As with all allergic diseases, allergic conjunctivitis is an inflammation of the conjunctiva that occurs when the conjunctiva comes into contact with an allergen. It can affect either adults or children, but children are the most affected, especially those with allergies. The incidence of allergic conjunctivitis in children is high and we often see such children in our daily outpatient practice. The symptoms of allergic conjunctivitis, such as tearing, burning sensation and discharge, are similar to those of other ocular diseases, so it is easy to misdiagnose. Therefore, it is important to remind parents that if your child rubs his or her eyes frequently or blinks frequently at any given time, he or she may have allergic conjunctivitis, and ordinary anti-inflammatory eye drops may not help at all, and may even lead to other eye diseases due to long-term medication errors.
Allergens are the culprits of allergic conjunctivitis. Allergens are substances that cause allergies, medically called allergens. These allergens enter the conjunctiva and bind to immunoglobulin E (IgE) on the mast cells, causing the mast cells to release histamines, which cause small local blood vessels to dilate, producing redness, swelling and itching. Allergens include pollen, dust, cold and humid air, dust mites, animal hair, soap, perfume, cosmetics, medications, contact lenses and their care solutions, etc. Because people are so different individually, allergens vary from person to person. The most common substance that causes allergic conjunctivitis is pollen, and the symptoms of this allergic conjunctivitis tend to vary seasonally. If the allergen is dust, dust mites or animal hair, etc., because these allergens are present year-round, the symptoms of allergy are also continuous throughout the year, and the symptoms are generally mild, but may worsen with the seasons.
Broadly speaking, there are 5 main types of allergic conjunctivitis.
1, chytridiomycosis conjunctivitis (also known as seasonal allergic conjunctivitis): most common in young and middle-aged people, with rapid onset and can occur with exposure to allergens, and symptoms generally resolve after removal from the allergen.
2. Contact allergic conjunctivitis: with a clear history of exposure, such as drug or cosmetic exposure, symptoms usually resolve after avoiding exposure.
3, giant papillary conjunctivitis: often with a history of contact lens (corneal contact lens) wear.
4, Spring Catarrhal Keratoconjunctivitis: Most often seen in adolescents, often occurring or worsening in the spring and summer.
5, atopic keratoconjunctivitis: most commonly seen in middle-aged men, often with a history of mild allergies in the early stages.
”Itch” is the feeling of most patients with allergic conjunctivitis, and unlike ordinary itch, this itch is often very strong and unbearable, so the medical term “strange itch”. In addition, conjunctival congestion, edema, mucus discharge, and redness of the eyelid skin can be combined, and the closer to the corner of the eye, the more severe the condition. These symptoms can come and go with the seasons and recur. Allergy symptoms usually worsen on warm, dry days when flowers are in bloom, and some patients may have a combination of allergic rhinitis in addition to eye discomfort.
The treatment of allergic conjunctivitis (referred to as the “four-in-one quadruple therapy”) includes the following.
1. Use of high-quality standardized desensitizing agents.
2. The use of optimal allergy treatment protocols, including allergen removal and patient immune repair.
3. Symptomatic drug treatment in case of allergy complicated by inflammation.
4. Immunotherapy with standardized desensitizing agents.
Many allergic conjunctivitis are self-limiting, so the main goal of treatment is to reduce symptoms and avoid sequelae. Avoidance of allergens is the most effective treatment, for example, for pollen allergy, try to go out less during the pollen season or wear goggles when going out to reduce allergens entering the eyes. However, most allergic conjunctivitis does not necessarily identify the exact allergen, or the allergen type is complex and difficult to identify one by one, resulting in recurrent allergic conjunctivitis, which is not easy to cure completely. First of all, it is important to improve the living environment, especially the air quality and indoor temperature, so that the impact of allergens can be reduced. Secondly, we should pay attention to nutrition and exercise, regular life and rest, and enhance physical fitness. Because the improvement of physical health can make the body’s potential to fight against allergy attacks increase, and reduce and slow down allergy attacks. Again, local cold compresses or ice packs on the eyes can be used to reduce the discomfort. Artificial tears can be applied topically to the eyes to reduce the concentration of allergens and inflammation-causing factors and improve symptoms.
There are six main types of drugs used in the treatment of allergic conjunctivitis.
1, antihistamines DD eye drops can generally achieve a more satisfactory effect;
2, mast cell stabilizer DD cromoglycate sodium eye drops can both treat and prevent allergic conjunctivitis, is also the more commonly used drugs;
3, dual-action drugs DD can antagonize histamine, but also can stabilize the mast cells of the dual-action drugs is currently the most used anti-allergy drugs, such as Patanlo;
4.Glucocorticoids – usually glucocorticoids are used only when other drugs are ineffective, because their side effects are large and should be used with caution under the guidance of a doctor;
5.Non-steroidal hormone anti-inflammatory drugs;
6.Immunosuppressants.
In case of combined ocular bacterial infection, topical antibiotics can be used for treatment. It is important to note that drug anti-allergy treatment can only control the symptoms of allergy, but it is difficult to completely cure allergic conjunctivitis, which is one of the reasons why allergic conjunctivitis remains untreated.