Seasonal and perennial allergic conjunctivitis: the possible role of nasal allergy

Abstract

There is a link between conjunctiva and nose. Nasal allergy is suspected to be involved in some cases of conjunctivitis. This work aims to investigate the possible role of nasal allergy in seasonal (SAC) and perennial (PAC) allergic conjunctivitis and the value of nasal challenges with allergens (nasal provocation tests [NPTs]) for the diagnostic procedures of the conjunctivitis. In 61 adults suffering from SAC or PAC with a positive history and skin tests, but responding insufficiently to the local treatment, 122 NPTs and 61 control nasal challenges with phosphate-buffered saline (PBS) were performed using rhinomanometry combined with recording of ocular response. In 16 control subjects suffering only from allergic rhinitis without a history of conjunctivitis, 16 positive NPTs were repeated and supplemented with registration of ocular features. Of the 61 patients, 55 developed 103 positive nasal responses of various types (P < 0.01), 82 of which were accompanied by significant conjunctival response (P < 0.01) without any corneal involvement. No significant ocular responses were recorded during 61 control PBS challenges (P > 0.05) as well as during 16 challenges in control subjects (P > 0.1). These results illustrate a possible involvement of nasal allergy in some patients with allergic conjunctivitis (SAC and PAC) and the value of the nasal challenges with allergen combined with registration of the ocular features in the diagnostic approach to these disorders.