 2020The rising global burden of allergic diseases, particularly in the pediatric population, is of serious concern. Ocular allergy is one of the most common ocular... (Review)
Review
PURPOSE OF REVIEW
The rising global burden of allergic diseases, particularly in the pediatric population, is of serious concern. Ocular allergy is one of the most common ocular pathologies met in clinical practice. A large proportion of children and adolescents suffer from allergic eye diseases (AEDs), which affect their quality of life. The available treatments and surgical modalities have their limitations and side effects. Therefore, the development of novel and alternate strategies is the need of the hour and requires a timely review of currently available knowledge.
RECENT FINDINGS
The current review covers the incidence and prevalence of AEDs, factors influencing occurrence and severity of AED (age, sex, socioeconomic status etc.), underlying mechanisms, role of allergy testing and immunotherapy in children, development of diagnostic markers and novel therapies including cells and molecules.
SUMMARY
Understanding the demographics, clinical patterns and risk factors of AED can help formulate appropriate preventive and therapeutic strategies for the effective management of this common cause of ocular morbidity. The future therapeutics for AED seems to rely primarily on cells (mesenchymal stem cells, Tregs, mast cells), cell products, molecules with immunosuppressive potential and immunotherapy.
Topics: Adolescent; Cell- and Tissue-Based Therapy; Child; Conjunctivitis, Allergic; Eye; Female; Histamine Antagonists; Humans; Immunosuppression Therapy; Incidence; Male; Mast Cell Stabilizers; Prevalence; Quality of Life; Risk Factors; Treatment Outcome
PubMed: 32739978
DOI: 10.1097/ACI.0000000000000675 -
Immunology and Allergy Clinics of North... Feb 2008Allergic conjunctivitis is common, especially during the allergy season. Consultation with the allergist to perform skin tests or in vitro tests may be useful and... (Review)
Review
Allergic conjunctivitis is common, especially during the allergy season. Consultation with the allergist to perform skin tests or in vitro tests may be useful and confirmatory in the diagnosis of ocular allergy. If treatment is necessary, antihistamines, mast cell stabilizers, and nonsteroidal anti-inflammatory drugs are safe and reasonably effective. Corticosteroids are an order of magnitude more potent than noncorticosteroids; however, they have attendant side effects that are best monitored by the ophthalmologist. The development of "modified" corticosteroids has been a boon to the treatment of ocular allergy because these drugs may reduce potential side effects without sacrificing potency.
Topics: Anti-Allergic Agents; Conjunctivitis, Allergic; Humans; Immunotherapy; Physical Examination; Seasons
PubMed: 18282545
DOI: 10.1016/j.iac.2007.12.005 -
International Ophthalmology Clinics 1988
Review
Topics: Conjunctivitis, Allergic; Humans; Keratoconjunctivitis
PubMed: 3053488
DOI: 10.1097/00004397-198802840-00007