Incidence of allergic conjunctivitis in patients with allergic rhinitis: A randomized observational study

Abstract

Background: Although nasal allergy has been prominent in allergy research, ocular allergy is increasingly recognized as a distinct symptom complex that imposes its own disease burden and reduction in patients' quality of life. In the past year, knowledge of the relationships between allergic conjunctivitis (AC) and allergic rhinitis (AR) has increased. AC is commonly manifesting as itchy or watering or red eye, comprising the symptoms of the total ocular symptom scores (TOSS). Allergic conjunctivitis is highly prevalent and has a close epidemiologic relationship with allergic rhinitis. Both conditions also exhibit similar pathophysiologic mechanisms. Therefore, the objective of the present study was to identify the incidence of AC in patients with AR. Methods: This randomized observational study was conducted on 150 patients for a 6 month period from June to November 2021, having diagnosed AR and attending the outpatient clinic of our department. The patients were directly questioned if they had AC, clarified by using standard screening questions of red, itchy and watery eyes and quantified by TOSS and were asked about indirect symptoms that may be attributable to AC. Results: Among the 150 patients, 54.66% of patients identified AC on direct questioning; additional symptoms were squint at 41.33% and blinking at 52.66%. Olopatadine, significantly reduced TOSS scores within 5 minutes of treatment and 82.66% showed improvement, which identified 44.66% silent sufferers of AC. A total of 94% AC subjects were identified through TOSS symptoms and totally 96.66%, detecting additional symptoms. Conclusions: The screening questions could identify only about 54.66% of the patients with AC. Additional specific questioning and a therapeutic challenge in suspected patients can help identify patients who may benefit from treatment of AC.