Allergy
ALLERGIC/ HYPERSENSITIVITY CONJUNCTIVITIS
Huraaaaay! Summer is here once again...... Enjoy the best of every moment with your family and friends . Summer with all the fun that comes seasonally with it, brings many medical conditions that causes discomforts in the life of many individuals who fall a victim to the season due to their body's reaction to the weather . As many cant wait for summer to come,others fear for the seasons return because of their eye ALLERGIES that recurrently occurs every summer ;medically its called VERNAL KERATOCONJUNCTIVITIS (spring catarrh).
Allergies are simply a hypersensitivity reaction of the human body following exposure to noxious stimuli in the environment.(pollen,dust,smoke,snow,perfumes,contact lenses,drugs,surgical sutures etc).Allergens as type 1 (immediate ) hypersensitivity reaction resulting in the secretion of eosinophils and mast cell degranulation causing inflamation,itchy sensation,redness,pain and tearing of the eyes.
Signs/symptoms
Redness
Watering eyes
Itchiness
Swelling of the lids
Pinkish hyperaemia (pink eyes)
Photophobia(discomfort looking at light)
Chemosis( swelling of the conjunctiva )[severe cases only]
Foreign body sensation
Allergic conjunctivitis may differ according to the mode of onset or cause of the hypersensitivity reaction :
1. Vernal keratoconjunctivitis (spring catarrh ) : mostly affects both eyes,and usually occurring in the spring or summer.it typically affects children and male young adults
2. Seasonal allergic conjunctivitis : this conjunctival inflammatory response can occur in atopic individuals following exposure to seasonal allergens like pollen(hayfever ), dust,snow flakes.
3.Giant papillary conjunctivis : occurs due to direct irritation to the superior palpebral conjunctiva. This condition is associated with the presence of contact lenses,ocular prosthesis, and prominent suture ends.this reaction is seen in more than 70% extended contact lens wearers.
Management include removal of foreign foreign body(contact lens,sutures etc) and sodium hyaluronase may be helpful for temporal relief.
4. Atopic keratoconjunctivitis : this is commonly associated with individual with eczema,rhinitis,asthma, and common cold.
A true AKC is rare but it's variants are common as in situations like reaction to certain shampoos, body spray, soap, and smoke.
Persons affected may experience severe bilateral papillary conjunctivis,blurred vision,swollen eyelids,burning sensation,laceration,photophobia and sometimes mucus discharges.
5. Ocular cicatricial pemphigoid: this is an autoimmune disorder which results from a type 11 hypersensitivity reaction of the conjunctival basement membrane auto antibodies.
This is normally seen in patients over 70 years,Stevens-Johnsons syndrome,.
The eyes become chemists,red,discharge with mucous adhering to the surface of the conjunctiva.Canthus become compromised,symblepharon,entrepion,dry eye and subsequent corneal involvement resulting in blindness. Azathioprine,methotrexate,and corticosteroid may be helpful.
6. Phlyctenulosis : phlyctenular conjunctivis takes the form of a small vascularized nodule on the bulber conjunctiva frequently situated near the limbus.
This relatively common in tuberculosis patients,Candidiasis, and blepharitis.
Most often its necessary to ensure frequent eyelid hygiene,condition may self resolve.
7. Toxic conjunctivitis : Adverse reaction reaction of topical medications After prolonged usage (Anti glaucoma drugs ) or more acute onset.Acute allergic reaction has been associated with almost all topical drugs containing the preservative Benzalkonium chloride,thiomersal)
It's better to opt for Eye drugs that are preservative free or with lower percentages so to be safe from these allergies.
In some instances,there is a hyperacute copious mucopurulent discharge and Punctuate corneal opacities with tearing in both eye.
Don't be surprised , all drugs have side. It is the duty of your Doctor to make informed decisions to treat you as well as minimize some of these Effects.
In practice it can be difficult differentiate between a true allergy and Toxicity.
management include stopping responsible drug causing the allergy,use topical therapy with unpreserved agents that may be curative.
NOTE: in some people,severe allergies to the environment or dietary allergens or to medications may result in life- threatening anaphylactic reactions and potential death.
Seeking immediate medical attention may save lives.
