Chronic Allergic Conjunctivitis Research Articles

The associations between asthma and common comorbidities: a comprehensive Mendelian randomization study.

Asthma is a chronic respiratory disease and is often associated with multiple comorbidities. The causal relationship between asthma and these comorbidities is still unclear. This study aimed to investigate the association between genetically predicted asthma and common comorbidities. After searching PubMed and GWAS summary statistics, we identified 26 comorbidities of asthma. The causal relationship between asthma and comorbidities was assessed in two independent GWASs by bidirectional Mendelian randomization, followed by validation of the results using a multivariate Mendelian randomization analysis and several sensitivity analyses. In the bidirectional Mendelian randomization analysis, chronic sinusitis [odds ratio (OR) = 1.54, p = 1.40 × 10-5], atopic dermatitis (OR = 1.36, p = 9.37 × 10-21), allergic conjunctivitis (OR = 2.07, p = 4.32 × 10-6), and allergic rhinitis (OR = 1.53, p = 5.20 × 10-6) were significantly associated with increased asthma risk. Hyperthyroidism (OR = 1.12, p = 0.04) had a potential increased risk for asthma. For the reverse direction, asthma showed significant associations with an increased risk of chronic obstructive pulmonary disease (OR = 1.24, p = 2.25 × 10-9), chronic sinusitis (OR = 1.61, p = 5.25 × 10-21), atopic dermatitis (OR = 2.11, p = 1.24 × 10-24), allergic conjunctivitis (OR = 1.65, p = 6.66 × 10-35), allergic rhinitis (OR = 1.90, p = 2.38 × 10-57), and a potential higher risk of allergic urticaria (OR = 1.25, p = 0.003). This study suggested a significant bidirectional association of chronic sinusitis, atopic dermatitis, allergic conjunctivitis, and allergic rhinitis with asthma. In addition, hyperthyroidism was associated with an increased risk of asthma and asthma increased the risk of chronic obstructive pulmonary disease and allergic urticaria.

Prevalence, Severity, and Treatment Outcomes of Meibomian Gland Dysfunction in Patients With Dry Eye Symptoms at a Tertiary Care Center in South India.

Background and objectiveDry eye disease (DED) is one of the most common reasons why patients seek eye care. With increasing age, widespread adoption of technology, and environmental changes, its prevalence has been on the rise, and will likely increase further. Meibomian gland dysfunction (MGD) is the most common cause of DED; however, for a variety of reasons, it is currently underrecognized. We aimed to determine the etiology of DED from a sample of patients visiting our center with dry eye symptoms and study the characteristics of those diagnosed with MGD.MethodologyWe conducted this prospective observational study from 2016 to 2018. We included patients with two or more dry eye symptoms and excluded those with systemic conditions or structural issues causing dry eye. Each patient underwent a detailed evaluation of the dry eye, including the Ocular Surface Disease Index (OSDI) questionnaire, Oxford corneal staining, Schirmer test 1, tear film break-up time (TBUT), tear meniscus height, and non-contact meibography. All patients subsequently received appropriate treatment. Patients with MGD were evaluated once again after one month.ResultsWe included 250 patients in the study. Their mean (standard deviation) age was 45.3 (16.9) years, and 138 (55%) of them were males. Grittiness and itching were the most common symptoms. MGD was the most common diagnosis, seen in 100 (40%), followed by chronic allergic conjunctivitis. Patients with MGD were more likely to be elderly and had significantly worse DED parameters. Over half of all MGD cases were mild or less severe. With appropriate treatment, all DED metrics improved significantly.ConclusionsMGD was the most common cause of DED in our sample. Patients with MGD were more likely to be elderly and had more severe DED, consistent with other studies in the literature. With specific treatment of MGD, there was a significant improvement in the patients' condition. DED is a growing ocular health issue that causes great detriment to patients’ quality of life and finances. Our findings support the need for a detailed evaluation and specific treatment of patients presenting with dry eye symptoms.

Major Complications of Overnight Orthokeratology Lens for Myopic Correction

Orthokeratology adopts reverse geometry rigid gas-permeable contact lenses to alter the corneal shape and hence refractive power. The effect is transient; therefore, the users need to wear the orthokeratology lenses during night time while asleep, so that they can avoid wearing glasses during daytime. The compressive forces of the reverse geometry rigid lenses may disrupt the corneal epithelium and extended overnight wear may potentiate various side effects, such as lens-corneal binding, corneal staining, microbial keratitis, chronic allergic conjunctivitis and lens decentration. In this article, we conducted a systemic review to summarize the major complications associated with orthokeratology lens use and solutions.

