The spectrum of allergic ocular diseases

Abstract

Ocular allergy is recognized as a heterogeneous collection of immunoglobulin E (IgE) and noneIgE-mediated diseases. IgE-mediated ocular allergies include seasonal allergic conjunctivitis, perennial allergic conjunctivitis, 1 vernal keratoconjunctivitis, and atopic keratoconjunctivitis. NoneIgE-mediated ocular allergies and hypersensitivities include contact blepharoconjunctivitis, giant papillary conjunctivitis, irritative conjunctivitis, and blepharitis.The following 4 cardinal symptoms characterize ocular allergies: redness, itchiness, swelling, and watering (tearing), with several symptoms overlapping with dry eye disease.Allergological workup (skin prick testing, serum-specific IgE measurements, conjunctival provocation testing, and patch testing) is helpful in confirming a causative allergic mechanism.Newer topical corticosteroid formulations such as loteprednol have not been found to increase the risk of cataracts unlike older corticosteroids.Successful treatment usually involves a combination of avoidance of allergic triggers, medications (topical, oral, or both), and in some cases, allergy immunotherapy.

Total IgE in tears accurately reflects the severity and predicts the prognosis of seasonal allergic conjunctivitis

“…Allergic conjunctivitis (AC), an inflammatory response of the conjunctiva to allergens such as pollen, animal dander, and other environmental antigens, affects 15%–40% of the population 1–3 . Seasonal allergic conjunctivitis (SAC) is the most common form of ocular allergy and accounts for 90% of AC cases 4,5 . SAC has a considerable impact on patients' quality of life and comfort, and results in a substantial burden on the economy through health care costs and the reduction in productivity 6 .…”

“… 1 , 2 , 3 Seasonal allergic conjunctivitis (SAC) is the most common form of ocular allergy and accounts for 90% of AC cases. 4 , 5 SAC has a considerable impact on patients' quality of life and comfort, and results in a substantial burden on the economy through health care costs and the reduction in productivity. 6 Signs and symptoms of SAC include redness, periocular itching, epiphora, burning, stinging, photophobia, watery discharge, and swollen or dry eyes, with differing degrees of severity and variable duration.…”

Pollen shells and soluble factors play non-redundant roles in the development of allergic conjunctivitis in mice

“…Ocular allergy is a common allergic manifestation [1][2][3][4]. Its prevalence has increased in the past decades [3,5,6] and is estimated to have reached approximately 50% in Japan [1] and 40% in the US [3].…”

“…Its prevalence has increased in the past decades [3,5,6] and is estimated to have reached approximately 50% in Japan [1] and 40% in the US [3]. Seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC) are the most common but least severe forms, while vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC) are relatively rare but severe forms that potentially lead to corneal involvement and ultimately to vision loss [1,2,4,[7][8][9][10]. The proliferative lesions such as giant papillae are observed in VKC, and in some cases of AKC [2,[7][8][9][10].…”

Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy - On behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI)

“…These include acute and chronic allergic conditions (eg giant papillary conjunctivitis, vernal conjunctivitis, atopic keratoconjunctivitis, upper limbic conjunctivitis, follicular conjunctivitis; infectious causes -eg chlamydial disease, molluscum contagiosum, pirinaud oculoglandular syndrome); and various disorders such as keratoconjunctivitis sicca, acne rosacea, ocular pemphigoid, and blepharoconjunctivitis. 115…”