Allergic conjunctivitis treatment in adults and children

htmlconvd - 17Regardless of the type of allergen that provoked allergic conjunctivitis, the treatment of this disease is carried out using local and general antiallergic agents.

Also, the patient is prescribed immunostimulating therapy. But the most important condition for the successful treatment of conjunctivitis is to limit, and it is better to completely exclude contact with the allergen.

What is allergic conjunctivitis and when does it occur?

Allergy is a common disease. The number of patients is increasing every year. In some people, allergic reactions occur extremely rarely and are not very pronounced, others suffer from several types of this disease, they are forced to constantly monitor their lifestyle and carry drugs for emergency relief of the reaction.

Allergies are caused by a malfunction in the immune system, when it perceives an ordinary substance as potentially dangerous, and reacts with the release of histamine. There are several types of allergic reactions: skin, respiratory, food.

One of the forms of the disease is allergic conjunctivitis – inflammation of the eye caused by an allergic reaction. Unlike infectious conjunctivitis, allergic conjunctivitis is not contagious, caused by pathogen activity, and does not require antibiotic treatment. But in some cases, a bacterial infection can join the existing inflammation.

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Conjunctivitis can occur as an independent disease, but more often it develops simultaneously with rhinitis or hay fever.

As a separate disease, it occurs as a result of direct contact (eye contact with irritants, allergies to certain topical medicines or cosmetics).

Allergic conjunctivitis occurs in adults and children. Kids are less in control of themselves, often comb their eyes, which is why the allergic is complicated by infectious conjunctivitis.

Causes of the disease

The main factor that affects the onset of conjunctivitis is a special reaction of the immune system. An allergen, an irritant substance, provokes the development of the disease. There are no universal allergens: different substances act as a provocateur of the disease in each person.

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Most often, conjunctivitis is caused by:

  • dust,
  • wool, saliva, feathers, or industrial pet food,
  • plant pollen (often causes seasonal conjunctivitis)
  • contact lenses or solution for them,
  • for women – cosmetics for the eyes (decorative – mascara, eyeliner, shadows, as well as care – anti-wrinkle creams and serums),
  • medicines – drops that are used to treat ophthalmic diseases,
  • the activity of viruses and bacteria in the upper respiratory tract, the toxins produced by them (the main cause of redness of the eyes and lacrimation in ARVI and influenza).

It is difficult to independently establish the cause of conjunctivitis in adults and children; a doctor should do this.

Only he will distinguish an infectious inflammation from an allergic one, will be able to determine the type of allergen as accurately as possible and prescribe an effective treatment.

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Symptoms of allergic conjunctivitis: how does the disease manifest itself?

Signs of the disease can appear immediately after contact with an allergen, or after a time – from a couple of hours to 2 days. Unlike infectious conjunctivitis, allergic conjunctivitis occurs immediately in both eyes (occasionally – on one, but this is an atypical form of the disease).

It is characterized by:

  • profuse lacrimation
  • itching, burning,
  • redness of the mucous membrane of the eye,
  • visual impairment – blurred picture before the eyes,
  • discharge from the eyes that thickens over time
  • photophobia (occurs in severe forms),
  • dry eye
  • visual fatigue,
  • the appearance of a rash and papillae on the mucous membrane,
  • runny nose (accompanies conjunctivitis in about 85% of cases).

The patient may not have all symptoms, some may be less severe. In milder forms, the disease may be limited to slight redness and itching.

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In especially severe cases, temporary severe visual impairment may occur. The symptoms are the same in an adult and a child.

Types of allergic conjunctivitis

In the time of occurrence and duration of the course, the disease is:

  • Permanent – develops if the patient is in regular contact with the allergen. This is an immune response to house dust, animals.
  • Seasonal – occurs during the flowering period of allergenic plants, usually in late spring and summer. In the cold season, the disease does not manifest itself.
  • Contact – occurs through direct contact with an allergen, the rest of the time the person is absolutely healthy.

The types of the disease, depending on the time of occurrence and the type of allergen, are presented in the table.

