Nasal, bronchial, conjunctival, and food challenge techniques and epicutaneous immunotherapy of food allergy
Richard F. Lockey, Dennis K. Ledford in Allergens and Allergen Immunotherapy, 2020
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].
Medical Therapy for Glaucoma
Neil T. Choplin, Carlo E. Traverso in Atlas of Glaucoma, 2014
The numerous side effects of oral CAIs resulted in five decades of research, which culminated in the development and release of the first topically active CAI, dorzolamide 2% (Trusopt). Used three times daily, the drug is approximately equal in efficacy to betaxolol and slightly less effective than timolol. It is an excellent additive drug to topical β-adrenoreceptor antagonists, resulting in reductions in intraocular pressure reaching 35% from baseline. Many glaucoma specialists are of the opinion that twice-daily dosing of dorzolamide is sufficient when the drug is used as additive therapy. The drug is fairly well tolerated with minimal or no systemic side effects. The most common side effects are stinging and burning upon instillation, reported in up to 33% of patients, and bitter taste, which has been reported in up to 25% of patients. Allergic blepharoconjunctivitis (Figure 14.9) occurs in a small number of patients.
Herpes Simplex Virus Ocular Disease
Marie Studahl, Paola Cinque, Tomas Bergström in Herpes Simplex Viruses, 2017
In a study of 107 patients with primary ocular HSV infections, the mean age for this first episode of ocular HSV was 25 years of age. An upper respiratory infection was present in 35%, and generalized symptoms in 31%. Conjunctivitis was present in 84%, blepharitis was present in 38%. Dendritic ulcers occurred in 15% and disciform keratitis in 2%. The disease was unilateral in 81% and bilateral in 19%. These same 107 patients with primary ocular HSV were then followed for 2 to 15 years to determine the pattern of recurrent disease (66). Thirty-two percent had a recurrence, and it was more frequent in patients under the age of 20. Of those with a recurrence, 49% had one recurrence, 40% had two to five recurrences, and 11% had six to 15 recurrences. This is the first study to demonstrate that recurrences occurred most commonly as either conjunctivitis or lid lesions. Of those with a corneal infection during the primary episode of ocular HSV, 31% developed a recurrent infection.
Therapeutic Effect of Intense Pulsed Light on Ocular Demodicosis
Published in Current Eye Research, 2019
XiaoZhao Zhang, Nan Song, Lan Gong
Blepharitis and blepharoconjunctivitis are characterized by inflammation of the outer eyelids and the conjunctiva that results in redness, swelling, prickle and stabbing pain, and also can lead to scarring of the eyelid and loss of proper eyelid function over time. Both of them are closely associated with Demodex infestation.1–3Demodex is a microscopic, elongated mite which is the common permanent ectoparasite of humans.4 The prevalence of Demodex infestation increases with age, reaching 84% of the population at age 60 years and 100% of those older than 70 years.5 Ocular manifestations of Demodex infestation include unexplained keratitis, superficial corneal vascularization, marginal infiltration, phlyctenule-like lesions, nodular corneal scarring, etc.6,7 It was proven that ocular demodicosis can be essentially diagnosed by the modified eyelash sampling and counting method and in vivo confocal microscopy (IVCM).8,9 However, there are only a few effective treatments at present.
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.
Herpetic Eye Disease Following the SARS-CoV-2 Vaccinations
Published in Ocular Immunology and Inflammation, 2023
Shai Cohen, Hagar Olshaker, Naomi Fischer, Vicktoria Vishnevskia-Dai, David Hagin, Amir Rosenblatt, Dinah Zur, Zohar Habot-Wilner
Our cohort included two patients with ocular HSV post the BNT162b2 mRNA vaccine, and the literature review revealed five additional cases. Most of these patients were women (57%). The median age of the patients in our cohort was higher than of the published cases. All patients presented with symptoms of HSV infection up to 7 days following vaccination. To the best of our knowledge, our cases are the first reports of ocular HSV infection after the third vaccine dose and could be explained by the fact that Israel was the first country to administer the third booster dose. No patient in our cohort had a previous HSV infection whereas in the literature cohort most patients had previous keratitis. Overall, the most common presentation was keratouveitis. Our cohort included the first reported case presenting with blepharoconjunctivitis. All our HSV patients had complete resolution without any long-term complications, whereas two out of the five published cases had permanent complications: one with corneal haze (although final visual acuity was 20/20) and one with a corneal perforation and a residual corneal scar. There was also a lack of long-term data for the HSV published cases, and only one patient had a 4-week follow-up, whereas our patients had 4-month follow-up with no recurrence and a good final VA.
Related Knowledge Centers
- Antibiotic
- Conjunctiva
- Eyelid
- Inflammation
- Common Cold
- Sclera
- Viral Disease
- Pathogenic Bacteria
- Microbiological Culture
- Hand Washing