Tele-ophthalmology as an aid tool for primary care physicians in the IDF, during the Covid-19 lockdown.

PurposeTo describe tele-ophthalmology consultations for primary-physicians in the IDF during the Covid-19 lockdown.MethodsRetrospective cross-sectional study. Medical records of tele-ophthalmology consultations from March to June 2020 were reviewed.ResultsThe study included 245 cases in which an ophthalmologist was consulted. In 62.0% cell-phone camera photographs were used. The mean age was 21.5 ± 6.4 years. The most common diagnoses were acute-conjunctivitis (8.6%); conjunctival-hyperemia (non-specific diagnosis, 8.2%); scleritis/episcleritis (7.3%); chronic allergic-conjunctivitis (7.3%); chalazion (7.3%) hordeolum (6.5%); acute allergic-conjunctivitis (4.5%). 37.6% of patients received primary physician-based treatment, 24.9% of patients received specialist-based treatment. 13.1% were referred to the ER. The consult prevented ER referral for 39.2% and changed the physician's treatment plan in 70.6% of cases. Foreign-body sensation complaints were more likely treated by a primary-physician (p = 0.015). Cases with suspected foreign-body diagnosis were referred more to the ER (p < 0.001). For most cases of eyelid complaints and diagnoses, primary physician care was sufficient (p < 0.001). Conjunctival complaints and diagnoses received significantly more ophthalmologist-based treatment (p < 0.001). Corneal disorders were significantly referred more to the ER (p = 0.001).ConclusionDespite of possible ethical and legal problems and clinical limitations of this instrument, Tele-ophthalmology using objective aids such as smartphone photography can be an efficient tool in aiding the primary-physician, especially for patients with low access to ophthalmologists, with major impact on patient management.

Epidemiologic features and burden of atopic dermatitis in adolescent and adult patients: A cross-sectional multicenter study

BackgroundAtopic dermatitis (AD) is considered as one of the most frequent chronic skin conditions. Previous AD epidemiologic studies have been mainly retrospective and/or have been performed through surveys instead of in-person visits. Epidemiological studies concerning AD in Latin American countries are scarce. ObjectiveTo describe sociodemographic and clinical features and the economic burden of AD on children and adult patients in Colombia through in-person visits. MethodsThis was a cross-sectional study of 212 patients that included sociodemographic and clinimetric data. The diagnostic criteria of Hanifin and Rajka was used and data relating to disease distribution, disease severity (through the BSA: Body surface area; EASI: Eczema Area and Severity Index; SCORAD: Scoring Atopic Dermatitis), Fitzpatrick's skin phototypes, personal and familiar history of allergic diseases, previous treatments, and personal history of comorbidities, was collected. ResultsPatient age range was 12–76, and 52.8% were female. Disease distribution was mainly flexural (19.6%). Early age start, Denni-Morgan fold, and infections tendency were more frequent in adolescents compared to adults. Mean age of diagnosis was 12 years old, AD diagnosis was made mostly by a dermatologist, 48.1% (102 patients) reported alcohol consumption, and 59% of consumers were heavy drinkers. Comorbidities found were: chronic rhinitis (68.9%) food allergy (32.5%), allergic conjunctivitis (29.7%), and asthma (28.8%). Around 81% earned less than $896 US dollars and 59% invested 6–30% of their monthly budget yearly, and 40% had work or school absenteeism. Mean scores of BSA, EASI, and SCORAD involvement were 32.6, 13.7, and 42.4, respectively. ConclusionsThis study adds well-supported data through an in-depth clinical and economical characterization of Colombian adolescents and adult patients with atopic dermatitis and shows its high impact and burden on patients and their families. It also contributes to understand the burden of AD in Latin America.

Vernal Keratoconjunctivitis: Beyond the Classic Treatment

Vernal keratoconjunctivitis is a chronic allergic conjunctivitis with corneal involvement that affects children and adolescents. Its pathogenic mechanisms are not entirely clear, but IgE and other inflammatory mediators are involved. An 8-year-old boy with vernal keratoconjunctivitis not responding to conventional treatment started immunotherapy with good results, decreasing the topical steroid dependence. Conventional vernal keratoconjunctivitis treatment involves topical antihistamines and steroids. These are not always effective and steroids can be associated with severe ocular complications in the long term. The authors suggest searching for possible allergens and starting immunotherapy associated with conventional topical treatment earlier, in addition to measuring the health-related quality of life by applying the Quality of Life in Children with Vernal Keratoconjunctivitis questionnaire and adjusting the treatment according to the impact on patients' quality of life. [ J Pediatr Ophthalmol Strabismus. 2021;58(5):e36–e39.]

