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Journal of Ayub Medical College,... 2022Allergic conjunctivitis is a common ocular disease which not only affects vision but can also compromise the quality of life of patients to a greater extent. If it is...
BACKGROUND
Allergic conjunctivitis is a common ocular disease which not only affects vision but can also compromise the quality of life of patients to a greater extent. If it is not properly managed it can lead to decreased vision due to corneal complications. This study was conducted to evaluate the epidemiological aspects of allergic conjunctivitis.
METHODS
This cross-sectional study was carried out in the Ophthalmology department of Federal General Hospital, from June 2018 to June 2020. We enrolled 236 patients of allergic conjunctivitis. Data collection form consisted of a structured questionnaire, records of ocular findings using slit lamp biomicroscope and skin prick test results. Data analysis was done using SPSS version 23.0.
RESULTS
The mean age (±SD) of study population was 22.71±13.11 years, 60.2% were females. Most common type of conjunctivitis was vernal keratoconjunctivitis (VKC) 46.2%, followed by perennial (27.1%), seasonal (17.4%) and atopic (9.3%). There was significant association of type of conjunctivitis with the age, pvalue< 0.001. VKC was prevalent in patients of age <20 years. There was a significant association of gender with type of conjunctivitis, p-value =0.000. Perennial variety was more prevalent in females while VKC was common in males. Collateral atopy was present in 52.1% patients. Corneal involvement was seen in 17.8% patients. There was a significant association between corneal involvement and interference with daily visual activities, p-value 0.034. SPT was positive in 79.7% patients.
CONCLUSIONS
Ocular allergies/ conjunctivitis was more prevalent in female population. VKC is the most common type of allergic conjunctivitis, prevalent in males of age <20 yrs. Allergic rhinitis was the most common co-morbidity followed by dermatitis.
Topics: Adolescent; Adult; Child; Conjunctivitis, Allergic; Cornea; Cross-Sectional Studies; Female; Humans; Male; Quality of Life; Young Adult
PubMed: 35466641
DOI: 10.55519/JAMC-01-9432 -
Journal of Investigational Allergology... 2019Among the constellation of symptoms that characterizes allergic conjunctivitis, many (eg, burning and stinging) can be attributed to chronic neuropathic pain. Cumulative... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Among the constellation of symptoms that characterizes allergic conjunctivitis, many (eg, burning and stinging) can be attributed to chronic neuropathic pain. Cumulative data support that these hallmark symptoms might be linked to the effects of allergen-induced neuromodulation. This review investigates the key characteristics of neuropathic itch and pain in allergic conjunctivitis and their underlying pathogenic mechanisms.
METHODS
A literature review was conducted using a PubMed search focusing on allergic conjunctivitis, neurogenic inflammation, neuropathic itch, and neuropathic pain. Articles were reviewed, and those discussing clinical course, pathophysiology, and neuronal regulation of chronic neuropathic symptoms as related to allergic disease were summarized.
RESULTS
Recent evidence suggests that some symptoms of allergic conjunctivitis may be better represented as a chronic neuropathic disorder. We found that neurogenic mechanisms may have a significant role in chronic ocular surface inflammation from allergic inflammation. Manifestations may be associated with repeated ocular sensory nerve injury leading to an acute-to-chronic transition, which is in turn associated with neuropathologic changes (peripheral and central sensitization), neuronal dysfunction, and spontaneous ocular pain.
CONCLUSION
Current goals in the management of allergic conjunctivitis aim to minimize the inflammatory cascade associated with the allergic response in the initial stages of the pathogenic mechanism. Based on the mechanistic data reviewed herein, the recognition that neuronal inflammation explains many of the symptoms in allergic conjunctivitis opens new frontiers for drug discovery.
Topics: Animals; Anti-Allergic Agents; Biomarkers; Clinical Trials as Topic; Conjunctivitis, Allergic; Disease Management; Disease Susceptibility; Humans; Immunization; Neuralgia; Neuritis; Pruritus; Treatment Outcome
PubMed: 30222114
DOI: 10.18176/jiaci.0320 -
Current Opinion in Allergy and Clinical... Oct 2011To describe currently available epidemiological data on the prevalence of allergic conjunctivitis. Allergic conjunctivitis is often underdiagnosed and consequently... (Review)
Review
PURPOSE OF REVIEW
To describe currently available epidemiological data on the prevalence of allergic conjunctivitis. Allergic conjunctivitis is often underdiagnosed and consequently undertreated except when it is severe and the chief complaint of a consultation in a specialty clinic. Use of healthcare resources and reduced quality of life of affected individuals justify studies on the prevalence of allergic conjunctivitis.
RECENT FINDINGS
The association of allergic nasal and ocular symptoms (rhinoconjunctivitis) is common. Most children with allergic conjunctivitis have allergic rhinitis. Older population studies estimate a prevalence of 15-20% of allergic conjunctivitis, but more recent studies implicate rates as high as 40%. Ocular symptoms are common and contribute to the burden of allergic rhinitis and lower quality of life. Ocular allergies rank a very close second and at times may overcome the primary complaints of nasal congestion in rhinoconjunctivitis patients.
