Allergic conjunctivitis: a comprehensive review of the literature

Abstract

Ocular allergy represents one of the most common conditions encountered by allergists and ophthalmologists. Allergic conjunctivitis is often underdiagnosed and consequently undertreated. Basic and clinical research has provided a better understanding of the cells, mediators, and immunologic events, which occur in ocular allergy. New pharmacological agents have improved the efficacy and safety of ocular allergy treatment. An understanding of the immunologic mechanisms, clinical features, differential diagnosis, and treatment of ocular allergy may be useful to all specialists who deal with these patients. The purpose of this review is to systematically review literature underlining all the forms classified as ocular allergy: seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratocongiuntivitis, contact allergy, and giant papillary conjunctivitis.

Ocular itch associated with allergic conjunctivitis: latest evidence and clinical management

“…Although these combinations reversibly blocked histamine receptors, controlling ocular itching and conjunctival hyperemia, they had no effect on the other proinflammatory mediators, such as the prostaglandins and leukotrienes [La Rosa et al 2013]. The first-generation antihistamines also cause considerable stinging and the short durations of the single agents remained a limitation [Williams et al 2011].…”

“…The mechanism of action of mast-cell stabilizers is still not clear; they may reduce degranulation and/or biosynthesis of inflammatory mediators via a reduction of cellular calcium influx [Cook et al 2002;Leonardi, 2002;La Rosa et al 2013]. Another suggestion is that they inhibit IgE production [Loh et al 1994;Alton and Norris, 1996].…”

“…Of course, vasoconstrictors alleviate only hyperemia, offering little to no relief of itching [Abelson et al 1980]. Moreover, their efficacy is of short duration, and their use is subject to tachyphylaxis [Abelson et al 1990b;Owen et al 2004;Williams et al 2011;La Rosa et al 2013]. Low-dose brimonidine is a longer-acting alpha-2 agonist formulated in a much lower concentration than that approved for the treatment of glaucoma, and it is in its final stages of development for the treatment of ocular redness (https://clinicaltrials.gov/ct2/show/NCT0 1959230?term=brimonidine+ocular+redness&r ank=1).…”

Ketorolac eye drop induced allergic wheal and chemosis

“…1 Patient usually presents with itching, watering of eyes, conjunctival redness, chemosis, and eyelid swelling. Pathogenesis of ocular inflammation and allergy results from mast cell activation, which subsequently leads to cascade of events.…”

Vernal Keratoconjuctivitis: A Review

“…5 Trantas dots tend to appear when VKC is active, and disappear when symptoms abate. 9 The cornea can be involved in up to 50% of cases. Corneal manifestations include a superficial pannus and a punctate epithelial keratitis.…”