Treatment of seasonal allergic conjunctivitis. Allergic conjunctivitis, symptoms and treatment in adults and children

Greetings, dear readers and readers! Allergic conjunctivitis is a condition in which the connective membrane of the eye becomes inflamed.

In many cases, this eye disease develops in parallel with other allergic diseases, which significantly complicates the possibility of diagnosing it in the initial stages.

Allergic conjunctivitis in adults it can occur as a result of an eye reaction to wearing contact lenses, taking certain medications, allergies to animals, etc. The peculiarity of this unpleasant form of pathology is that both eyes are affected at once.

Today I will tell you about what methods of treatment of this disease are offered by modern ophthalmology.

What factors provoke the development of allergic conjunctivitis and how does the disease manifest?

The following factors provoke the appearance of conjunctivitis of allergic origin are identified:

1. Household. This very first group of allergens includes the well-known household dust, dust mites, feathers, fluff, etc.
2. Epidermal. Wool of various animals, bird feathers, fish food.
3. Pollenaceae. The most powerful allergens are pollen from plants that bloom in spring and poplar fluff.
4. Chemical. Wash, powder, perfume, air fresheners, cosmetics, etc.

Signs of allergic conjunctivitis appear as:

• unbearable itching and burning in the eyes;
• increased lacrimation;
• inflammation and redness of the conjunctiva;
• mucous or purulent discharge;
• fast visual fatigue;
• increased sensitivity to bright light sources.

One more a clear sign, indicating allergic conjunctivitis, is swelling in the lower eyelid. In addition to the listed symptoms, the patient may be bothered by a cough. At acute form The symptoms of the disease are pronounced, and chronic allergic conjunctivitis proceeds more calmly (lasts for 6-12 months).

Symptoms of this ophthalmological pathology appear immediately after contact with allergens, which quickly penetrate the mucous membrane of the eye, resulting in inflammation.

What is the treatment of eye pathology based on?

Treatment process allergic form conjunctivitis is quite long-lasting. This is due not only to the difficulty of diagnosing the problem on early stages development, but also because the drugs used during therapy do not immediately have the desired effect.

Treatment of allergic conjunctivitis is carried out using the following groups medicines:

1. Antihistamines. Patients suffering from this disease are prescribed 2nd generation antihistamines (Claritin, Cetrin, Kestin) and 3rd generation (Erius, Xizal, Telfast). You need to take 1 tablet per day for 2 weeks. If necessary, the treatment course can be extended to 2-3 months. These antihistamines have a beneficial effect on the entire body, stopping allergic manifestations.
2. Topical corticosteroids. The indication for the use of this pharmacological group of drugs is severe inflammation and severe complications, developed against the background of this type of conjunctivitis. They are prescribed if the inflammatory process does not go away after taking other medicines.

This medicinal group represented by steroid ointments and drops, which include such active substances, like dexamethasone and hydrocortisone. Before use, be sure to consult a specialist, since the above medications are hormonal.

• Antiseptics, antibiotics. To treat allergic conjunctivitis, ointments containing an antiseptic (based on tetracycline, gentamicin and erythromycin) are often used. With their help, it is possible to prevent the spread of germs.
• Immunomodulatory. Medicines in this group are prescribed for the chronic course of the disease. The most popular medication is Histaglobulin (in the form of injections).
• Reparants (for restoration of the conjunctiva). To eliminate the consequences of allergic keratitis, medications that have a healing effect are prescribed. With their help, it is possible to restore damaged eye tissue and eliminate the consequences of the disease (conjunctival ulcers, etc.).

An excellent drug is eye gel Solcoseryl, which must be used for 1-2 weeks after eliminating the symptoms of conjunctivitis. This gel helps to activate metabolic processes at the cellular level, due to which the process of restoring the damaged structure of eye tissues is significantly accelerated.

When asked how to treat allergic conjunctivitis, most ophthalmologists will answer that first of all you need to eliminate the allergen, and only then can you begin conservative treatment.

Some of the most popular medications used to treat this disease are eye drops.

List of the most effective drops for conjunctivitis in children, see.

I bring to your attention the types of drops that qualified ophthalmologists recommend using for patients suffering from conjunctivitis of allergic origin:

1. To constrict blood vessels. Such drops (Vizin, Okumetil, Octilia) narrow blood vessels, due to which it is possible to achieve relief from swelling and redness of the eyes.
2. Antihistamines. The main purpose of antihistamine eye drops (Lecrolin, Cromohexal, Alocomid, Opatanol, Hi-chrome) is to block histamine. They help relieve swelling and eliminate itching.
3. Anti-inflammatory corticosteroids. Drops of this group (Dexamethasone, Prenacid, Maxidex, Hydrocortisone) are prescribed in case of acute or severe disease. Use strictly as prescribed by your eye doctor.
4. Tear substitutes. The pain and burning sensation in the eyes that occurs with allergic conjunctivitis very often leads to the development of dry eye syndrome, especially in old age. To eliminate the problem, ophthalmologists advise using artificial tears (Vizin, Oftogel, Inox, Systane, Oksial).
5. Fortified. Eye drops containing vitamins (Quinax, Katachrom, Emoxipin, Khrustalin) should be used by patients who have inflammation of the cornea as a result of allergic conjunctivitis.

conclusions

Allergic type conjunctivitis is enough serious illness, giving a person unpleasant painful sensations.