SUMMARY
Little focus has been set on the impact of allergic conjunctivitis as comorbidity to asthma and rhinitis in atopic patients. Conjunctivitis symptoms are at least as severe as rhinitis symptoms in patients with 'hay fever' and some have even generated the term of conjunctivorhinitis stressing the ocular symptoms. Prevalence studies should be specifically addressed to ocular allergy symptoms.
Topics: Asthma; Child; Comorbidity; Conjunctivitis, Allergic; Diagnosis, Differential; Eye; Humans; Paranasal Sinuses; Prevalence; Rhinitis, Allergic, Seasonal
PubMed: 21785348
DOI: 10.1097/ACI.0b013e32834a9676 -
Journal of Investigational Allergology... 2009Allergic conjunctivitis is the most common form of ophthalmological allergy. Eye symptoms are one of the main and most frequent reasons for consultation among patients... (Review)
Review
Allergic conjunctivitis is the most common form of ophthalmological allergy. Eye symptoms are one of the main and most frequent reasons for consultation among patients with allergic rhinoconjunctivitis, which in turn is the most common reason for visiting the allergologist, according to the Alergológica 2005 study. Itching is the key symptom of allergic conjunctivitis, and its relief is the principal objective of the broad range of treatment options available. Topical antihistamines with multiple actions (mast cell stabilization, and antiinflammatory and antihistaminic actions) are probably the best treatment option, thanks to their rapid action, safety and convenience of use. However, oral antihistamines (preferentially second generation drugs) can also play an important role, since they are of established efficacy and offer adequate treatment of the nasal symptoms that tend to accompany the ocular manifestations of allergic rhinoconjunctivitis. Models of allergic conjunctivitis are useful for investigational purposes and for advancing our knowledge of allergic reactions. Advances in the study of the physiopathology of ocular allergy allow us to introduce new therapeutic options for the management of such allergic reactions, thanks to the findings derived from models of this kind. The present review provides an update to the published data on allergic conjunctivitis and the current role of both topical and ocular antihistamines in treating the disorder.
Topics: Administration, Oral; Administration, Topical; Clinical Trials as Topic; Conjunctivitis, Allergic; Histamine H1 Antagonists; Humans
PubMed: 19476049
DOI: No ID Found -
Current Opinion in Allergy and Clinical... Oct 2013The focus of this review is to provide a logical paradigm for the diagnosis and treatment of ocular allergies, with a focus on seasonal allergic conjunctivitis (SAC) and... (Review)
Review
PURPOSE OF REVIEW
The focus of this review is to provide a logical paradigm for the diagnosis and treatment of ocular allergies, with a focus on seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC).
RECENT FINDINGS
Several classes of topical medications are currently available for the management of ocular allergies, including: lubricating agents, vasoconstrictors, antihistamines, mast cell stabilizers, and topical corticosteroids.
SUMMARY
SAC and PAC make up the vast majority of ocular allergy cases. A proactive approach to these diseases, anticipating the regional spring and fall allergen spikes, is needed for optimally managing these disorders. A multifaceted treatment regimen comprising patient education, lifestyle modification, and topical medications (such as antihistamines and/or mast cell stabilizers and corticosteroids) may be required in order to manage ocular allergies effectively. The appropriate treatment paradigm is based on the severity of the patients' signs and symptoms. For moderate-to-severe cases, especially chronic vernal keratoconjunctivitis, atopic keratoconjunctivitis, and giant papillary conjunctivitis, comanagement with an ophthalmologist is recommended.
Topics: Adrenal Cortex Hormones; Animals; Conjunctivitis, Allergic; Decision Making; Disease Progression; Histamine Antagonists; Humans; Lubricants; Seasons; Vasoconstrictor Agents
PubMed: 23974684
DOI: 10.1097/ACI.0b013e328364ec3a -
Acta Bio-medica : Atenei Parmensis Sep 2020Allergic rhinitis (AR) is induced by an IgE-mediated immune reaction after allergen exposure. The typical symptoms are itching, nasal discharge, sneezing and nasal...
Allergic rhinitis (AR) is induced by an IgE-mediated immune reaction after allergen exposure. The typical symptoms are itching, nasal discharge, sneezing and nasal obstruction. The diagnosis is based on the concordance between allergic symptoms and diagnostic tests. The skin prick test (SPT) is recommended as the "gold standard" method. First generation H1-antihistamines are widely used for treatment of AR. Intranasal glucocorticosteroids are well tolerated and can be used also in paediatric age. Allergic rhinitis cannot be considered as an isolated pathology. Other atopic diseases (allergic conjunctivitis, atopic eczema, asthma) are commonly associated.
Topics: Asthma; Child; Conjunctivitis, Allergic; Humans; Rhinitis, Allergic; Skin Tests
PubMed: 33004777
DOI: 10.23750/abm.v91i11-S.10310 -
International Ophthalmology Clinics 1988
Review
Topics: Chronic Disease; Conjunctivitis, Allergic; Humans
PubMed: 3053492
DOI: 10.1097/00004397-198802840-00014 -
International Ophthalmology Jan 2022To evaluate the effect of subcutaneous omalizumab therapy on the allergic conjunctivitis symptoms of patients being treated for asthma.
