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Allergic Conjunctivitis

Article
Allergy
Eye & Vision
+1
Contributed byKrish Tangella MD, MBAApr 18, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Allergic Conjunctivitides
  • Atopic Conjunctivitides
  • Atopic Conjunctivitis

What is Allergic Conjunctivitis? (Definition/Background Information)

  • Allergic Conjunctivitis is triggered by allergens or irritants that cause an allergic reaction when the eye comes into contact with these substances
  • Common allergens include: Pollen, dust, smoke, animal hair, perfumes, and cosmetics
  • In most cases the symptoms clear spontaneously after a few days; once the factors that caused the condition is removed. But, the symptoms could return, if exposure to the allergic substance(s) recurs
  • Conjunctivitis is inflammation of conjunctiva of the eye, which is the membrane covering the white region of the eye
  • In Conjunctivitis the white part of the eye turns red or pink, and hence it is known as Pink Eye. The infection may affect either one, or both the eyes, and is accompanied by inflammation, irritation, with watery discharge from the eyes. Under normal circumstances, Conjunctivitis does not affect vision. Allergic Conjunctivitis is not infectious

Allergic Conjunctivitis is classified into the following types:

  • Seasonal Allergic Conjunctivitis
  • Perennial Allergic Conjunctivitis
  • Giant Papillary Conjunctivitis
  • Vernal Keratoconjunctivitis
  • Atopic Keratoconjunctivitis
  • Phlyctenular Keratoconjunctivitis

Who gets Allergic Conjunctivitis? (Age and Sex Distribution)

  • Individuals in any age group are vulnerable to Allergic Conjunctivitis, if they are allergic to any specific substance(s)
  • Different geographical regions of the world may have widely differing allergens (in terms of type, quality, and potency); hence prevalence of this condition varies across the regions

What are the Risk Factors for Allergic Conjunctivitis? (Predisposing Factors)

The potential risk factors for Allergic Conjunctivitis are:

  • Environmental or occupational exposure to allergy causing substances such as pollen (from flowering plants, trees, grasses, weeds), dander (animal hair, skin particulates), rodent/insect waste, dust, insects, fungal molds, chemical pollutants, detergents, smoke, fumes, strong scents, eye drops, etc.
  • An individual with a family history of allergies (like when parents are allergic to such allergens), is more prone to the condition
  • Sometimes, the presence of other diseases or disorders (like asthma, eczema) may initiate Allergic Conjunctivitis
  • Regular use of contact lens (particularly the extended wear variety)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Allergic Conjunctivitis? (Etiology)

  • Allergic Conjunctivitis is caused by exposure to external agents or particles that cause an allergic inflammatory response. An individual has to be allergic to that substance (these could either be single or multiple allergens)
  • When the allergen comes into contact with the conjunctiva and mucus membranes lining the eyes, the body releases histamine (an organic chemical) triggering the allergy symptoms. This is caused due to an extremely sensitive body immune system
  • Environmental factors and allergic substances like dust, pollen, smoke, exposure to chemicals, and other pollutants
  • Chronic use of contact lenses (for some individuals); since they may come into contact with many foreign material, lens solution

What are the Signs and Symptoms of Allergic Conjunctivitis?

Most symptoms of Allergic Conjunctivitis often develop immediately in response to the allergy triggering substance, although some develop slowly after a while. These include:

  • Itching and redness of the eye(s)
  • Eye pain and inflammation; gritty feeling of sand-like particles inside the eye
  • Continuous discharge of water from the eyes
  • Blurred vision, light sensitivity

How is Allergic Conjunctivitis Diagnosed?

Allergic Conjunctivitis is diagnosed as follows:

  • The ophthalmologist or physician performs an eye examination and evaluates the patient’s medical history
  • Slit lamp exam (if necessary), for a detailed study of the eye
  • Blood analysis; to measure serum IgE level, eosinophil count
  • Allergy skin test or radioallergosorbent test; to determine the specific allergy causing substance
  • Examination of conjunctival scrapings; culture to rule out infectious cause
  • Differential diagnosis of other types of conjunctivitis should be considered, in order to eliminate other eye conditions

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Allergic Conjunctivitis?

Complications may arise if Allergic Conjunctivitis is not treated. It is also dependent upon the presence of other secondary conditions (if any). The complications could include:

  • Prolonged discomfort, mental and emotional stress
  • Corneal damage, scar
  • Damage to the eye, loss of vision (rare)
  • Bacterial infection
  • Sinusitis
  • Recurrence of the condition; this maybe frequent, seasonal, or periodical

How is Allergic Conjunctivitis Treated?

Allergic Conjunctivitis is managed by controlling the substance responsible for an allergic trigger, treating the symptoms, and moderating the body immune response system. Some general management measures include:

  • Avoidance of outdoor allergens and control of indoor allergy-inducing irritants should be considered. It is important that the specific allergen(s) be identified. Normally, once the condition that caused the problem (the allergy trigger) is removed, it gradually clears the ailment
  • Application of cold compress can help reduce discomfort
  • Medications such as oral antihistamines and mast cell stabilizers (a non-steroid drug), may be used depending on the type of symptoms and their occurrence rate (seasonal or regular). Other drugs to provide relief from symptoms are corticosteroids (prescribed in severe cases only), lubricating or anti-inflammatory eye-drops, and ointments
  • Immunotherapy (allergy shots) is used to desensitize the body and prevent it from overreacting to such external triggers. This method is usually considered, in case of a severe allergic attack that does not respond well to treatment, or when other medical disorders are also present
  • Avoid the use of contact lens during this period; wear eye glasses instead

How can Allergic Conjunctivitis be Prevented?

  • Allergic Conjunctivitis is a spontaneous body (eye) response to the presence of an allergen; it cannot be prevented, but only managed
  • Be aware of the allergy activating factor(s) and avoid such locations or situations, which provoke the body immune system to respond in such a manner
  • In order to preserve the eye condition, always maintain hygiene and wash hands regularly. Prevent aggravation of the condition by staying out of the sun, keeping away from dust and smoke. Also avoid touching or rubbing the eyes (this may be difficult when the individuals are very young children)
  • Stop or restrain yourself from smoking tobacco, or drinking alcohol
  • Keep clean, air-conditioning filters, either at home or at offices, in order to prevent airborne allergens (like pollen) from reaching or circulating indoors; particularly during the allergy periods
  • Allergic Conjunctivitis is seasonal/periodic and individuals may chronically contract Conjunctivitis

What is the Prognosis of Allergic Conjunctivitis? (Outcomes/Resolutions)

  • Allergic Conjunctivitis, mild or severe, can be treated and it has an excellent outcome. But, it will recur if the person comes again in contact with the particular irritant causing the allergic response
  • Over time, a few individuals (usually children) outgrow the condition; since their body gets used to the substance. However in many, it generally affects them over their entire lifetime (or for a very long-term)
  • Without treatment or due to repeated exposure to the allergen, complications may develop. It may also cause further discomfort, and in some extreme cases affect the vision. However, such situations are infrequent

Additional and Relevant Useful Information for Allergic Conjunctivitis:

  • Many alternatives medicine therapies, natural therapy, or home remedies are available to ease the discomfort of Allergic Conjunctivitis. However, such treatment methods are not a proven science and should not be substituted for a qualified healthcare provider’s medical advice
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Krish Tangella MD, MBA

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