Allergic Eye Disease

Overview

Allergic eye diseases always include conjunctivitis and sometimes keratitis in response to an allergen. The diseases affect 10%-20% of people globally and have a negative impact on quality of life and productivity. It is usually bilateral and itchiness is the predominant symptom. Early diagnosis and accurate treatment is essential to reduce the frequency of recurrence, to avoid complications that are potentially sight-threatening, and to enhance patient self-care.

Signs and Symptoms

Intense itchiness in the eye, Burning sensation, Redness, Watery or mucus stringy discharge from the eye, Puffiness of the eyelids, Conjunctival edema, Mild photophobia, Severe forms: lesion on the upper tarsal conjunctiva in ‘cobble stone' pattern, congestion of the bulbar, gelatinous thickened accumulation

Common Causes

Type 1 immediate hypersensitivity reaction mediated by IgE and subsequent mast cell activation, following exposure of ocular surface to airborne allergens.

Risk Factors

Age between 4-20 years old, Gender: it is more common in males than females, Season: more common in summer, Climate: more prevalent in tropics, less in temperate zones and almost none in cold climate

Investigation Techniques

History, Eye examination, Skin prick test

Treatment and Prevention

Identification and avoidance of the allergens, Topical dual action antihistamine and mast cell stabilizers, Topical steroids, Topical mast cell stabilizers, NSAIDs eye drops, Topical cyclosporine is indicated when steroids are ineffective or poorly tolerated, Systemic therapy: oral antihistamines, oral steroids, General measures: dark goggles to prevent photophobia and cold compression