Application Of The Preparation Floxal In Treatment Of Acute And Chronic Diseases Of The Lid And Conjunctives

The problem of treating inflammatory diseases of the anterior segment of the eye, in particular chronic allergic conjunctivitis, blepharoconjunctivitis , continues to be relevant. In addition to the pronounced subjective discomfort, cosmetic defect, these diseases pose a danger to the cornea. Our study was aimed at studying the effectiveness of Floxal antibacterial ophthalmic ointment - in the treatment of acute and chronic diseases of the eyelids and conjunctiva.

Clinical forms of allergic eye manifestations: prospects of therapy

The review presents the main clinical forms of eye allergy. The modern classification of conjunctival allergic diseases (CAD) divides them into several types according to the presence or absence of proliferative changes complicated by atopic dermatitis or mechanical artifactual irritation. These include: 1) allergic conjunctivitis (AC) without proliferative changes, including seasonal allergic conjunctivitis and chronic allergic conjunctivitis, in which the symptoms persist the whole year; 2) atopic keratoconjunctivitis, a chronic allergic conjunctival disease affecting patients with atopic dermatitis, 3) spring keratoconjunctivitis with conjunctival and proliferative changes — papillary conjunctival hyperplasia with the involvement of the cornea (superficial punctate keratitis, erosion, persistent epithelial defect, sterile corneal ulceration), 4) giant papillary conjunctivitis (GPC) accompanied by proliferative changes in the upper lid and the arch of the conjunctiva of the eyeball, caused by mechanical irritation factors (contact lenses, eye prostheses, or surgical sutures). To treat these conditions, the following groups of medications are used: artificial tears; topical antihistamine drugs; mast cell membrane stabilizers; dualaction drugs, preferably without preservatives, nonsteroid anti-inflammatory medications and vasoconstrictors having side effects. Olopatadin 1 mg/1 ml, preservative free (Olofadin -ECO), has certain advantages due to the fact that it combines antihistamine and membrane stabilizing action. Due to the presence of an antihistamine component in the composition, an acute reaction is stopped, while the effect of the drug is accumulated due to the presence of a membrane-stabilizing component. It is safe for long-term therapy.

Modification of AQI as an Effective Representation of Air Quality by Considering Weighting Factors

Controversy persists because residents in regions where air quality is poor are always dissatisfied with the presentation of the air quality index (AQI). To make management policies acceptable, it needs to be determined whether adding the various weighting factors can make the AQI more reasonable and practical. The authors selected three indices i.e. AQI, revised air quality index (RAQI), and the air-dispersion AQI (ADRAQI) to compare their results in different atmospheric situations and to determine whether the AQI was made more reliable by adding various weighting factors such as multi-air pollutants and air dispersion derived from the mean function and an entropy function. Results show in comparison to AQI, the RAQI and ADRAQI have greater values in the multi-air pollutant and poor dispersion events, leading to a great difference between single air pollutant and multi-air pollutant events. The eclipsed phenomena in the AQI for the means of diseases related to air pollution such as acute atopic conjunctivitis, other chronic allergic conjunctivitis, other atopic dermatitis and related conditions, contact dermatitis and other eczema, and unspecified causes clearly appear. The findings suggest that the representation of AQI can be modified by considering the weighting factors of multiple air pollutants along with air dispersion; these can easily be applied to similar regions elsewhere.

Vernal keratoconjunctivitis.

Vernal keratoconjunctivitis (VKC) is a chronic allergic conjunctivitis that is most often seen in young, males. Although most types of allergic conjunctivitis do not affect vision, VKC is unusual in that damage to the cornea from the condition can result in vision loss. Although it is typically seasonal, year-round symptoms can be seen, which can lead to uncertain diagnoses being made. Although the pathophysiology of VKC is better understood in recent years, allowing more targeted therapies, management of these patients can still be very challenging, and complications can occur. As such, aggressive management of VKC is necessary, especially since vision loss in the amblyogenic age range can be permanent.