Due to the fact that its occurrence cannot be completely prevented, ophthalmologists strongly recommend contacting medical care immediately after the first symptoms of the disease appear. This will allow the specialist to select the appropriate medications, as well as draw up a competent and effective scheme treatment.

Take care of yourself and be healthy, Dear friends, see you again!

Sincerely, Olga Morozova.

Allergic conjunctivitis means inflammation of the mucous membrane of the eyes, which is of an allergic nature, i.e., developing as a result of an inadequate reaction immune system.

The conjunctiva is the thin transparent membrane lining the inner part eyelids and covering the sclera of the eyeballs. The pathology is also called “red eye disease”, since swollen and reddened eyelids are one of the characteristic clinical manifestations.

According to medical statistics Allergic conjunctivitis affects about 15% of the population. In some countries with poor environmental conditions, allergic symptoms are periodically observed in 40% of people. Young patients are more susceptible to pathology.

Causes of occurrence

The following exogenous factors can provoke the disease:

1. Plant pollen;
2. Down, feathers or animal hair;
3. Cosmetical tools;
4. House dust.

Medicines (most often allergic reactions are caused by antibacterial drugs);

1. Contact lenses;
2. Dry food for aquarium fish;
3. Perfumes;
4. Facilities household chemicals;
5. Food products.

And this is far from full list substances that can cause allergies. A sick person does not pose a threat to others, since the disease is not contagious.

Classification

Depending on the reason that caused such a reaction in the body, there are the following types allergic conjunctivitis:

1. Hyperpapillary (large-papillary) – occurs when the mucous membrane is damaged foreign bodies(lenses, prostheses, postoperative sutures);
2. Infectious-allergic - increased susceptibility of the body to toxins that are released pathogenic bacteria or viruses, fungi. In this case, the allergen is not detected in the patient’s eye;
3. Hay fever (hay fever) occurs during the flowering period of various plants, cereals, and trees. It is seasonal and occurs slowly. It starts off sharp. In children, it is often accompanied by headache;
4. Tuberculosis-allergic - characterized by the fact that the cornea and the conjunctival membrane covering the eyeball are simultaneously affected. Appears as a result of a reaction to waste products of mycobacteria, which are carried through the blood throughout the body;
5. Spring - appears only in the warm season with a large number of sunlight. It is more often observed in boys from 5 to 12 years old. This type of disease can be limbal, mixed or conjunctival. May lead to weakened vision and corneal pathology; medicinal - develops with frequent use eye drops. An ophthalmologist may notice erosions and clouding of the vitreous body on the mucous membranes of the eye;
6. Atopic - often occurs with urticaria.

Symptoms

Allergic conjunctivitis is characterized by bilateral eye damage. The full picture of symptoms may appear immediately after contact with the allergen or several days later (the so-called immediate and delayed reactions).

People with all forms of allergic conjunctivitis experience severe itching and burning in both eyes. Although symptoms usually occur in both eyes, in some cases one eye may be more affected than the other. The conjunctiva becomes red and sometimes swells, giving the eyeball a swollen appearance.

With seasonal and year-round conjunctivitis appears a large number of thin, watery discharge, which can sometimes become stringy. Occasionally, vision may deteriorate. Most people suffering from this disease also note the presence of a runny nose. With spring conjunctivitis, the discharge from the eyes is thick and mucus-like. It, unlike other types of allergic conjunctivitis, often causes damage to the cornea and leads to painful ulcers. The latter cause severe pain in the eye when looking at bright light and sometimes lead to permanent decrease in vision.

What does allergic conjunctivitis look like: photo

The photo below shows how the disease manifests itself in people.

Diagnostics

If you have the above symptoms, you should consult an ophthalmologist. In most cases, further diagnosis and treatment are carried out together with an allergist. Most often, the clinical picture does not raise doubts about the diagnosis. But in order to establish the cause of the development of the inflammatory process and prescribe the correct treatment, diagnostic procedures should be carried out.

During the examination, the doctor should find out the patient's personal and family history. After this, the specialist can prescribe the following laboratory and instrumental tests:

• microscopic examination of conjunctival scraping;
• exposure and elimination test;
• prick test;
• other allergic skin tests.

Such research methods allow not only to accurately establish a diagnosis, but also to identify the suspected allergen. If there is a suspicion of infection, a bacteriological examination of a smear of conjunctival scraping is carried out. Only on the basis of the obtained tests can the correct treatment of the patient be prescribed.

Treatment of allergic conjunctivitis

The key to success in treating allergic conjunctivitis in adults is to promptly identify the allergen and prevent contact with it. However, as shows practical experience, often this activity is not feasible.

