Allergic Conjunctivitis and Its Treatment Options
Published on Jul 06, 2018 and last reviewed on Nov 15, 2022 - 3 min read
Abstract
This article looks at the various ways in which allergy, eye allergies in particular, can present, the effects of longstanding allergic conditions of the eye and the effects of treatment with their side effects.
An allergy is simply a hypersensitivity reaction of the body to various foreign substances referred to as allergens. Allergens, if found to be from within the patient's body itself, give rise to a group of disorders called as autoimmune diseases. Here we will be looking in particular at only allergic eye disorders.
How Is Allergy Caused?
Allergy is mainly caused by cells called mast cells and neutrophils in our bodily organs. These cells are part of a wider subfamily called white blood cells, the main function is the defense of our body. These cells contain substances like histamine, leukotrienes, prostaglandins, etc., whose main function is to alter blood flow characteristics within the blood vessels of our body. This change in blood flow coupled with a few mechanisms causes the changes basic to all allergies - redness, increase in temperature, and pain. The release of inflammatory mediators is effected by a process called degranulation, which is an important event as it triggers the inflammation cascade and sets the rest of the changes in motion.
Allergic Conjunctivitis
This refers to the allergic condition affecting the conjunctiva. The manifestations of this disorder include itching, watering, redness and blurred vision. The characteristic symptom of exposure to an allergen is often not seen in a majority of cases, the main clue is itching and an urge to rub. This is a universal symptom seen in most patients of allergic conjunctivitis.
The heart of the problem lies in the symptom of rubbing. Rubbing causes degranulation of mast cells and neutrophils, worsening the problem of allergy. Hence, it is imperative that the patient avoids rubbing in spite of the uncontrollable urge to do so. Rubbing sets up a vicious cycle, such that the more the patient rubs, the more the itching and severity of the allergy.
Treatment
There are several treatment modalities, each with its own mechanism of action and side effect profile. The main determinant of the type of treatment given is the severity of the allergic response. The other determinants being age, duration of the allergy and intraocular pressure.
The most commonly used modalities include eyedrops of the following types -
a) Steroids - these drugs act by suppressing the immune responses of our body. So, there will be less severe inflammation and hence less damage to tissues. Steroids, although not the first line of treatment in most cases is the most potent drug in allergy treatment.
A few notable examples are Loteprednol, Prednisolone, Difluprednate, and Fluorometholone. Although having the best results in a short time, the steroids are notorious for causing side effects such as glaucoma, cataract formation, increased susceptibility to infection. This basic dictum applies even within the class of steroids - more potent the steroid, the more the side effects. Hence it becomes a matter of balancing side effects with the potency of the treatment. Another drawback is that the drug cannot be stopped at once but needs to be slowly tapered and stopped.
b) Mast cell stabilizers - these drugs act by preventing the degranulation of mast cells, which are the key mediators of inflammation. These drugs are usually considered the main drugs to control allergy. The downside of these drugs is that they are not as potent as steroids and have a period of waiting before they start to act. The advantages being that it is safer than steroids and does not have to be tapered.
c) Cyclosporine - these drugs act by inhibiting the actions of mediators of inflammation such as interleukin-2, is currently being used more than ever before because of its very minimal side effect profile, especially in children who will need a potent drug for long periods of time. Its limitations are that it needs a long time before it begins action. This latent period makes the cost of therapy significant and quite unsustainable for the not so well off patients.
Complications in Long-Standing Allergic Conjunctivitis
- Stye.
- Keratoconus.
- Dark circles.
- Secondary infective conjunctivitis.
Hence allergic conjunctivitis, although a simple problem, can cause quite a bit of trouble. A good follow up with your ophthalmologist and proper adherence to treatment is recommended.
For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist
Frequently Asked Questions
1.
What Are the three Causes of Conjunctivitis?
Conjunctivitis is an inflammation of a membrane of the eye called the conjunctiva. It can be caused by bacteria or viruses, allergens or any foreign particle in the eye, and certain chemicals.
2.
What Causes Eye Allergy?