Diagnóstico diferencial de conjuntivitis alérgica crónica en rinitis alérgica

Introducción: en la clínica de optometría de la Facultad de Estudios Superiores (FES) Iztacala, de la Universidad Nacional Autónoma de México, se presentó un caso clínico de rinoconjuntivitis alérgica persistente monocular en un paciente de 13 años de edad, diagnosticado y tratado como conjuntivitis bacteriana por varias instancias médicas previas a nuestra consulta. Se analizó el caso al considerar los signos y síntomas, así como la evolución de la patología. Objetivo: desarrollar un diagnóstico diferencial entre conjuntivitis alérgica crónica con rinoconjuntivitis alérgica persistente, a partir de un proceso diagnosticado como infeccioso. Método: valoración a través de biomicroscopia, revisión de fosas nasales y garganta y, como apoyo al diagnóstico, exudado conjuntival. Resultados: después de efectuar la valoración clínica del paciente, se diagnosticó rinitis alérgica crónica; así, se remitió al médico general para tratamiento sistémico y se administró un tratamiento local con antihistamínicos. Conclusión: la rinoconjuntivitis persistente tiene una prevalencia de cerca del 88 % de los pacientes que asisten a consulta oftalmológica. Es importante que en la práctica clínica el optometrista fortalezca el diagnóstico con pruebas especiales para la detección de la alergia y con la aplicación de cuestionarios diagnósticos como el presentado por el estudio International Study of Asthma and Allergies in Childhood (ISAAC) y el trabajo multidisciplinario.

Contributions of Interleukin-33 and TSLP in a papain-soaked contact lens-induced mouse conjunctival inflammation model.

IntroductionPathological changes of severe chronic allergic conjunctivitis are driven not only via acquired immunity but also via innate immunity. Type 2 immune response‐initiating cytokines may play some roles as innate immunity‐dependent components of the ocular surface inflammation. To investigate the involvement of type 2 immune response‐initiating cytokines in innate immunity‐dependent, papain‐induced conjunctival inflammation model using IL‐25‐, IL‐33‐, and TSLP receptor (TSLPR)‐knockout (KO) mice with reference to basophils and ILC2.MethodsPapain‐soaked contact lenses (papain‐CLs) were installed in the conjunctival sacs of C57BL/6‐IL‐25 KO, IL‐33 KO, TSLPR KO, Rag2 KO, Bas‐TRECK, and wild‐type mice and their eyes were sampled at day 5. The eosinophil and basophil infiltration in papain‐CL model was evaluated histologically and cytokine expression was examined. To clarify the roles of basophils and ILC2, basophil/ILC2‐depletion experiments were carried out.ResultsPapain‐induced conjunctival inflammation exhibited eosinophil infiltration and upregulation of Th2 cytokine expression. Reduction of eosinophil and basophil infiltration and attenuated Th2 cytokine expression were observed in the papain‐CL model using IL‐33 KO and TSLPR KO mice. Depletion of basophils or ILC2s in the conjunctivae of the papain‐CL model reduced eosinophil infiltration.ConclusionsInnate immunity‐driven type 2 immune responses of the ocular surface are dependent on IL‐33, TSLP, basophils, and ILC2. These components may be possible therapeutic targets for refractory allergic keratoconjunctivitis.

. Oсumethyl in the treatment of allergic diseases of eyelids and conjunctiva

Treatment of allergic diseases of eyelids and conjunctiva (conjunctivites and blepharoconjunctivites) often presents difficulties due to peculiarities of their pathogenesis - allergic and vascular reactions, disorder of lacrimal production, meibomian gland dysfunction, and possible bacterial contamination. It has been suggested to use Ocumethyl, which contains zinc sulfate (binding, drying, anti-inflammatory, and antiseptic effect), diphenhydamine hydrochloride (an Н1-antihistamine that decreases capillary permeability and helps resolve conjunctival and eyelid edema), naphazoline hydrochloride (a sympathomimetic notable for its strong, rapid, and long-lasting vasoconstrictive effect), and methylene blue (antiseptic effect, disintoxication, and antioxidant activity). A total of 80 patients with chronic allergic conjunctivitis, blepharoconjuntivitis, or giant papillary conjunctivitis associated with contact lens wearing were treated with Ocumethyl instillations (3 times daily for 15-30 days). A clinically significant effect was obtained in 77-91% of patients depending on the disease entity.