Medicines used in the treatment of the disease:

• “Ketotifen”, “Cromohexal” - drops that stabilize the eye membrane;
• “Allegra”, “Clargotin”, “Lorizan”, “Claritin” - antihistamines for oral administration;
• Histamine receptor blockers intended for persons over twelve years of age - “Histimet” and “Opatanol”;
• If the cornea becomes inflamed, then drops are prescribed with vitamin complex“Hilo – chest of drawers”;
• Eye drops "High-Krom" (for children over four years old), "Alomide" (over two years old), "Lecrolin", "Ledoxamide" and "Krom-Allerg" are used to stabilize mast cells, helping to prevent the production of histamine;
• For dry eyes, drugs that replace tear fluid are prescribed: Oxial, Alcon Pharmaceuticals, Systane Gel, Systane Balance, Oftogel, Vidisik, Optiv;

In severe cases of pathology, the doctor usually prescribes drugs containing dexamethasone, hydrocortisone or diclofenac.

Treatment of seasonal conjunctivitis - hay fever

It is unrealistic to avoid the flowering of weeds, cereal plants, and almost all trees; therefore, in both children and adults, hay fever most often begins acutely with burning, photophobia, itching and lacrimation. What to do to treat allergic conjunctivitis?

Therapy is as follows:

1. Instillation of Allergodil and Spersallerg eye drops. Within 15 minutes, relief of symptoms occurs, especially with Spersallerg, since it also contains a vasoconstrictor.
2. At the beginning of allergies, drip 3-4 times a day, then 2 times a day. If the allergy is very severe, oral antihistamines in tablets.
3. For such subacute or chronic conjunctivitis, the doctor also prescribes drops for allergic conjunctivitis, such as Cromohexal and Alomide 3-4 times a day.
4. Vasoconstrictor drops - Visin alert.

Folk remedies

Allergic conjunctivitis is a disease against which traditional medicine is powerless. Various lotions, washing the eyes with herbal decoctions and other “grandmother’s methods” will not help relieve symptoms and, moreover, influence the cause. The only thing that can be achieved with such self-medication is to provoke an exacerbation and cause infectious complications.

Prognosis and prevention

In most cases, once the allergen is identified and eliminated, the prognosis for allergic conjunctivitis is favorable. In the absence of treatment, an infection may develop with the development of secondary herpetic or bacterial keratitis and a decrease in visual acuity.

In order to prevent allergic conjunctivitis, contact with known allergens should be avoided whenever possible. In case of seasonal forms of allergic conjunctivitis, preventive courses of desensitizing therapy are necessary. Patients suffering from allergic conjunctivitis should be observed by an ophthalmologist and an allergist.

The term “allergic conjunctivitis” means inflammation of the mucous membrane of the eyes, which is of nature, i.e., developing as a result of an inadequate reaction. The conjunctiva is the thin transparent membrane that lines the inside of the eyelids and covers the sclera of the eyeballs. The pathology is also called “red eye disease”, since swollen and reddened eyelids are one of the characteristic clinical manifestations.

According to medical statistics, about 15% of the population is susceptible to allergic conjunctivitis. In some countries with poor environmental conditions, allergic symptoms are periodically observed in 40% of people. Young patients are more susceptible to pathology.

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Types of disease

It is customary to highlight:

Seasonal allergic conjunctivitis (hay fever or flower fever) develops as a reaction to pollen. Symptoms appear annually, strictly in the same months.

Year-round allergic conjunctivitis occurs within hours or even days after exposure to certain types household chemicals, hygiene products or cosmetics.

The cause of the development of conjunctivitis with papillary hyperplasia is most often the long-term continuous wearing of soft contact lenses. Protein compounds present in normal discharge eyes, accumulate on inner surface of these optical devices and change their structure. If a person has a tendency to allergies, they provoke a local immunological reaction with the formation of papillae on the inner surface of the eyelids.

Vernal keratoconjunctivitis (spring catarrh) is more common in childhood and extremely rarely - in people over 20-25 years old. The incidence among boys is 2 times higher than among their peers. Symptoms develop annually in warm weather; the total duration of the disease is from 4 to 10 years. Giant papillae form on the inside of the eyelid. This type of allergic conjunctivitis in children is dangerous because the pathological process can affect the cornea.

Atopic keratoconjunctivitis is characterized by a chronic course and poses a particular danger due to the high likelihood of developing complications - corneal ulcers and retinal detachment. This form of the disease is characterized by the parallel development of allergic rhinitis.

Causes of development of allergic conjunctivitis

The disease develops as a result of immediate and delayed hypersensitivity reactions on the part of the immune system. The immediate cause is contact with a specific allergen.

Possible allergens:

• wool and particles of skin (epidermis) of animals;
• active and auxiliary components of medicinal products;
• detergent components;
• plant pollen (typical of hay fever);
• cosmetical tools;
• dust;
• dry food for aquarium fish.

Important:Allergic conjunctivitis in some cases develops as a reaction to wearing contact lenses.

