Eye Allergy Research Articles

Urban eye allergy syndrome: a new clinical entity?

ABSTRACTBackground: A significant number of patients present with conjunctivitis that is not strictly speaking of allergic, infectious, or dry eye origin. Patients affected by this pseudo-allergic form of vasomotor or idiopathic conjunctivitis usually live in urban polluted areas and may be affected by a new clinical entity called the ‘urban eye allergy syndrome’.Scope: To identify the incidence, pathogenesis and therapeutic response of this condition by collecting from the literature experimental evidence on the relationship between air pollution, allergy, and conjunctival disease.Findings: Allergen susceptibility might be increased in areas with increased air pollutants. Both allergens and pollutants can directly initiate specific and nonspecific mucosal inflammation through several interweaving mechanisms.Conclusions: The present commentary introduces the concept of ‘urban eye allergy syndrome’ discussing interactions between air pollutants and pollens, the increase of allergic signs and symptoms by pollutants, the prevalence of urban allergy, preliminary data from a single restricted geographical area, and proposed mechanisms of action.

Fortschritte in der Diagnose und Therapie von Erkrankungen der Augenoberfläche: Trockenes Auge und okuläre Allergien

The 77th meeting of the Association for Research in Vision and Ophthalmology (ARVO) presented the latest developments in clinical research and practice across a range of ophthalmic disciplines. Of particular interest was the current status of research in dry eye and ocular allergy. With these conditions being very common to ophthalmologists, and the fact that they are difficult to differentiate due to the number of overlapping symptoms, there remains a need for more rapid and accurate methods for their diagnosis. Therefore, a number of new tools were presented that have the potential for use in clinical trials and practice to improve the diagnosis and assessment of dry eye and ocular allergy. Some of these tools have been developed based on a greater understanding of the pathophysiology of dry eye and ocular allergy, and the various molecular pathways involved. Indeed, a greater understanding of the molecular mechanisms involved in the pathogenesis of dry eye and ocular allergy has identified potential targets for the treatment of these conditions. Continuing research into new agents can provide ophthalmologists with a number of options that will ultimately benefit the patient.

The reliability, validity, and preliminary responsiveness of the Eye Allergy Patient Impact Questionnaire (EAPIQ)

BackgroundThe Eye Allergy Patient Impact Questionnaire (EAPIQ) was developed based on a pilot study conducted in the US and focus groups with eye allergy sufferers in Europe. The purpose of this study was to present the results of the psychometric validation of the EAPIQ.MethodsOne hundred forty six patients from two allergy clinics completed the EAPIQ twice over a two-week period during the fall and winter allergy seasons, along with concurrent measures of health status, work productivity, and utility. Construct validity, reliability (internal consistency and test-retest), concurrent, known-group, and clinical validities, and responsiveness of the EAPIQ were assessed. Known-group validity was assessed by comparing EAPIQ scale scores between patients grouped according to their self-rating of ocular allergy severity (no symptoms, very mild, mild, moderate, severe, very severe). Clinical validity was assessed by assessing differences in EAPIQ scores between groups of patients rated by their clinician as non-symptomatic, mild, moderate, and severe.Results and DiscussionResults from the validation study suggested the deletion of 14 of 43 items (including embedded questions) that required patients to complete the percentage of time they were troubled by something (daily activity limitations/emotional troubles). These items yielded a significant amount of missing or inconsistent data (50%). The resulting factor analysis suggested four domains: symptoms, daily life impact, psychosocial impact, and treatment satisfaction. When included as separate scales, the symptom-bother and symptom-frequency scales were highly correlated (> 0.9). As a consequence, and due to superior discriminative validity, the symptom bother and frequency items were summed. All items met the tests for item convergent validity (item-scale correlation = 0.4). The success rate for item discriminant validity testing was 97% (item-scale correlation greater with own scale than with any other). The criterion for internal consistency reliability (alpha coefficient ≥ 0.70) was met for all EAPIQ scales (range 0.89–0.93), as was the criterion for test-retest reliability (intraclass correlation [ICC] ≥ 0.70). Largely moderate correlations between the scales of the EAPIQ and the mini Rhinoconjunctivitis Quality of Life Questionnaire (miniRQLQ) and low correlations with the Health Utilities Index 2/3 (HUI2/3) were indicative of satisfactory concurrent validity. The EAPIQ symptoms, Daily Life Impact, and Psychosocial Impact scales were able to distinguish between patients differing in eye allergy symptom severity, as rated by patients and clinicians, providing evidence of satisfactory known-group and clinical validities, respectively. Preliminary analyses indicated the EAPIQ Symptoms, Daily Life Impact, and Psychosocial Impact scales to be responsive to changes in eye allergies.ConclusionFollowing item reduction, construct validity, reliability, concurrent validity, known-group validity, and preliminary responsiveness were satisfactory for the EAPIQ in this population of ocular allergy patients.

