Each person at least once in his life has encountered an atypical reaction of the body to external factors. This reaction is an allergy, and its symptoms can occur on the skin, in the organs of vision, respiration or digestion. To date, immunologists have not been able to come up with a method to eliminate such inadequate reactions of the body, but their symptoms, including signs of allergic conjunctivitis, can be removed and relieved.
The essence of the disease
Allergic conjunctivitis is an inflammatory process in the ocular membrane (conjunctiva), which is expressed by lacrimation, swelling and itching. Most often, the disease manifests itself at a young age and can be combined with other symptoms of an allergic reaction - a runny nose, shortness of breath, skin rashes. According to studies, symptoms of the disease occur in approximately 40% of people with other pathologies of allergic origin. The International Classifier of Diseases (ICD) has assigned the H10 code to allergic conjunctivitis, 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 nasal mucosa and conjunctiva actively produce immunoglobulins that are fixed in the connective tissue. Of these, mediators of inflammation of allergic genesis subsequently stand out. 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.
- The pathochemical 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 site of inflammation. With 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.
Kinds
Depending on the frequency of symptoms, as well as factors causing allergic conjunctivitis, the disease is divided into several types:
- Contact - reactions occur when in contact with an allergen, for example, on cosmetics, eye drops, solutions for lenses.
- Periodic (hay fever) - symptoms occur during the presence of an allergen, such as flowering plants.
- Year-round - the symptoms of the disease are caused by persistent allergens such as bird feathers, animal hair, dust, cleaning products.
How to treat allergic conjunctivitis depends on the allergen and the type of disease. For effective therapy, it is necessary to eliminate the effect of the irritating factor and then carry out therapeutic measures.
According to the International Classifier 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.
Causes
The development of allergic conjunctivitis of the eyes is based on the immediate type of hypersensitivity mechanism, respectively, the symptoms of the disease occur immediately after contact with the allergen. The human eye, due to its special anatomical structure, is accessible for exposure to many external factors that can cause an atypical reaction.
The most common allergens that cause conjunctivitis are:
- Household: dust mites, dust, feathers from pillows, cosmetics, household chemicals, medicines (especially eye).
- Epidermal: wool, dead skin cells of animals, bird feathers, food for aquarium fish.
- Pollen: pollen of various plant species during their active flowering.
At the same time, an allergic reaction to food becomes extremely rare for conjunctivitis. The probability of the onset of symptoms of the disease is also affected by heredity. Allergic conjunctivitis in children, the treatment of which is rather complicated, especially at an early age, often appears in cases where 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 exposure to an allergen. The disease primarily affects 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 excessive secretion of mucus and frequent blowing, additionally irritating the ocular mucosa.
- Swelling and hyperemia of the eyelids.
- Tearing of the eyes, active itching, burning of the eyelids. Itching causes severe discomfort and a desire to constantly scratch your eyes, which can lead to the attachment of a bacterial infection and exacerbate the course of the disease.
- The appearance on the ocular membrane of viscous, colorless, mucous secretions, and in the case of attachment of bacteria also purulent contents in the corners of the eyes.
- Bonding of the eyelids after sleep.
- Reducing the production of tear fluid, washing the eye in normal condition, and dry eyes (sensation of sand in the eyes).
- Photophobia.
- Fatigue and redness of the eyes.
- Pain during the movements of the eyeball 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 a sudden onset and quick 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 occur by 3-4 years, more often in those who had other symptoms of allergic reactions earlier (diathesis, allergic dermatitis and others).
The main cause of the disease in children is not only hypersensitivity 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.
For children, the characteristic signs of the disease are photophobia, swelling of the eyelids, conjunctival hyperemia, lacrimation and pruritus. Intense itching leads to the child combing his eyes with the subsequent attachment of a bacterial infection, therefore, local antibiotics are necessarily used in the treatment.
To prevent the transition of the disease into a chronic form in childhood, allergen-specific therapy is possible. During this treatment, the child is given small doses of the allergen, gradually increasing its concentration. Such actions help the body to get used to the annoying factor with a subsequent decrease (up to the complete disappearance) of the symptoms of allergic conjunctivitis.
Diagnostics
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 such factors:
- allergic history;
- heredity;
- connection with external factors;
- clinical symptoms.
To finally confirm the diagnosis, the ophthalmologist can 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 IgE immunoglobulin in the blood test is also increased. In the presence of purulent discharge from the conjunctival cavity, a bacteriological analysis of the discharge from the eye is performed. Specify the cause of allergic conjunctivitis in adults and children using skin allergy tests.
Drug treatment
The treatment of allergic conjunctivitis in adults is complex and begins only after the final diagnosis and confirmation of the nature of the disease.
For therapy, drugs of the following groups are prescribed:
- Antihistamines. Preferred medication is second (Claritin, Cetrin) or third generation (Erius, Xizal). 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 administration of such drugs is extended to several months.
- Topical antihistamines. Antiallergic drugs in tablet form do not provide the desired result, and in parallel with their administration, local 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, Opticrom). Such drugs are used for a long time, since the effect of them occurs no earlier than a couple of weeks. The tool is considered the safest and can be used often and for a long time.
- Local corticosteroids (hydrocortisone-based drugs). They are prescribed in the form of drops or eye ointment in case of severe inflammation of the conjunctiva.
Often, treatment of conjunctivitis of a bacterial or viral nature using specific drugs can cause an allergic reaction and exacerbate the course of chronic conjunctivitis. For this reason, in the complex treatment of eye diseases of an infectious nature, including fungal, chlamydial, herpetic and adenoviral pathologies, local antihistamine drops for the eyes are additionally prescribed.
In children, eye inflammation often manifests itself in the form of spring keratoconjunctivitis. With this disease, in addition to the main symptoms, there is a papillary proliferation of cartilage. Pathology can be so large that it causes deformation of the eyelid. In this case, histaglobulin injections are often added to the main therapy, and sometimes even surgical intervention is required after the elimination of acute symptoms.
Traditional treatment
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 the folk remedies for allergic conjunctivitis, the most effective are:
- drops of honey;
- aloe juice;
- rosehip infusion for compresses;
- tea leaves;
- decoctions of herbs;
- camomile tea.
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 disappears within 7-10 days, however, if its symptoms are aggravated, 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 conjunctivitis of an allergic nature, an infection or an exacerbation of eye pathologies, such as keratitis, glaucoma, blepharitis, is likely.
Isolation of purulent contents from the eye requires antibacterial 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, it is possible clouding of the lens, decreased vision, cicatricial changes in the conjunctiva and even the development of cataracts and detachment of the retina, fraught with complete blindness.
Prevention
There are no specific preventive measures for allergic conjunctivitis, since the reasons for the development of allergic reactions are still not clear. The main method of preventing relapse of the disease is the complete elimination of contact with the allergen.
To speed up recovery, you must:
- limit contact with allergen;
- wear sunglasses during exacerbation of the disease;
- do not use contact lenses in the inflammatory process;
- observe the rules of hygiene;
- use separate pipettes, napkins and drops for each eye;
- have a separate towel, cosmetics, glasses and other means and objects in contact with the eyes.
Allergic conjunctivitis is an extremely unpleasant and fairly long-term disease, but if you follow the recommendations and accurately determine the allergen that causes this reaction, good results can be achieved.