The cause of the disease is often factors such as light and ionizing radiation (), as well as infectious agents of a viral or bacterial nature.

The course of the disease can be either protracted, chronic (sluggish), or acute (develops sharply and quickly passes when contact with the allergen is stopped).

As a result of the progression of the pathological process, growth is often observed connective tissue. As a consequence, fibrosis and enlargement (hypertrophy) of the conjunctival papillae become possible.

Note:inflammation of the conjunctiva is very often combined with allergic and atopic rhinitis. An increased predisposition to such eye lesions is observed in patients suffering from bronchial eye diseases.

Allergic reactions of the cornea develop when the body reacts to drugs for local application, as well as toxins that can be produced by certain types of bacteria (in particular, staphylococci and).

Symptoms of allergic conjunctivitis

In pathology, as a rule, the lesion is symmetrical, i.e. both eyes are affected. Unilateral damage is not excluded, but is extremely rare.

All forms of the disease are characterized by the following: clinical manifestations:

• eyelid hyperemia;
• swelling of the eyelids;
• itching (burning or stinging) in the eyes;
• lacrimation;
• photophobia.

Note:itching is the main manifestation; it forces the patient to constantly rub his eyes, which only increases the severity of other symptoms.

Often there are parallel developing allergic symptoms such as frequent sneezing, cough and .

Complications

The consequence of the atopic form of the disease can be corneal ulcers that develop against the background of the addition of a viral (for example, herpetic) or bacterial infection. There is enough high probability such serious complications as

bacterial inflammation eyelids (blepharitis), as well as the development of clouding of the lens of the eye (cataracts) and retinal detachment. As a result, partial or complete loss of vision is possible.

Diagnostics

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The diagnosis of “allergic conjunctivitis” is made by an ophthalmologist. In most cases it is required additional consultation allergist.

The grounds are data from anamnesis and external examination. To clarify the nosological form and identify the allergen, a number of additional studies are required, including skin (scarification) tests.

Allergic conjunctivitis in children

Allergic conjunctivitis in children early age very rarely diagnosed. In most cases, this disease develops in a child over 3 years of age. The likelihood of this pathology occurring is higher in young patients with a history of allergic reactions (diathesis,).

When identifying a possible allergen and making a diagnosis, it is necessary to take into account some features. In childhood, hypersensitivity reactions to various foods are very common. In addition, the child may develop the so-called. pseudoallergic reaction caused by diseases gastrointestinal tract or .

Treatment of allergic conjunctivitis

Required condition successful therapy Allergic conjunctivitis is the complete cessation of contact with the factor that is the allergen or its elimination. At mild flow In case of illness, it is enough to use cold compresses on the eyelids and instillation of drugs similar in composition to tear fluid. Pathogenetic and symptomatic therapy involves the use of anti-inflammatory and antiallergic () agents.

To treat allergic conjunctivitis caused by a reaction to pollen, medications are used that constrict small blood vessels, as well as drugs that reduce the release of histamine and other mediators of allergy and inflammation. Medicines are prescribed locally, and in case of pronounced allergic symptoms– orally (Loratadine, Cetirizine). In some cases, an appointment is necessary hormonal drugs(glucocorticosteroids).

In case of allergic conjunctivitis that has developed as a result of the use of cosmetics or other substances, it is necessary to avoid contact with the allergen, and apply cold lotions to the eyelids several times a day. If the symptoms do not disappear, then you need to contact a specialist who will prescribe medication.

For conjunctivitis with papillary hyperplasia, it is advisable to temporarily abandon lenses or reduce the time they are worn. It is also recommended to replace them with models made of a different polymer. Devices should be washed as often as possible to prevent the accumulation of eye secretions. Some types of eye drops can help reduce the severity of symptoms. If the doctor has determined that numerous and fairly large papillae have already formed, then the lenses should be abandoned altogether. The use of vasoconstrictors and antihistamines may be indicated.

Symptoms of vernal keratoconjunctivitis improve with long stay in the cold. Methods of carrying out specific therapy not developed; recommended remedies help stop acute symptoms inflammation. Positive effect Hormonal (steroid) drugs (mometasone furoate and fluticasone propionate) can achieve this, but the disease lasts a long time, which precludes their constant use in order to avoid the development of severe side effects. A way out could be hormone therapy carried out at certain time intervals.

A good effect in the treatment of allergic conjunctivitis can be achieved by using H1-topic antihistamines (Allergodil, Analergin). Levocabastine drops are indicated for children under 12 years of age. Drugs in this group allow you to very quickly eliminate the symptoms of inflammation, but they have to be used quite often (up to 4 times a day), since they are characterized by a short period of action.

Many patients are prescribed vasoconstrictor (vasoconstrictor) drops.

Note: drugs Visin, Sanorin, Octilia and Naphazolin cannot be used for a long time, since drug addiction develops quickly and others cannot be excluded side effects(including drug-induced conjunctivitis).

A symptom such as itching can be relieved by the parallel use of H1 blockers and vasoconstrictors.