Prevalence of various types of allergens in ocular allergic conditions of patients from Pokhara, Nepal

Introduction: Ocular allergic conditions are mostly recurrent and the drugs prescribed, especially corticosteroids, have serious side effects. Therefore, when maximal tolerated topical and systemic medications are unable to control allergic conjunctivitis, a skin prick test for allergens should be conducted and patients should be taught to avoid these allergens. Objective: To find out the prevalence of common allergens inciting ocular allergic diseases in Nepal. Subjects and methods: A total of 13,376 skin prick tests were performed on 76 patients suffering from different chronic recurrent ocular allergic conjunctivitis with 176 common allergens (pollens, fungi, insects, dusts, danders, fabrics/ feathers, food, parthenium leaves, tobacco and mite). Buffer saline was used as a negative control while histamine acid phosphate was used as a positive control. Grading of the skin prick test reaction was done by comparison to the histamine positive control. Only markedly positive reactions were considered positive. Relevant data were entered into the excel spreadsheet and analyzed with the Stata-12 commercial package. The association between allergic conditions and socio-demographic, environmental and other co-variates were tested by the chi-square test. Results: The common offenders found in the study were mite (42.11 %) followed by fabrics/ feathers (20.39 %), dusts (18.18 %), pollen (17.05 %), non-juicy food (15.02 %), dander (13.60 %), juicy food (11.64 %) and fungus (9.87 %), and tobacco (6.58 %), parthenium leaves (5.26 %) and insects (3.17 %) were less common offenders. Conclusions: All ocular allergy patients should undergo skin prick tests to find out the allergens causing their allergy and then receive specific immunological treatment (SIT). DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10759 Nepal J Ophthalmol 2014; 6 (2): 6-23

Patient initiation and persistence with allergen immunotherapy

BackgroundAllergen immunotherapy (AIT) is advised for patients with allergic rhinitis who remain symptomatic despite the use of pharmacotherapy and allergen avoidance. Several factors influence the decision to initiate and complete the AIT regimen. ObjectiveTo evaluate patient initiation and persistence with subcutaneous and sublingual immunotherapies (SCIT and SLIT) according to physician recommendation. MethodsA retrospective review of electronic health records of patients with allergic rhinitis for whom AIT was recommended was conducted in a large private allergy practice in Pennsylvania. ResultsOf 8,790 patients advised to consider AIT, 36.2% initiated AIT (57% adults, 43% children); 78% chose SCIT and 22% chose SLIT drops. Election of AIT was significantly associated with select comorbidities, specifically chronic sinusitis (8.1% for AIT vs 10% for no AIT), allergic conjunctivitis (12.5% for AIT vs 18.5% for no AIT), and asthma (33.8% for AIT vs 37.4% for no AIT; P < .05). Choice of SCIT vs SLIT drops was significantly associated with older age, female sex, select comorbidities, and more allergy medications at initiation (P < .05). Of adults, 30.2% completed at least 3 years of recommended treatment. Median time on treatment was longer for adults on SCIT vs SLIT drops (3 vs 1.6 years). Similarly, 35.4% of children completed treatment, with a longer median time on treatment for SCIT (4.7 years) vs SLIT drops (3.5 years). ConclusionA minority of patients initiated AIT according to allergist recommendation and a subset of these patients completed therapy. AIT might be an underused option that could benefit patients unable to manage allergic rhinitis symptoms by other means. Trial Registrationclinicaltrials.gov Identifier: NCT01549340.

Alpha-1 antitrypsin, a diagnostic and prognostic marker of vernal keratoconjunctivitis.

A major chunk of ocular allergies in humans involve the conjunctiva, of which Vernal Keratoconjunctivitis (VKC) appears to be more common. VKC, a chronic allergic conjunctivitis, frequently affects young males and is characterized by intense inflammation of the limbal and/or tarsal conjunctiva. The etiology and immuno-pathogenesis of VKC still remain unclear. Alpha-1 antitrypsin (AAT), a member of serine proteinase inhibitor (SERPIN) superfamily, is an acute phase protein whose concentration in blood increases in response to inflammation. AAT deficiency is one of the many factors that may be involved in several abnormalities such as liver disease, emphysema, inflammatory joint diseases and inflammatory eye diseases. In the present study, the role played by this protein in VKC was analyzed in a selective case/control study to assess its diagnostic and prognostic value. The case control study included 50 patients of VKC reporting to Ophthalmology out patient department (OPD). Age and sex matched 40 healthy subjects served as control. Serum AAT level of both the cases and controls were evaluated and compared. Moreover the serum AAT levels of the patients at presentation were compared with their serum AAT level after three weeks post treatment. Levels of AAT in the serum of VKC patients at presentation (2.80 ± 0.42 mg/ml) were significantly higher as compared to controls (2.31 ± 0.21 mg/ml) whereas no significant difference was observed between the serum level of post treatment VKC patients (2.48 ± 0.26 mg/ml) and controls. AAT is a potent acute phase protein whose concentration rises significantly in VKC, irrespective of the age and sex of the patient. Moreover, the serum level of AAT declined significantly post treatment; therefore it might be used as a prognostic marker.

