Allergic conjunctivitis: Update on pathophysiology and prospects for future treatment

Cellular changes in tears associated with keratoconjunctival responses induced by nasal allergy

“…On the other hand, the cytologic examination of tears, collected by means of aspiration with a micropipette, is a very simple and valuable method, which can be repeated almost endlessly, requires no anesthesia, does not traumatize the ocular tissue, and is most similar to the natural drainage of tears. 7,10,13,17,20,23,25,27,34 However, results produced by this technique are valid only for cellular events in tears and not in the mucosal membrane. This may only be derived from a mucosal tissue biopsy.…”

“…There is a dearth of data demonstrating the role of a nasal allergy in the conjunctiva, cornea and in the possible induction of the secondary keratoconjunctival response (SKCR). [7][8][9][10]16,23,26 Moreover, little data are available to illustrate the cytologic changes in tears during the particular types of SKCR. [7][8][9][10] The purpose of this study, which is a continuation of our earlier work, [7][8][9][10]27 was (1) to investigate the cytologic profiles and changes in the counts of individual cell lineages in tears during the particular types of SKCR, (2) to evaluate the significance of cytologic changes in tears for the possible role of various immunologic mechanism(s) underlying the particular types of SKCR.…”

“…[1][2][3][4][5][6]23,28,33 These tests, generating static data, provide only general evidence for a possible existence of hypersensitivity mechanism elsewhere in the body, without further specification of its location and possible involvement of local antibodies in the particular organ. [7][8][9][10]26,27 Importance of the provocation tests…”

“…7,10,27,40 The numbers and the condition of the expelled cells can indicate the qualitative and quantitative features of the allergic reaction in the particular mucosal membrane. [7][8][9][10]16,23,26 However, the involvement of the individual cell types in the allergic reaction can only be evaluated by comparing their counts and their conditions before and repeatedly after a well-defined intervention, which is an allergen challenge. [7][8][9][10]12,14,16,26,27,34,35,38 Keratoconjunctival response-cytologic changes in tears Z Pelikan…”

Allergic Conjunctivitis: An Immunological Point of View

“…Swelling appears 15-30 minutes after antigen exposure and slowly diminished; a small quantity of white mucus secretion may form during the acute phase which can later becomes thick strands in the chronic form. In chronic forms a remodeling process is induced in conjunctiva tissue as fibrosis with vascularization that can be easily identified with slit lamp (Ono & Abelson, 2005) There are numerous classifications for AOD according to the underlying pathophysiology and clinical findings. Common signs and symptoms exist in the different types of allergic disorders with frequent overlapping between SAC, PAC (acute forms of allergic conjunctivitis), VKC and AKC (chronic forms of conjunctivitis); therefore, classifications are recommended to standardize disease based on signs and symptoms, (mild, moderate or severe), (Abelson et al, 1990;Uchio et al, 2008;) length of the disease (acute vs chronic disease), mechanism of immunopathogenesis (EPR and LPR stages), and duration of episodes activity (quiescent, intermittent and persistent), only suggested to VKC and AKC (Bonini et al, 2007;Calonge & Herreras, 2007), since they impact the quality of life.…”