At seasonal allergies It is advisable to start using agents from the group of mast cell membrane stabilizers (Ketotifen, CromoHexal, Lecrolin) in advance. They inhibit the release of allergy mediators.

If the patient wears contact lenses, then 15 minutes before their installation it is advisable to drop Zaditen into the eyes. The drug is indicated for patients over 12 years of age.

For seasonal conjunctivitis of an allergic nature, a doctor as an alternative hormonal drugs may prescribe NSAIDs (Ketorolac, Diclofenac). U non-steroidal drugs There are no side effects typical of glucocorticoids. According to clinical studies, they do not relieve symptoms such as photophobia and swelling, but help cope with the feeling of itching.

Corticosteroids are indicated for the treatment of diseases accompanied by papillary hyperplasia and the treatment of atopic keratonic conjunctivitis. eye ointments(Prenacid, Dexamethasone, Maxidex).

Severe forms of allergic conjunctivitis in some cases require long-term therapy with immunosuppressants (Ciclosporin).

Important: allergic conjunctivitis is a disease against which traditional medicine is powerless. Various lotions, washing the eyes with herbal decoctions and other “grandmother’s methods” will not help relieve symptoms and, moreover, influence the cause. The only thing that can be achieved with such self-medication is to provoke an exacerbation and cause infectious complications.

You will receive more detailed information about the causes of development, types and methods of treatment of allergic conjunctivitis by watching this video review:

Plisov Vladimir, medical columnist, herbalist

According to the logic of the name, it affects those people who have increased sensitivity to any allergen. Allergy itself is a rather unpredictable problem that can “climb out” in the most different places body. Since the conjunctiva of the eye comes into contact with the outside world in the forefront, it is also the first to be attacked by allergens.

Most often, the conjunctiva perceives plant pollen as an allergen. For this reason, this type of conjunctivitis can be perceived as a seasonal disease. However, in addition to pollen, allergy sufferers also have reactions to pet hair, dust, and medications. And this is not the whole list.

The impact of allergens on the conjunctiva of the eye can be guessed almost immediately by their occurrence. severe itching– I just want to rub my eyes. In some cases, itching is accompanied by pain and slight swelling of the eyelids. And this problem can become chronic.

For reference. Allergic conjunctivitis is the appearance inflammatory reaction mucous membrane of the eye in response to exposure to allergens. For the development of allergic conjunctivitis, an increased, genetically determined sensitivity to a given allergen is required.

The main symptoms of allergic conjunctivitis are the appearance of lacrimation, itching of the eyelids and conjunctiva, redness of the mucous membrane, swelling of the eyelids, and the appearance of inflammatory formations (papillae and follicles) on the conjunctiva. In severe cases of allergic conjunctivitis, damage to the cornea (allergic keratoconjunctivitis) may occur, accompanied by visual impairment.

Attention. According to statistics, ophthalmic allergies (allergic conjunctivitis, allergic keratoconjunctivitis, etc.) varying degrees severity occurs in approximately twenty percent of the population.

In the structure of allergic lesions of the eye, conjunctivitis accounts for about ninety percent of all ophthalmic allergies.

Due to the presence of a genetic predisposition, allergic conjunctivitis is often combined with other diseases of an allergic nature ( bronchial asthma, allergic rhinitis, pharyngitis, atopic dermatitis, etc.).

The disease code for allergic conjunctivitis according to ICD10 is H10.1 (acute atopic conjunctivitis).

Causes of development of allergic conjunctivitis

The main cause of allergic conjunctivitis is pollen. In this regard, most patients experience a pronounced seasonality of the disease (spring, late summer or early autumn), caused by the flowering of ragweed, poplar, plantain, wormwood, quinoa, etc.

Also, the cause of the development of allergic conjunctivitis may be:

• dust;
• animal hair;
• cockroaches;
• cosmetics (mascara, eye shadow, makeup remover, etc.);
• contact lenses and solutions for their storage;
• medicines (eye drops, ophthalmic ointments, gels), etc.

Classification of allergic conjunctivitis

The disease can occur in acute and chronic forms.

According to clinical form and the causative agent of the inflammatory process, allergic conjunctivitis is divided into:

• hay fever seasonal allergic conjunctivitis;
• spring conjunctivitis and keratoconjunctivitis;
• large papillary allergic conjunctivitis;
• drug-induced conjunctivitis;
• chronic allergic conjunctivitis and keratoconjunctivitis.

For reference. Depending on the pathogen, allergic conjunctivitis can be permanent (caused by exposure to dust or other factors that the patient encounters regularly) or seasonal.

Seasonal hay fever allergic conjunctivitis (also called hay fever or pollen allergy) is divided into three types, according to the type of pollen that causes the allergy.

The first type of seasonal allergic conjunctivitis includes inflammation caused by flowering trees and exposure to their pollen. The second type includes allergies caused by meadow grass pollen. The third type is allergic conjunctivitis caused by weed pollen.