PURPOSE
To evaluate the effect of subcutaneous omalizumab therapy on the allergic conjunctivitis symptoms of patients being treated for asthma.
METHODS
A total of 84 eyes of 42 patients who were receiving subcutaneous omalizumab therapy for asthma and complained of allergic conjunctivitis symptoms underwent complete ophthalmic examination. All of the patients were graded according to signs and symptoms and duration of symptoms, evaluated using an ocular severity index (SI) and quality of life questionnaires. Immunoglobulin E (IgE) levels and both initial and final %FEV (forced expiratory volume in the first second) values were also evaluated. p values < 0.05 were accepted as statistically significant.
RESULTS
The study included 36 women (85.7%) and 6 men (14.3%) with a mean age of 54.5 ± 10.8 years. The mean duration of omalizumab therapy was 46 ± 30.9 months. There were statistically significant changes between initial and final values for ocular SI, quality of life, subjective symptom frequency and severity and %FEV1. Final values of SI, quality of life, and symptom severity and frequency were statistically significantly lower compared to initial values, while final %FEV was statistically significantly higher compared to initial value (p < 0.001).
CONCLUSION
Omalizumab therapy for asthma had a favorable effect on the patients' allergic conjunctivitis symptoms and decreased parameters related to ocular disease severity, improved quality of life and increased %FEVvalues.
TRIAL REGISTRATION NUMBER
2019/5-5, Trial Registration Date: 28/03/2019, Retrospectively registered.
Topics: Adult; Aged; Asthma; Conjunctivitis, Allergic; Female; Humans; Male; Middle Aged; Omalizumab; Quality of Life; Treatment Outcome
PubMed: 34426862
DOI: 10.1007/s10792-021-02010-w -
Expert Opinion on Emerging Drugs Jun 2014Allergic conjunctivitis (AC) is a very common disease, especially in association with allergic rhinitis but may also occur in isolated presentation. The treatment of AC... (Review)
Review
INTRODUCTION
Allergic conjunctivitis (AC) is a very common disease, especially in association with allergic rhinitis but may also occur in isolated presentation. The treatment of AC has long been based on antihistamines, cromones and topical corticosteroids, but none of these drugs completely abolishes the clinical expression of AC.
AREAS COVERED
The development of new drugs for AC is analyzed highlighting the recent insights into the pathophysiological mechanisms of the disease. The major aim of development of drugs for AC is to have agents able to prevent the inflammatory effects of the interaction between the allergen and the specific IgE antibodies on mast cell surface. This may be obtained by blocking the effects of histamine (the main mediator of early allergic response) by H1-receptor antagonists, inhibiting the release of soluble factors able to recruit inflammatory cells (that sustain prolonged inflammation) by mast-cell stabilizers, inhibiting the effects of single mediators, inducing tolerance to the allergen by specific immunotherapy or even acting on factors related to activation and differentiation of T lymphocytes such as the toll-like receptors.
EXPERT OPINION
AC is an underestimated disease for which there is a search of more effective treatments. The availability of the drugs under current evaluation will allow more refined therapeutic strategies to apply according to the characteristics and the clinical severity of AC.
Topics: Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Calcineurin Inhibitors; Conjunctivitis, Allergic; Desensitization, Immunologic; Histamine H1 Antagonists; Humans; Quality of Life; Toll-Like Receptors
PubMed: 24661261
DOI: 10.1517/14728214.2014.902443 -
Chemical Immunology and Allergy 2006The eye is largely exposed to foreign substances, and ocular tissues have a complete array of immune cells to interact with offending antigens. In particular, the... (Review)
Review
The eye is largely exposed to foreign substances, and ocular tissues have a complete array of immune cells to interact with offending antigens. In particular, the external eye represents an ideal site for immediate hypersensitivity reactions because of the high number of mast cells in the eyelids and bulbar conjunctiva, as well as for the potential local synthesis of IgE. In fact, the involvement of the eye was part of the original description of hay fever by Charles Blackley in 1873. In a large epidemiological survey of allergic patients we reported since 1987, 40% had symptoms possibly related to allergic conjunctival disease. However, the participation of the conjunctiva to the multiorgan picture of allergy is largely underestimated. Allergic eye diseases have long been referred to the classical Type I hypersensitivity mechanism according to Coombs and Gell. Recently, however, the tremendous progress in understanding allergic mechanisms and inflammation has brought new insights into the pathophysiology of several allergic diseases, including those of the eye. Accordingly, several systematic descriptions of allergic eye diseases should be revisited. In particular, the classification of the various forms of a 'red eye' of allergic origin appears inadequate to answer the progress achieved in their multifactorial pathogenesis.
Topics: Allergens; Conjunctivitis, Allergic; Humans
PubMed: 16354953
DOI: 10.1159/000090247