First Aid Management of allergic conjunctivitis :
Apply cold compress
( dip a clean tissue in ice packs and massage swollen eyes: this will reduce the redness and the pain temporal )
GENERAL OVER THE COUNTER TREATMENT OF ALLERGIC CONJUNCTIVIS
Antihistamines: block the action of endogenous histamines thereby reducing itching.
Cetirizine(oral tablets)
Azeladtine
Nafazoline
Mast cell stabilizers: prevent allergy symptoms by preventing allergic cascade events that lead to the inflamatory process (swelling,itching,redness,runny nose)
Sodium cromoglycate
Lodoxamide
Ketotifen
Olopatadine
1. Vernal keratoconjunctivitis (spring catarrh ) : mostly affects both eyes,and usually occurring in the spring or summer.it typically affects children and male young adults
2. Seasonal allergic conjunctivitis : this conjunctival inflammatory response can occur in atopic individuals following exposure to seasonal allergens like pollen(hayfever ), dust,snow flakes.
3.Giant papillary conjunctivis : occurs due to direct irritation to the superior palpebral conjunctiva. This condition is associated with the presence of contact lenses,ocular prosthesis, and prominent suture ends.this reaction is seen in more than 70% extended contact lens wearers.
Management include removal of foreign foreign body(contact lens,sutures etc) and sodium hyaluronase may be helpful for temporal relief.
4. Atopic keratoconjunctivitis : this is commonly associated with individual with eczema,rhinitis,asthma, and common cold.
A true AKC is rare but it's variants are common as in situations like reaction to certain shampoos, body spray, soap, and smoke.
Persons affected may experience severe bilateral papillary conjunctivis,blurred vision,swollen eyelids,burning sensation,laceration,photophobia and sometimes mucus discharges.
5. Ocular cicatricial pemphigoid: this is an autoimmune disorder which results from a type 11 hypersensitivity reaction of the conjunctival basement membrane auto antibodies.
This is normally seen in patients over 70 years,Stevens-Johnsons syndrome,.
The eyes become chemists,red,discharge with mucous adhering to the surface of the conjunctiva.Canthus become compromised,symblepharon,entrepion,dry eye and subsequent corneal involvement resulting in blindness. Azathioprine,methotrexate,and corticosteroid may be helpful.
6. Phlyctenulosis : phlyctenular conjunctivis takes the form of a small vascularized nodule on the bulber conjunctiva frequently situated near the limbus.
This relatively common in tuberculosis patients,Candidiasis, and blepharitis.
Most often its necessary to ensure frequent eyelid hygiene,condition may self resolve.
7. Toxic conjunctivitis : Adverse reaction reaction of topical medications After prolonged usage (Anti glaucoma drugs ) or more acute onset.Acute allergic reaction has been associated with almost all topical drugs containing the preservative Benzalkonium chloride,thiomersal)
It's better to opt for Eye drugs that are preservative free or with lower percentages so to be safe from these allergies.
In some instances,there is a hyperacute copious mucopurulent discharge and Punctuate corneal opacities with tearing in both eye.
Don't be surprised , all drugs have side. It is the duty of your Doctor to make informed decisions to treat you as well as minimize some of these Effects.
In practice it can be difficult differentiate between a true allergy and Toxicity.
management include stopping responsible drug causing the allergy,use topical therapy with unpreserved agents that may be curative.
NOTE: in some people,severe allergies to the environment or dietary allergens or to medications may result in life- threatening anaphylactic reactions and potential death.
Seeking immediate medical attention may save lives.
First Aid Management of allergic conjunctivitis :
Apply cold compress
( dip a clean tissue in ice packs and massage swollen eyes: this will reduce the redness and the pain temporal )
GENERAL OVER THE COUNTER TREATMENT OF ALLERGIC CONJUNCTIVIS
Antihistamines: block the action of endogenous histamines thereby reducing itching.
Cetirizine(oral tablets)
Azeladtine
Nafazoline
Mast cell stabilizers: prevent allergy symptoms by preventing allergic cascade events that lead to the inflamatory process (swelling,itching,redness,runny nose)
Sodium cromoglycate
Lodoxamide
Ketotifen
Olopatadine
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