Allergic conjunctivitis - symptoms

The main common manifestations of all allergic conjunctivitis are:

• pronounced hyperemia of the mucous membrane of the eye;
• severe redness of the eyelids;
• swelling of the eyelids and conjunctiva;
• complaints of itching, burning, pain in the eyes;
• itching of the eyelids;
• the appearance of profuse lacrimation;
• absence of purulent discharge from the eyes;
• blurred vision;
• the appearance of inflammatory formations on the mucous membrane of the eyes (pathological papillae and follicles).

In most cases, allergic conjunctivitis is combined with allergic symptoms:

• rhinitis (complaints of constant nasal congestion, nasal voice, constant itching in the nose, discharge of copious mucous discharge from the nose, sneezing, characteristic redness of the tip of the nose, etc.);
• pharyngitis (sore throat, cough, dry throat, hoarseness, choking, etc.).

Attention. Allergic conjunctivitis in children occurs in the same way as in adults. There are no fundamental differences in symptoms. However, in young children, allergic conjunctivitis is more often complicated by the addition of a bacterial infection. This is due to the fact that due to severe itching, they constantly rub the eyes and often spread to the mucous membranes. pathogenic microorganisms.

It should be noted that allergic conjunctivitis is similar in clinical picture to viral conjunctivitis, therefore, in order to avoid errors in diagnosis, making a diagnosis, differential diagnosis and treatment should be prescribed exclusively by an ophthalmologist and an allergist.

As well as viral conjunctivitis, allergic can be combined with symptoms of rhinitis and pharyngitis, but with allergies there is no temperature, fever, pain in muscles and joints, or swollen lymph nodes.

Allergic conjunctivitis - how to treat it

Treatment of allergic conjunctivitis should be prescribed by ophthalmologists and allergists. According to indications, can be used:

• specific hyposensitization by allergens;
• antihistamine eye drops;
• vasoconstrictor eye drops;
• tear substitutes;
• eye drops with interferons;
• eye drops and ointments with glucocorticosteroids;
• drops with mast cell stabilizers.

Allergic conjunctivitis - eye drops with antihistamines

The most commonly used agents are drops:

• Okumetil ( combined drops for eyes with diphenhydramine, naphazoline and zinc sulfate). They have antihistamine, vasoconstrictor, decongestant, antiseptic and anti-inflammatory effects;
• Opatanol (antihistamine drops with olopatadine);
• Cromohexal (antihistamine drops with a mast cell membrane stabilizer - cromoglycic acid);
• Lecrolin (antiallergic eye drops with sodium cromoglycate (mast cell stabilizer));
• Allergodil (antiallergic drops with azelastine).

Allergic conjunctivitis - eye drops with a vasoconstrictor effect

To narrow blood vessels and reduce the severity of edema, vasoconstrictor eye drops are used:

• with tetrizoline (Tizin, Vizin, Montevisin, Octilia, etc.);
• combined drops with naphazoline and pheniramine (Opcon-A);
• combined drops with antazoline and naphazoline (Alergoftal);
• comb. drops with antazoline and tetrizoline (Spersallerg).

If necessary, vasoconstrictor nasal drops (Naphthyzin) are additionally prescribed.

Allergic conjunctivitis - eye drops with glucocorticosteroids

In most cases, hormonal drops are used:

• Betazon (drops with betamethasone);
• Dexona, Dexoftan, Dexamethasonelong (drops with dexamethasone).

Hay fever seasonal allergic conjunctivitis

Hayallergic allergic conjunctivitis is called seasonal ophthalmological allergies that develop due to exposure to pollen allergens on the mucous membrane during the flowering of trees, flowers, herbs, cereals, etc. This type allergic conjunctivitis is one of the most common.

Diagnosis of hay fever conjunctivitis, as a rule, is not difficult, since the appearance of symptoms of the disease has a clear connection with exposure to the allergen. To clarify the diagnosis, use:

• intradermal allergen test;
• cytological studies of scrapings from the conjunctiva of the eyes.

A significant role in the diagnosis of allergic conjunctivitis is played by collecting an anamnesis of the disease (the presence of a hereditary allergic history in the patient, concomitant atopic conditions, seasonality of symptoms, etc.).

For reference. In most cases, patients with hay fever allergic conjunctivitis are diagnosed with concomitant allergic rhinitis, pharyngitis, dermatitis, bronchitis, and bronchial asthma.

Pollinous conjunctivitis begins acutely, with damage to both eyes at once. Patients complain of the appearance of:

• unbearable burning and itching of the eyelids;
• severe and constant lacrimation;
• burning and itching under the eyelids;
• increased sensitivity to light;
• swelling of the eyelids and conjunctiva;
• redness of the eyelids and conjunctiva.

Swelling of the conjunctiva can be so severe that it seems as if the cornea is “sinking” into it.

Due to severe swelling eyelid patients may experience difficulty opening their eyes and constantly squint. The appearance of marginal pathological infiltrates in the cornea is also often noted. Subsequently, superficial pathological papillae and follicles may undergo ulceration, leading to the formation of ulcers and corneal erosions.

