Today, there is a significant increase in the number of various allergic diseases, with the course of which there is eye damage. These include eye lesions in patients with pollinosis, allergic keratoconjunctivitis and allergic conjunctivitis. On the first place in this list (according to the frequency of occurrence) is allergic conjunctivitis. In this article, we will try to cover most of the issues associated with this allergic disease.
Allergic conjunctivitis is an inflammation of the conjunctival membrane of the eye of an allergic nature, manifested by swelling, itching, and lacrimation. : конъюнктива – ткань, выстилающая внутреннюю поверхность век, а также переднюю поверхность глазного яблока. For reference : conjunctiva is a tissue lining the inner surface of the eyelids, as well as the anterior surface of the eyeball.
Allergic conjunctivitis is most common at a young age, with the same sex ratio. Accurate statistics on the prevalence of the disease does not exist due to the fact that allergic conjunctivitis is often combined with other allergic manifestations, usually allergic dermatitis and allergic rhinitis. According to numerous observations and studies, it was found that the symptoms of allergic conjunctivitis are observed in about 30% of patients with other allergic pathologies
Causes of allergic conjunctivitis
Because of the peculiarities of the anatomical structure of the eyes, access to them of various allergens from the external environment is unhindered. Most often, the development of allergic conjunctivitis causes pollen allergens (more often pollen of wind-pollinated plants), epidermal allergens (down and feathers of birds, dander and animal hair, etc.) and household allergens (library dust, house dust, house dust mites, etc.). At women allergic reactions to household chemistry and cosmetics are often enough observed. Food allergies cause the development of allergic conjunctivitis rarely.
Symptomatic of allergic conjunctivitis develops almost immediately after contact with an allergy-causing substance
Symptoms of allergic conjunctivitis
After contact with the allergen, the symptoms of allergic conjunctivitis develop from a few minutes to a day. For allergic conjunctivitis inflammation of the conjunctival membranes of one eye is quite unusual, therefore, as a rule, both eyes are affected (one eye is usually affected only if the allergen has been brought directly into it, for example, with hands).
The main typical symptoms of allergic conjunctivitis: redness of the conjunctiva, puffiness, lacrimation, strong ass in the eye area. In case of severe illness, photophobia may develop. Itching is usually the most annoying symptom of allergic conjunctivitis, causing the patient to constantly rub his eyes, thereby only strengthening the remaining clinical manifestations.
In the course of an allergic conjunctivitis is divided into acute (sudden onset and fairly rapid cure) and chronic (inflammatory process has a sluggish prolonged course). The nature of inflammation directly depends on the causative provoking allergen and the frequency of contact with it.
With incorrectly selected or completely absent treatment, allergic manifestations are often associated with a secondary infection, which is manifested by the appearance of a purulent discharge in the corner of the eye.
Often in the process of diagnosis, patients themselves point to causative allergens causing them to exacerbate. A small initial relief often brings a trial of antihistamines.
Diagnosis of allergic conjunctivitis is within the sphere of interest of two doctors - an ophthalmologist and an allergist, therefore, immediately after the detection of the above symptoms, the patient must first turn to one of them for further examination, and it is desirable to start with an ophthalmologist, since such manifestations are often observed when other eye diseases
Treatment of allergic conjunctivitis
Therapy of allergic conjunctivitis is based on the elimination of a provoking allergen, drug symptomatic therapy and immunotherapy. If this is possible, the most effective method of therapeutic action and further prevention of the development of an allergic reaction is the complete elimination of the causative allergen.
With polyallergy, as well as in the case of an unexpressed reaction, non-specific hyposensitizing immunotherapy is shown, which in ophthalmology consists of injections of histoglobulin (six to ten injections per course). Specific hyposensitizing treatment is carried out only if it is impossible to achieve elimination of precisely established causative allergens and inefficiency of symptomatic drug therapy.
In case of severe course of allergic conjunctivitis, systemic use of antihistamines is indicated, and these medications are included directly in complex therapy for three to five days.
Due to the fact that all antihistamines of the first generation (Pipolphen, Tavegil, Diazolin, Suprastin, Dimedrol, etc.) have a pronounced sedative effect, they are prescribed only on an exceptional basis, without failing to warn the patient about such a side effect as persistent drowsiness. In the practice of treating allergic conjunctivitis, preference is given to a second-generation drug such as Claritin.
To remove the constantly annoying patient symptoms (conjunctival hyperemia, edema, lacrimation, photophobia, itchy eyelids), with allergic conjunctivitis shows the local antiallergic drug therapy. Already for a long time the main place in the antiallergic therapy of conjunctivitis is occupied by such two groups of eye drops as the stabilizers of mast cells of the conjunctiva and antihistamine eye drops. Moreover, they can be used either alone or in combination with each other and with medicinal agents of anti-inflammatory therapy.
With subacute and chronic conjunctivitis use eye drops of cromoglycates (Kromogeksal, Alomid, etc.). The drugs of choice in case of acute course of allergic conjunctivitis are providing a quick anti-allergic effect and reducing the body's reaction to histamine such antihistamine drops as Allergoodil and Spersallerg.
Treatment of allergic conjunctivitis by methods of traditional medicine should not be carried out, since experiments with washing the eyes with various "grandmother's" tinctures can only provoke exacerbation and promote accession to allergic conjunctivitis of secondary infection
Allergic conjunctivitis in children
Typically, allergic conjunctivitis occurs in children after three years, although exceptions are always possible and very rarely it is observed even at the earliest age. It is quite traditional, when allergic conjunctivitis in a child is accompanied by an allergic rhinitis. Most often, if the child has developed allergic conjunctivitis for the first time, in the past he already had any allergic symptoms (usually by the type of diathesis, allergic dermatitis, etc.).
The highest prevalence in children was food allergy, which is treated according to generally accepted principles. In case the diagnosis of food allergy is confirmed, it is necessary to start allergen-specific therapy as soon as possible, since in childhood it shows the most optimal results.
In addition, pseudoallergic reactions that are very similar to allergy are often observed in children, but in fact develop due to completely different causes (gastrointestinal diseases, parasites, etc.).
Allergic conjunctivitis during pregnancy
It is very rare, but still it occurs when allergic conjunctivitis manifests during the period of pregnancy, or the existing disease is aggravated. Treatment of any allergic (and not only) diseases during pregnancy is fraught with many difficulties due to the fact that at this time most drugs and some examinations are strictly prohibited due to the potential harm to the fetus.
In pregnancy, the symptoms of allergic conjunctivitis are absolutely no different from the classical ones. The disease itself does not affect the fetus negatively. Toxic effects on the baby can occur only in the case of use by the expectant mother during pregnancy of prohibited drugs.
Diagnosis of allergy during pregnancy is reduced only to the analysis of blood for specific immunoglobulins. Local treatment is possible exclusively with sodium cromoglycate derivatives. Because of the potential negative impact on the fetus, when treating allergic conjunctivitis during pregnancy, the use of antihistamines should be minimized as much as possible. If their reception is inevitable, then preference should be given to third-generation drugs (Telfast, etc.).
Like any other allergic reaction, allergic conjunctivitis is a chronic disease. Existing methods of therapy can cause a fairly long lasting remission, but the allergic mood of the organism still remains.
The prognosis for allergic conjunctivitis is quite favorable, however, in the absence of treatment, secondary infection or exacerbation of the existing pathology of the eyes (keratitis, glaucoma, etc.) is often observed.
Prevention of allergic conjunctivitis has not been developed to date. Secondary methods of prevention are aimed at eliminating the provoking allergen from the environment and preventing the exacerbation of an already existing ophthalmologic disease.