Every person at least once in his life faced with an atypical reaction of the body to external factors. Such a reaction is an allergy, and its symptoms can appear on the skin, in the organs of vision, breathing or digestion. To date, immunologists have not been able to come up with a method to eliminate such inadequate body reactions, but their symptoms, including signs of allergic conjunctivitis, can be removed and alleviated quite possibly.
The essence of the disease
Allergic conjunctivitis is an inflammatory process in the eye membrane (conjunctiva), which is expressed by lacrimation, swelling and itching. The disease most often manifests itself at a young age and can be combined with other symptoms of an allergic reaction - a runny nose, difficulty breathing, skin rashes. According to studies, symptoms of the disease occur in about 40% of people withother pathologies of allergic origin. In the International Classification of Diseases (ICD), allergic conjunctivitis is assigned the H10 code, which includes various subtypes of the disease.
The disease develops and proceeds in three stages:
- Immunological stage. During this period, the body produces antibodies to allergens. Lymphocytes in the mucous membranes of the nose and conjunctiva actively produce immunoglobulins that are fixed in the connective tissue. Of these, mediators of inflammation of allergic genesis are subsequently released. The disease can occur both with direct contact of the allergen with the eye, and with its penetration through the nose. In this case, rhinitis develops in parallel with conjunctivitis.
- Patochemical stage. Inflammatory mediators enter the blood and intercellular fluid and actively act in the capillaries, on the mucous membranes and in the nerve endings, attracting new cells to the focus of inflammation. Upon repeated contact of the allergen with immunoglobulin antibodies, histamine, bradykinin and serotonin are released, causing the main symptoms of conjunctivitis. Prolonged contact with the allergen prolongs the allergic reaction and is the main reason for the transition of the disease to a chronic form.
- Pathophysiological stage. At this stage, an acute form of the disease occurs and all its symptoms are most pronounced.
Views
Depending on the frequency of symptoms, as well as the factors that cause allergic conjunctivitis, the disease is divided into several types:
- Contact - reactions occur when in contact with an allergen, for example, cosmetics, eye drops, lens solutions.
- Periodic (pollinosis) - symptoms occur during the presence of an allergen, for example, to flowering plants.
- Year-round - persistent allergens, such as bird feathers, animal hair, dust, cleaning products, cause symptoms of the disease.
How to treat allergic conjunctivitis depends on the allergen and the type of disease. For effective therapy, it is required to eliminate the effect of the irritating factor and then carry out therapeutic measures.
According to the International Classification of Diseases (ICD-10), allergic conjunctivitis is divided into the following types:
- mucopurulent conjunctivitis;
- acute atopic conjunctivitis;
- other acute conjunctivitis;
- acute conjunctivitis, unspecified;
- chronic conjunctivitis;
- blepharoconjunctivitis;
- other conjunctivitis;
- conjunctivitis, unspecified.
Reasons
The development of allergic eye conjunctivitis is based on the mechanism of immediate type hypersensitivity, respectively, the symptoms of the disease occur immediately after contact with the allergen. The human eye, due to its special anatomical structure, is exposed to many external factors that can cause an atypical reaction.
The most common allergens that cause conjunctivitis areare:
- Household: dust mites, dust, pillow feathers, cosmetics, household chemicals, medicines (especially eye medicines).
- Epidermal: wool, dead animal skin cells, bird feathers, aquarium fish food.
- Pollen: pollen from various plant species during their active flowering.
At the same time, an allergic reaction to food causes conjunctivitis extremely rarely. The likelihood of symptoms of the disease is also affected by heredity. Allergic conjunctivitis in children, which is difficult to treat, especially at an early age, often occurs when one or both parents are allergic.
Symptoms
The rate of onset of symptoms of allergic conjunctivitis can range from a couple of minutes to two days after contact with the allergen. The disease affects in the vast majority of cases the conjunctival membranes of both eyes. The rate of development of symptoms of allergic conjunctivitis is affected by the concentration of the allergen in the body, as well as the individual reaction of the body to its penetration.
The main symptoms of the disease are:
- Allergic rhinitis with copious mucus and frequent blowing of the nose, additionally irritating the ocular mucosa.
- Swelling and hyperemia of the eyelids.
- Lachrymation of the eyes, active itching, burning of the eyelids. Itching causes severe discomfort and a desire to constantly scratch the eyes, which can lead to the addition of a bacterial infection and aggravationcourse of the disease.
- The appearance of viscous, colorless, mucous secretions on the eye membrane, and in the case of bacteria attached, also purulent contents in the corners of the eyes.
- Glue eyelids after sleep.
- Reduced production of tears in the normal eye and dryness of the eye (sandy feeling in the eyes).
- Photophobia.
- Easy fatigue and redness of the eyes.
- Pain during eye movements caused by partial atrophy of the conjunctiva.
Symptoms and treatment of allergic conjunctivitis depend on the form of the course of the disease, which can be acute (with sudden onset and rapid recovery) and chronic (recurrent, sluggish inflammatory process). The course of the disease directly depends on the frequency of contact with the allergen.
Allergic conjunctivitis in children
In young children, the disease is extremely rare. The first symptoms of allergic conjunctivitis in children usually appear by the age of 3-4, and more often in those who had other symptoms of allergic reactions earlier (diathesis, allergic dermatitis, etc.).
The main cause of the disease in children is not only increased sensitivity to environmental factors, but often a foreign body in the eye, allergens of viral, bacterial, parasitic or fungal origin. Symptoms and treatment of allergic conjunctivitis in a child will be different from adults.