For reference. In the chronic course of the inflammatory process, there is constant moderate itching of the eyelids and conjunctiva, scanty mucous discharge from the eyes and a constant pinkish tint of the eyelids and conjunctiva. The occurrence of moderate persistent pathological infiltration of the mucous membrane is also characteristic.

Diagnosis of hay fever allergic conjunctivitis

To diagnose the disease and clarify the type of allergen that caused allergic conjunctivitis, ophthalmological skin tests with allergens:

• scarification;
• scarification and application;
• electrophoresis;
• drip;
• application;
• prick test (used most often), etc.

In isolated cases, strictly according to indications, a provocative test can be used:

• conjunctival;
• nasal;
• sublingual.

For reference. The most important role in diagnosing the disease in the acute period is played by specific laboratory allergy diagnostics (the most significant is the detection of eosinophilic cells in scrapings from the conjunctiva).

Pollinous allergic conjunctivitis - treatment

The main and most effective method treatment is to carry out specific hyposensitization using pollen allergens. However this method treatment of allergic conjunctivitis in adults and children can only be used outside periods of exacerbation of the disease.

During the exacerbation phase, allergic conjunctivitis of the eyes is treated with systemic antihistamines (Suprastin, Loratadine, Zodak, Diazolin, Cetirizine, Zitrek, Tavegil, etc.). Antihistamine eye drops and vasoconstrictor drops are also used.

Attention. Strictly according to indications, drops and ointments with glucocorticoids and mast cell stabilizers (cromoglycic acid) can be prescribed.

With the development of dry eye syndrome, it is advisable to use tear substitutes and eye drops with interferons (Ophthalmoferon).

If necessary, the use of medications begins two weeks before contact with allergens.

Spring allergic conjunctivitis in adults and children

Spring keratoconjunctivitis is called seasonal inflammatory lesions of the conjunctiva and cornea. The onset of exacerbation occurs at the end of spring, the peak in mid-summer. In autumn, the inflammatory process subsides. In isolated cases, a chronic year-round course of the disease is possible.

To diagnose the disease, a study of conjunctival scrapings for eosinophilic cells is used.

Attention! The disease is characterized by complete regression of symptoms during puberty. In this regard, in addition to the allergic factor causing inflammation, the endocrine factor is also considered.

The distinctive signs of spring allergic conjunctivitis are:

• seasonality of the disease;
• children's age of patients (usually up to ten years);
• acute onset and damage to both eyes;
• the appearance of severe itching of the eyelids;
• lacrimation and photophobia;
• growth of cartilage on the conjunctiva upper eyelids pale pinkish papillae;
• discharge of a viscous thread-like discharge from the eyes;
• redness of the eyelids and conjunctiva;
• swelling of the eyelids and mucous membranes;
• inflammatory lesion of the cornea.

Spring allergic conjunctivitis in children treatment

To treat spring allergic conjunctivitis, glucocorticosteroid preparations (eye ointments and drops) are used. Additionally, the use of mast cell membrane stabilizers and systemic antihistamines is indicated.

Large papillary allergic conjunctivitis

Large papillary allergic conjunctivitis is an inflammation of the mucous membrane, accompanied by the appearance of large pathological papillae on it as a result of prolonged contact of the mucous membrane with a foreign body (lenses, sutures on the cornea, prosthesis, etc.)

The main symptoms of large papillary conjunctivitis are the appearance of:

• specific papillae,
• itching,
• mucous discharge,
• pain in the eyes,
• sometimes ptosis (drooping of the eyelid).

Large papillary allergic conjunctivitis: treatment in adults and children

The basis of treatment is the removal of the foreign body that caused the allergic inflammatory reaction. In the future, it is recommended to prescribe drops with mast cell membrane stabilizers, drops with interferons and tear substitutes.

Drug-induced conjunctivitis of the eyes

Drug contact conjunctivitis is called allergic inflammation mucous membrane of the eyes, due to individual intolerance to the drug used.

The development of allergies can be acute (within an hour after using the product), subacute (within 24 hours) and chronic (with long-term use facilities).

Symptoms of the disease are:

• severe pain and burning in the eyes;
• swelling and redness of the eyelids and conjunctiva;
• lacrimation;
• emergence inflammatory infiltration mucous membrane and cornea, etc.

For reference. To diagnose the disease in the acute period, specific laboratory allergy diagnostics are used. After graduation acute period diseases, provocative tests and ophthalmological skin tests (drip, patch, prick tests, etc.) can be used.

Drug-induced allergic conjunctivitis of the eyes - treatment

For reference. The basis of treatment is the immediate withdrawal of the drug that caused the allergic reaction. Additionally, systemic and local antihistamines, drops and ointments with glucocorticoids, and vasoconstrictor drops are used.

For severe allergic reaction may be required systemic use glucocorticosteroids.

Almost every person has experienced manifestations of an allergic reaction. It can be caused by food, dust, wool, perfumes and many other substances. It is important to know the symptoms and treatment of allergic conjunctivitis, because this will allow you to take timely measures to preserve full vision.