Allergy is mainly caused by cells called mast cells and neutrophils in our bodily organs. These cells are part of a wider subfamily called white blood cells. The main function is the defense of our body. These cells contain substances like histamine, leukotrienes, prostaglandins, etc., whose main function is to alter blood flow characteristics within the blood vessels of our body. This change in blood flow, coupled with a few mechanisms, causes the changes basic to all allergies - redness, increase in temperature, and pain. The release of inflammatory mediators is affected by a process called degranulation, which is an important event as it triggers the inflammatory cascade and sets the rest of the changes in motion.
3.
How Does Conjunctivitis Spread?
Conjunctivitis, also called pink, is a contagious disease and spreads from person to person. It spreads with skin-to-skin contact, hands-to-eye contact, and interaction of the eye with contaminated objects.
4.
What Are the Types of Allergic Conjunctivitis?
Type l hypersensitivity allergic conjunctivitis is subdivided into seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). There are other severe forms of allergic conjunctivitis, such as limbal and tarsal vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC), and atopic keratoconjunctivitis (AKC).
5.
Does Allergic Conjunctivitis Spread?
No. Allergic conjunctivitis is not a contagious disease and does not spread from person to person. The allergy becomes severe only if the person rubs the eye with an itching sensation.
6.
What Are the Signs and Symptoms of Allergic Conjunctivitis?
The manifestations of this disorder include itching, watering, redness, and blurred vision. The characteristic symptom of exposure to an allergen is often not seen in a majority of cases. The main clue is itching and an urge to rub. This is a universal symptom seen in most patients of allergic conjunctivitis.
7.
Does Allergic Conjunctivitis Need Treatment?
The treatment modality of allergic conjunctivitis depends on its severity. The other determinants are age, duration of the allergy, and intraocular pressure. Mild symptoms may not require treatment and can resolve by themselves in 7 to 9 days. At the same time, severe allergic actions may require treatment with steroids, mast cell stabilizers, and cyclosporine.
8.
What Is the Best Treatment for Allergic Conjunctivitis?
Allergic conjunctivitis can be treated with anti-allergy eye drops, warm compress, artificial tears, and allergy immunotherapy. It can be treated Best with antihistamines such as Azelastine and Epinastine. Both of these medications are effective in relieving the symptoms caused by allergic conjunctivitis.
9.
What Antibiotics Treats Conjunctivitis?
Antibiotics such as fluoroquinolones or used to treat conjunctivitis. Ciprofloxacin is one of the fluoroquinolones which acts against both gram-positive as well as gram negative bacteria and is hence used to treat conjunctivitis. It can be used as a topical ointment or solution.
10.
Can Cetirizine Cure Allergic Conjunctivitis?
Cetirizine is an antihistamine that prevents the inflammatory processes caused by allergic conjunctivitis. It is available as citrine eye drops. Application of these eyedrops can slow down the inflammatory process and thus relieves the allergic symptoms.
11.
How Do You Treat Conjunctivitis at Home?
Conjunctivitis generally resolves on its own but treatment can speed up the recovery process. Allergic conjunctivitis can be treated with antihistamines, whereas bacterial conjunctivitis can be treated with antibiotics. Keeping the eyes clean, preventing touch with your hands to the eyes, and cleaning the eyes with a soft and wet cloth. Preventing the eye from the allergen causing allergic conjunctivitis can help.
12.
How Do You Clean Conjunctivitis Eyes?
Wash your hands with soap and water. Take a clean cloth to make a compress and socket into the water and then wring it to remove the water completely. Both warm and cold water can be used to make a compress. Gently remove the fluid or water coming from the eyes. Do not touch the other eye with the same cloth if the other eye is not infected.
13.
How Do You Prevent Allergic Conjunctivitis?
- Try to prevent the allergens causing the allergic reaction, for example, pollen grains.
- Avoid wearing contact lenses if possible. Ask your doctor about it now, wearing it if required.
- Over-the-counter eye drops can help Prevent energy conjunctivitis. They are also called artificial tears. Prevent contamination with your hands from the infected eye to the other eye.
- A cold compress can help in reducing swelling. So, it can be used to treat allergic conjunctivitis.
14.
Can Warm Compresses Damage Eyes?
The heat from the warm compress can damage the thin surfaces of the eyelid. Whereas a cold compress can be beneficial as it reduces swelling. Also, extreme temperatures, hot or cold, can damage the eye structures.
Last reviewed at:
15 Nov 2022 - 3 min read
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