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

• Conjunctivitis - Allergic Perennial
• PAC (Perennial Allergic Conjunctivitis)

What is Perennial Allergic Conjunctivitis? (Definition/Background Information)

• Perennial Allergic Conjunctivitis (PAC) is triggered by allergens or irritants that cause an allergic reaction when the eye comes into contact with these substances
• This condition may occur all-round the year and is one of the more common types of Allergic Conjunctivitis. It is not contagious, and hence does not spread to others
• 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
• Common perennial allergens include: Animal dander (hair, skin particles), feathers, dust mites, chemicals, tobacco smoke, etc.
• 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 allergic substance(s) recurs. PAC is not infectious

Who gets Perennial Allergic Conjunctivitis? (Age and Sex Distribution)

• Individuals in any age group are vulnerable to Perennial Allergic Conjunctivitis, if they are allergic to any specific substance(s)
• Men and women are both equally affected
• 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 Perennial Allergic Conjunctivitis? (Predisposing Factors)

The potential risk factors for Perennial Allergic Conjunctivitis are:

• Environmental or occupational exposure to allergy causing substances such as animal hair, skin particulates, dust, and smoke
• 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 PAC

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 Perennial Allergic Conjunctivitis? (Etiology)

• Perennial 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
• Dander (animal hair, skin particulates), rodent/insect waste, dust, insects, fungal molds, chemical pollutants, smoke, and fumes are some of the main allergens that may be present in the environment, throughout the year
• Sometimes certain weather conditions (like dry air, sudden temperature changes, wind) may aggravate the situation. The intensity (whether mild or severe) of PAC is also dependent upon the allergen quality and quantity. However, PAC is generally mild and non-acute
• Some individuals suffering from PAC, may also be affected by seasonal allergens, like pollen

What are the Signs and Symptoms of Perennial Allergic Conjunctivitis?

Most symptoms of Perennial 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); often itching is a key symptom of PAC
• Eye pain and inflammation; with gritty feeling of sand-like particles inside the eye
• Continuous discharge of water from the eyes
• Blurred vision, light sensitivity

How is Perennial Allergic Conjunctivitis Diagnosed?

Perennial 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 to eliminate other conditions; since there are several other cause factors for Conjunctivitis

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 Perennial Allergic Conjunctivitis?

Complications are rare and do not normally arise with Perennial Allergic Conjunctivitis. Nevertheless, the presence of other secondary conditions may alter the situation. The complications include:

• Corneal damage, scar
• Damage to the eye
• Bacterial infection
• Sinusitis
• Recurrence of the condition, on exposure to the allergen again

How is Perennial Allergic Conjunctivitis Treated?

Perennial 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 airborne allergens (pollen) 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, vasoconstrictors, mast cell stabilizers (a non-steroid drug), and NSAIDs 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 Perennial Allergic Conjunctivitis be Prevented?

• Perennial 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, to prevent airborne allergens from reaching or circulating indoors; particularly during the allergy periods
• The condition is perennial since the allergens are present in the atmosphere all-round the year; the individuals may regularly contract PAC

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

• Perennial Allergic Conjunctivitis (usually mild), can be treated and has an excellent outcome. But, it will frequently 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 the 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, there may be complications such as superimposed bacterial infections. Such superimposed infections may also cause further discomfort, and in some extreme cases affect the vision. However, such situations are infrequent

Additional and Relevant Useful Information for Perennial Allergic Conjunctivitis:

• The term Perennial Allergic Conjunctivitis indicates that the allergens causing PAC are present, throughout the year. It does not mean that the disorder itself is manifested year-around
• 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