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Allergic Diseases of the Eye
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
The diagnosis of allergic conjunctivitis is clinical (Table 10.1). Itching is the characteristic and most prominent symptom, and is directly related to mast cell degranulation and histamine release. Redness, tearing, swelling of the eyes are other symptoms. Infectious forms of conjunctivitis and dry eye are the main differential diagnoses. These can be distinguished from allergies by the presence of discharge associated with infections and by the signs of deficient ocular surface wetting in the dry eye (Butrus and Portela 2005). It must be emphasized that the diagnosis is best left to an ophthalmologist. Thus, all patients with ocular symptoms should be referred to a specialist. As the condition is chronic and subject to periodic or seasonal exacerbations, the role of the primary care physician is to monitor and adjust treatment and refer to the specialist in the event of complications.
Nasal, bronchial, conjunctival, and food challenge techniques and epicutaneous immunotherapy of food allergy
Published in Richard F. Lockey, Dennis K. Ledford, Allergens and Allergen Immunotherapy, 2020
Mark W. Tenn, Matthew Rawls, Babak Aberumand, Anne K. Ellis
Allergic conjunctivitis is a symptomatic disorder of the eye that results from immunoglobulin E (IgE)–mediated mast cell degranulation initiating the release of histamine, cytokines, chemokines, and the recruitment of inflammatory cells. Common symptoms and signs of allergic conjunctivitis include ocular itching, tearing, redness, and chemosis, which is otherwise known as swelling of the conjunctiva. The conjunctiva is a thin, protective, mucosal membrane that covers the anterior sclera extending to behind the eyelids [57]. Allergic conjunctivitis symptoms are estimated to affect approximately 15%–20% of the population worldwide, with the United States reporting a prevalence of 40% [58,59]. Patients with allergic conjunctivitis often experience a reduced quality of life with a potential impact on daily activities such as reading, driving, and sleeping [60].
Adenovirus conjunctivitis
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
Patients with bacterial conjunctivitis present with persistent mucopurulent discharge. Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis are the common bacterial organisms. Neisseria gonorrhoeae causes a severe and sight-threatening conjunctivitis and presents with profuse purulent eye discharge in neonates and has a high risk of corneal perforation. Chlamydia can also cause conjunctivitis in infants. Herpes conjunctivitis is usually unilateral, with thin watery discharge and vesicular lesions on the eyelid and periorbital region. Allergic conjunctivitis is usually itchy with bilateral eye redness. The patient may also have a history of seasonal allergies or atopy.
Association between atopic dermatitis and conjunctivitis in adults: a population-based study in the United States
Published in Journal of Dermatological Treatment, 2021
Kevin K. Wu, Andrea J. Borba, Pierce H. Deng, April W. Armstrong
Conjunctivitis can be diagnosed with a detailed patient history and eye examination (7). Hyperemia of the eye is a hallmark symptom of conjunctivitis. Other symptoms of conjunctivitis may include pain, pruritus, and eye discharge. In bacterial, viral, and allergic conjunctivitis, pain is usually mild or absent. In a patient with continuous watery or serous discharge and pruritus, the diagnosis is most likely allergic conjunctivitis. Treatment for allergic conjunctivitis includes topical agents such as histamine receptor antagonists, mast cell stabilizers, nonsteroidal anti-inflammatory drugs, and corticosteroids. Patients with allergic conjunctivitis should avoid allergens by limiting outdoor exposure and keeping windows closed. Contact lens wearers should avoid putting on lenses during episodes of allergic conjunctivitis because doing so may trap allergens and exacerbate symptoms. In a patient with continuous watery or serous discharge without pruritus, the diagnosis is most likely viral conjunctivitis. Treatment for viral conjunctivitis is supportive and includes cold compresses, artificial tears, and topical ocular decongestants. In a patient with continuous and purulent discharge, the cause is most likely bacterial. Treatment for bacterial conjunctivitis is also supportive because most patients with bacterial conjunctivitis improve after two to five days without antibiotics (7). If the patient reports moderate to severe pain, photophobia, or blurred vision, an emergent ophthalmology referral is appropriate.
Mini-monoka stenting for patients with perennial allergic conjunctivitis
Published in Orbit, 2019
Lior Or, David Zadok, Morris E. Hartstein
However, even with all these limitations, we feel that the overwhelmingly positive outcomes were a direct result of inserting a MM stent. All of the patients in our study had severe allergic conjunctivitis with symptoms readily apparent to both patient and physician. It was also quite obvious to both patients and physicians that prolonged relief with various topical regimens, including steroids, was not achieved. Some patients may have also suffered from toxic allergic conjunctivitis due to multiple topical medications. Ultimately, they only achieved relief with MM stenting. Once patency was re-established in the punctum, both physician and patient noted the obvious reduction in redness and tearing, and topical medications were subsequently discontinued. Further prospective studies might establish a standard treatment regimen and optimal timing of MM placement in these patients. Our preliminary experience suggests that that MM stenting is a safe, effective, simple, and relatively non-invasive treatment strategy for the management of PAC in the presence of punctal stenosis.
Alcaftadine 0.25% versus Olopatadine 0.1% in Preventing Cedar Pollen Allergic Conjunctivitis in Japan: A Randomized Study
Published in Ocular Immunology and Inflammation, 2019
Hiroshi Nakatani, Paul Gomes, Ron Bradford, Qiang Guo, Eleonora Safyan, David A. Hollander
Allergic conjunctivitis is one of the most common ocular conditions affecting adult and pediatric patients.1 An estimated 6–30% of the general population is affected by allergic conjunctivitis alone or in association with allergic rhinitis.2 Studies in developed countries have reported that 14–40% of the population suffer from allergic conjunctivitis.3–6 In Japan, the estimated prevalence of allergic conjunctivitis is 15–20% and is most commonly associated with Japanese cedar pollen.7 In susceptible individuals, ocular exposure to allergens leads to immunoglobulin E-mediated mast cell degranulation and subsequent release of histamine and other inflammatory mediators.8,9 Activation of histamine receptors in the conjunctiva triggers ocular itching, the hallmark symptom of allergic conjunctivitis, and other signs and symptoms including conjunctival redness, tearing, eyelid swelling, and chemosis.10