Treating severe eye allergy.

Allergic eye conditions, particularly seasonal allergic conjunctivitis (SAC), are common. Itching, oedema and hyperaemia are relieved with topical H1-antagonists or sodium cromoglycate. The newer mast-cell stabilizing agent nedocromil sodium has a similar safety profile to sodium cromoglycate, but is more potent and has a more convenient twice-daily dosing regimen. When several placebo-controlled studies of its use in the treatment of SAC were analysed, it was found that 80% of patients reported symptom relief. In a further study, nedocromil sodium eyedrops (twice-daily dosing) had similar overall efficacy to sodium cromoglycate eyedrops (four-times-daily dosing) in subjects with SAC during the birch season, but during the period of highest pollen challenge, only the former agent was significantly more effective than placebo. Another study found that nedocromil sodium had efficacy equivalent to levocabastine over 7 days, but tended to have a more rapid onset of action. In patients with perennial allergic conjunctivitis (PAC) unresponsive to sodium cromoglycate, both clinicians and patients reported significantly better control of symptoms with nedocromil sodium eyedrops than with placebo. Recently, in a long-term study of treatment for vernal keratoconjunctivitis (VKC), it was found that nedocromil sodium 2% eyedrops produced a more rapid and marked improvement in symptoms than sodium cromoglycate 2% eyedrops and enabled lower use of steroid rescue medication. Both drugs were well tolerated and without serious side-effects.

A Color Atlas of Pediatric Allergy

Preparing a color atlas requires authors with 2 exceptional qualities. First, the authors must have clinical expertise that spans the field in depth and width. Second, the authors must have a long-standing love of documentation via photography. Both qualities are reflected well inA Color Atlas of Pediatric Allergy. This book includes a collection of patients' photographs, mostly gathered by the authors and partly borrowed. The high-quality photographs are richly supplemented by excellent photomicrographs of pathological specimens frequently encountered in clinical practice; superb illustrations, diagrams, roentgenograms, and tables are included. The legends are clear and descriptive, and the tabulated information is well organized. The text provides concise information on topics common to pediatric allergy and on selected related subjects. The topics covered include the following: allergy mechanisms; allergy evaluation; asthma differential diagnosis and management; otolaryngological and eye allergies; cutaneous allergies and related disorders; and specific allergies to foods, drugs, and

Allergy and Immunology of the Eye

Allergy and Immunology of the Eye

Allergy and immunology of the eye

Allergy and immunology of the eye

Two new books for patients to read

UNDERSTANDING ALLERGIES by Mary Steel explains eczema in childhood and later, ear and eye allergies, urticaria and angioedema, asthma and hay fever. Chapters are also devoted to allergies to insects, drugs and food. The book makes many helpful suggestions for alleviating symptoms and coping with the problems that allergy frequently brings, but emphasises when to seek medical advice.

The 1947 Year Book of Eye, Nose and Throat.

This Year Book, in a compact and handy manner, contains an accurate review of the previous year's publications in ophthalmology, with an excellent index to subject matter and authors. The abstracts are well chosen, and in presenting the special topic, "Suggestions for Accurate Records in Ophthalmology," the author of the section on the eye, Dr. Louis Bothman, brings Elschnig's classification of normal optic disks and the method of recording lesions of the fundus, as described in Dr. Alfred Kestenbaum's book entitled "Clinical Methods of Neuro-Ophthalmologic Examination." The comments by the author are set forth clearly and are well worth reading. The part on the eye occupies 222 pages, and under the heading "General and Miscellaneous" are brought a number of important abstracts, of which may be mentioned "Vascular Basis of Allergy of Eye and Its Adnexa," "Ocular Toxoplasmosis," "Pigmented Tumors" and "Congenital Encephalo-Ophthalmic Dysplasia." The book maintains the high standard

Allergy of the eye

Allergy of the eye

Allergy of the Eye

Allergy of the Eye