Type of diseaseWhen arisesMain symptoms
Pollinous allergic conjunctivitisOccurs during the flowering period of allergenic plantsSevere itching, lacrimation, thick discharge, runny nose.
Spring keratoconjunctivitisOccurs in spring and summer, associated with flowering plantsItching, burning, discharge from the eye, watery eyes are not always the case.
DrugOccurs at any time of the year while taking medicationsThis type accounts for approximately 30% of all allergic conjunctivitis. There is lacrimation, burning and itching, redness. The inflammatory process involves the mucous membrane, cornea and even the optic nerve.
AtopicThis form occurs at any time of the year, usually in people over 40It is accompanied by itching and inflammation of the tissues of the eye, lacrimation does not always occur.

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Forms of the disease

Allergic conjunctivitis is:

  • Acute is a primary or one-time allergic reaction that occurs with a single or rare contact with an allergen. The disease occurs quickly, and with proper treatment, it quickly passes. The signs of conjunctivitis are pronounced, there is severe inflammation and swelling. In this form, drug and contact conjunctivitis often occur, as well as infectious (against the background of ARVI).
  • Chronic occurs when the patient is in contact with the allergen for a long time or constantly. Symptoms are less pronounced than in the acute form, but complete sensitization does not occur. Inflammation of the eyes is often accompanied by skin symptoms (eczema) and bronchial asthma. In this form, allergies to house dust and other household allergens occur.

Chronic allergy often occurs against the background of a weakened immune system in the presence of parasitic diseases (especially in children) and chronic infections.

If you solve the main problem that caused the atypical immune response, the allergy itself in most cases goes away.

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How is conjunctivitis treated?

Treatment of this disease is a complex and lengthy process. Even if it is possible to completely stop the symptoms, this is not a guarantee that allergic conjunctivitis will never occur again.

Before starting treatment, it is necessary to conduct a thorough diagnosis, identify the allergen. Often, the results of allergic tests contradict the obvious allergens, when a person’s seasonal form does not appear exactly during the flowering period of the allergen plant.

In this case, they talk about cross-allergens – substances of different origins that contain a common component that causes such a reaction in the patient.

General principles of treatment

The treatment regimen for allergic conjunctivitis includes:

  • Local remedies – antihistamines and anti-inflammatory (eye drops).
  • Prescribing antihistamines.
  • Immunotherapy.
  • Complete limitation of contact with the allergen.

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Eye drops for allergic conjunctivitis

Local remedies give the fastest possible effect, help to quickly relieve the symptoms of conjunctivitis, improve vision and general well-being.

Antiallergic eye drops are especially effective for the contact form of the disease. For other forms, you should not be limited to local treatment only.

Eye drops that are used to treat allergic conjunctivitis:

  • Mast cell stabilizers (active ingredient – cromoglycic acid). Helps relieve the main symptoms, reduce redness and swelling. The main drugs in this group are Cromohexal, Crom-Allerg, Alomid. These remedies work well for adults, but there are some limitations for children.
  • Histamine receptor blockers (Gistimed, Opatanol, Azelastine, Vizin Allergy) are contraindicated in children under 12 years of age.
  • With dry eye syndrome, especially for elderly patients, drops are prescribed to moisturize the mucous membrane (Vizin, Vidisik, Oftogel).
  • To restore the cornea, drops with vitamins are prescribed (Taufon, Khrustalin, Quinax).

If the allergic reaction is very severe and does not respond to classical treatment, the doctor prescribes eye drops and ointments containing corticosteroids (based on hydrocortisone and dexamethasone). Treatment is carried out under the supervision of an ophthalmologist.

Sometimes, to relieve inflammation, eye drops are prescribed based on a non-steroidal anti-inflammatory substance – diclofenac.

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Oral antihistamines (tablets and syrups):

To cure conjunctivitis, general antihistamines are used. These medications are necessary if eye inflammation is accompanied by a runny nose, cutaneous or respiratory symptoms. The main drugs are Loratadin, Telfast, Tsetrin, etc.

In the chronic form, immunotherapy is additionally carried out, the drugs in this case are selected individually.

For the treatment of the dosage form of the disease, the same drugs are used, but they are chosen with extreme caution and careful adherence to the dosage. The drug that caused the allergy must be canceled. In case of urgent need, replace with a product with a similar effect, but based on a different active ingredient.

Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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