Children characteristicsigns of the disease are photophobia, swelling of the eyelids, conjunctival hyperemia, lacrimation and itching. Intense itching leads to the child scratching the eyes, followed by a bacterial infection, so topical antibiotics are required in the treatment.
To prevent the transition of the disease into a chronic form in childhood, allergen-specific therapy is possible. During such treatment, the child is given small doses of the allergen, gradually increasing its concentration. Such actions help the body get used to the irritating factor, followed by a decrease (up to complete disappearance) of the symptoms of allergic conjunctivitis.
Diagnosis
Diagnosis of allergic conjunctivitis is associated with several medical areas: allergology, immunology, ophthalmology. It is best to start the examination with an ophthalmologist, since similar symptoms can be observed not only with conjunctivitis. When establishing the allergic nature of the disease, the ophthalmologist will refer the patient to the following specialists.
During the diagnosis, doctors take into account the following factors:
- allergic history;
- heredity;
- connection with external factors;
- clinical symptoms.
To finally confirm the diagnosis, the ophthalmologist may additionally prescribe a microscopic analysis of the lacrimal fluid. In it, with allergic conjunctivitis, an increased content of eosinophils is determined, and the level of immunoglobulin IgE in the blood test also increases. In the presence of purulent discharge from the cavityconjunctiva conduct bacteriological analysis of discharge from the eye. The cause of allergic conjunctivitis in adults and children can be specified with the help of skin allergy tests.
Medicated treatment
Treatment of allergic conjunctivitis in adults is complex and begins only after the final diagnosis and confirmation of the nature of the disease.
Drugs of the following groups are prescribed for therapy:
- Antihistamines. It is preferable to take drugs of the second ("Claritin", "Cetrin") or third generations ("Erius", "Ksizal"). Such funds are prescribed according to the age of the patient and are taken once a day for 2 weeks. If it is necessary to obtain a membrane-stabilizing effect, the intake of such drugs is extended up to several months.
- Topical antihistamines. Antiallergic drugs in tablet form do not provide the desired result, and in parallel with their administration, topical drugs are prescribed. Antihistamine drops for allergic conjunctivitis ("Allergodil", "Opatanol") are instilled 2-4 times a day. The duration of treatment is determined individually.
- Drops based on derivatives of cromoglycic acid ("Cromohexal", "Optikrom"). Such drugs are used for a long time, since the effect of them occurs no earlier than after a couple of weeks. The tool is considered the safest and can be used frequently andlong.
- Topical corticosteroids (hydrocortisone-based products). They are prescribed in the form of drops or eye ointment for severe inflammation of the conjunctiva.
Often, the treatment of conjunctivitis of a bacterial or viral nature with the use of specific drugs can cause an allergic reaction and aggravate the course of chronic conjunctivitis. For this reason, in the complex therapy of eye diseases of an infectious nature, including fungal, chlamydial, herpetic and adenovirus pathologies, local antihistamine eye drops are additionally prescribed.
In children, inflammation of the eyes often manifests itself in the form of vernal keratoconjunctivitis. With such a disease, in addition to the main symptoms, there is a papillary proliferation of cartilaginous tissues. The pathology can be so extensive that it causes deformation of the eyelid. In this case, injections of histoglobulin are often added to the main therapy, and sometimes even surgery is required after the acute symptoms have resolved.
Treatment with folk methods
In addition to drug therapy, it is also possible to use traditional medicine, which will alleviate many symptoms of the disease, eliminate itching, swelling of the eyelids.
Among folk remedies for allergic conjunctivitis, the most effective are:
- drops of honey;
- aloe juice;
- rosehip infusion for compresses;
- tea brew;
- herbal decoctions;
- chamomile infusion.
Before using traditional medicine, you should carefully study their composition and make sure that they do not cause allergies and do not aggravate the disease. After eliminating the allergen, the disease resolves within 7-10 days, but if its symptoms worsen, you should immediately consult a doctor.
Possible Complications
Allergic conjunctivitis in most cases becomes chronic, like any other disease of an allergic nature. Modern methods of therapy help to achieve a stable remission in the patient, however, the predisposition to such reactions still remains. In the absence of adequate therapy for allergic conjunctivitis, infection or exacerbation of eye pathologies, such as keratitis, glaucoma, blepharitis, is likely to occur.
Isolation of purulent contents from the eye requires antibiotic therapy and medical supervision. The spread of the inflammatory process to the cornea of the eye can cause atopic keratoconjunctivitis and prolonged photophobia. In severe forms of the disease, clouding of the lens, decreased vision, cicatricial changes in the conjunctiva, and even the development of cataracts and retinal detachment, fraught with complete blindness, are possible.
Prevention
There are no specific preventive measures against allergic conjunctivitis, since the reasons for the development of allergic reactions are still not clear. The main method of preventing recurrence of the disease is the complete elimination of contact with the allergen.
To speed up your recovery, you need to:
- limitcontact with an allergen;
- wear sunglasses during flare-ups;
- do not use contact lenses in case of inflammation;
- observe hygiene rules;
- use separate pipettes, wipes and drops for each eye;
- have a separate towel, cosmetics, glasses and other products and items that come into contact with the eyes.
Allergic conjunctivitis is an extremely unpleasant and rather long-term disease, but if you follow the recommendations and accurately determine the allergen that causes such a reaction, you can achieve good results.
