Systematic allergy investigation of patients with red eyes

Abstract

AbstractPurpose“Red eyes” is a common patient complaint. Determining the underlying cause is often difficult as differential diagnoses are numerous. Allergic causes may be easily overlooked as the diagnosis relies on specialized investigation. We wanted to determine the prevalence of relevant allergy in patients with "red eyes", where initial ophthalmological consultation did not result in a definite diagnosis.Methods A multidisciplinary cooperation was established between ophthalmologists, allergologists, dermatologists and pediatricians. The investigation algorithm was based on clinical presentation. Patients with eye symptoms only, or eye and skin symptoms, underwent dermatological investigation comprising patch testing with European baseline series, eye drops and skin prick tests with inhalant allergens and the patients' own ophthalmological products. Patients with eye and airway symptoms were reviewed by allergologists and underwent skin prick tests and specific IgE analysis for relevant allergens and lung function tests. Children were reviewed by pediatric allergologists. Multidisciplinary conferences were held regularly and patients were reviewed and cross‐referred if relevant.Results In total 58 patients (21 males and 37 females) with “red eyes” were included over a one year period. In 21 patients (36%) a relevant allergy was found, diagnosing contact allergy in 15 patients (9 perfume, 3 phenylephrine, 3 others) and IgE‐mediated inhalant allergies in 6 patients. In 37 patients (64%) no allergy was found, and of these 10 patients were diagnosed with rosacea.Conclusion Multidisciplinary cooperation and systematic investigation resulted in identifying relevant allergy in 36% of patients presenting with “red eyes”.