Optic nerve injury in a patient with chronic allergic conjunctivitis.

Manipulation of the optic nerve can lead to irreversible vision changes. We present a patient with a past medical history of skin allergy and allergic conjunctivitis (AC) who presented with insidious unexplained unilateral vision loss. Physical exam revealed significant blepharospasm, mild lid edema, bulbar conjunctival hyperemia, afferent pupillary defect, and slight papillary hypertrophy. Slit lamp examination demonstrated superior and inferior conjunctival scarring as well as superior corneal scarring but no signs of external trauma or neurological damage were noted. Conjunctival cultures and cytologic evaluation demonstrated significant eosinophilic infiltration. Subsequent ophthalmoscopic examination revealed optic nerve atrophy. Upon further questioning, the patient admitted to vigorous itching of the affected eye for many months. Given the presenting symptoms, history, and negative ophthalmological workup, it was determined that the optic nerve atrophy was likely secondary to digital pressure from vigorous itching. Although AC can be a significant source of decreased vision via corneal ulceration, no reported cases have ever described AC-induced vision loss of this degree from vigorous itching and chronic pressure leading to optic nerve damage. Despite being self-limiting in nature, allergic conjunctivitis should be properly managed as extreme cases can result in mechanical compression of the optic nerve and compromise vision.

Comparative Evaluation of Topical Pranoprofen and Fluorometholone in Cases With Chronic Allergic Conjunctivitis

This study was conducted to compare the efficacy of 0.1% fluorometholone and 0.1% pranoprofen in cases with chronic allergic conjunctivitis. In an investigator-masked trial, patients with chronic allergic conjunctivitis were randomized to treatment with 4 times daily 0.1% pranoprofen (PN) or 0.1% fluorometholone (FL) eye drops for 4 weeks. A 4-point rating scale assessing the severity of 5 symptoms and 4 signs (0 = none, 1 = mild, 2 = moderate, and 3 = severe) was used. A linear mixed model was used to explore the rate of score changes. Regression analysis was used to evaluate the relation between clinical outcome and age. A total of 75 patients were enrolled at the baseline. There were no significant differences in the demographics and baseline skin prick scores between both groups. Mean baseline scores in PN and FL group were 6.71 ± 2.28 and 6.41 ± 2.06, respectively. The scores rapidly decreased to 3.35 ± 1.58 and 2.91 ± 1.71 on day 7, respectively. Fluorometholone showed a more rapid effect compared with pranoprofen during the first week of treatment (P < 0.05) but not later. Regression analysis showed that age was negatively associated with response to fluorometholone (younger than 29 years). The intraocular pressure increased by 0.7 mm Hg in the FL group and decreased by 0.5 mm Hg in the PN group on day 28 (P > 0.05). Both fluorometholone and pranoprofen were effective for management of cases with chronic allergic conjunctivitis. Fluorometholone provided more rapid relief as compared with pranoprofen. The effect of fluorometholone was more pronounced in younger patients.

The Role of Tear Substitutes in the Eye Relieve in Chronic Seasonal Allergic Conjunctivitis

The Role of Tear Substitutes in the Eye Relieve in Chronic Seasonal Allergic Conjunctivitis

Recent Patents and Emerging Therapeutics in the Treatment of Allergic Conjunctivitis

Ocular allergy is an inflammatory response of the conjunctival mucosa that also affects the cornea and eyelids. Allergic conjunctivitis includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and giant papillary conjunctivitis (GPC). In general, allergic conditions involve mast cell degranulation that leads to release of inflammatory mediators and activation of enzymatic cascades generating pro-inflammatory mediators. In chronic ocular inflammatory disorders associated with mast cell activation such as VKC and AKC constant inflammatory response is observed due to predominance of inflammatory mediators such as eosinophils and Th2-generated cytokines. Antihistamines, mast-cell stabilizers, nonsteroidal anti-inflammatory agents, corticosteroids and immunomodulatory agents are commonly indicated for the treatment of acute and chronic allergic conjunctivitis. In recent years newer drug molecules have been introduced in the treatment of allergic conjunctivitis. This article reviews recent patents and emerging therapeutics in the treatment of allergic conjunctivitis.