The disease is an inflammatory process localized in the conjunctiva of the eye - the mucous membrane lining white part eyeball. The cause is a hypersensitivity reaction that occurs in response to the action of an allergen. A wide variety of substances can act as a trigger for the process, but the clinical picture will be the same.

Symptoms

Clinical manifestations depend on the concentration of the allergen that affects the susceptible organism: the higher it is, the more severe the symptoms of conjunctivitis. They play a significant role and individual characteristics the body's reaction to the impact of the trigger of the allergic process. The difference in the time of onset of symptoms of the disease depends on this: from 30 minutes to a couple of days.

The following symptoms are characteristic of allergic conjunctivitis:

1. The most common complaint is itching and burning of the eyes, watery eyes. These manifestations sometimes bother the patient so much that they seriously impair his quality of life. They intensify in warm and dry weather.
2. Rapid eye fatigue sets in.
3. Swelling of the conjunctiva and eyelids.
4. There is redness of the eyes, which occurs due to the inflammatory process, and the redness intensifies due to constant scratching.
5. Gradually, the amount of secretion from the lacrimal gland decreases, so at the height of the disease, a feeling of dryness, a sensation of a foreign body, and a fear of sunlight appears in the eyes.
6. With conjunctivitis, there is a great desire to scratch the affected area, as a result of which lesions are formed on the mucous membrane, invisible to the naked eye. Pathogenic microorganisms can enter through them, aggravating the manifestations of conjunctivitis. If an infection occurs, discharge from the eye will have a yellow tint (pus). In the morning after sleep, it is difficult for such patients to open their eyes, as the eyelids stick together.
7. Small follicles or papillae appear on the conjunctiva.
8. The mucous membrane of the eye, especially when it is advanced, partially atrophies, which causes pain when moving the eyeball.

In parallel with the conjunctiva, the nasal mucosa also reacts to the action of the allergen, and rhinitis occurs. Accompanied heavy discharge from the nose.

Causes

Allergic conjunctivitis can result from the impact of many substances on the mucous membrane of the eye, but it all depends on the individual reaction to a specific allergen. Allergens are classified according to several criteria; it is most convenient to distinguish them by the nature of their origin.

Household

Among these allergens, the most important is house dust, which most often causes allergic reactions. It is found in clothes, carpeting, bedding, that is, in all those things that are in the house.

Epidermal

The source of these allergens are domestic animals: cats, dogs, birds, and so on. The reaction from the eyes is manifested by their fur, excrement and other substances that animals secrete in the process of life.

Pollen

In the spring, plants begin to bloom and release pollen, which becomes a real problem for patients suffering from hay fever. Allergic conjunctivitis is most often caused by pollen. Cross reactions of the body may develop - in cases where the composition of the pollen of two different plants similar to each other.

Classification

Several classifications of allergic conjunctivitis have been proposed:

1. By the nature of the antigen: keratoconjunctivitis, drug-induced conjunctivitis, atopic, spring catarrh.
2. Over the course of the disease, the eye disease can be acute, subacute, and then becomes chronic.
3. By time of occurrence: seasonal (usually in spring for flowering) or year-round.
4. According to the speed of onset of the first allergy symptoms: immediate reaction (occurs within half an hour from the moment the allergen begins to act) and delayed (after a day or more). This classification plays important role when selecting therapy for a patient.

The occurrence of allergic conjunctivitis is based on an immediate hypersensitivity reaction (type 1). Trigger serves as contact of the conjunctiva of the eye with a substance that causes an enhanced immune response. A number of processes in the body are launched. Mast cells degranulate, basophils are activated, mediators of the allergic reaction are released, which are responsible for all the symptoms. The vessels of the mucous membrane of the eye dilate, swelling of the conjunctiva occurs.

Chronic form

Allergic conjunctivitis is chronic if the allergen constantly affects the mucous membrane of the eye. In most cases, the factor that causes a hyperreaction of the immune system acts on the body periodically, so the symptoms of the disease do not always accompany a person.

It is very important to identify in time the allergen that causes conjunctivitis: by eliminating its effects, you can avoid this disease as an eternal companion. We must remember that often the clinical manifestations are quite insignificant, but at the same time the unpleasant sensations in the eyes are intense.

How does it manifest in children?

This disease is especially common in children, starting from birth. Manifestations in children and adults do not differ from each other; the intensity of certain symptoms depends on the characteristics of the active allergen and the susceptible organism. Children scratch their eyes more often, so the risk of bacterial infection is much higher.

Therefore, in the treatment of allergic conjunctivitis, ointments that contain an antibacterial component are often used. Also, the frequency of spread of the process depends on the characteristics of blood circulation in the child’s body: rich vascularization contributes to the rapid transfer of infection from the mucous membrane of the eye through the vessels.

Possible complications

Frequent and prolonged episodes of allergic conjunctivitis, especially those left without drug support, may in rare cases issue serious complications. Basically, such pathological processes arise from the eye, these include:

• myopia – poor visual acuity at a great distance from the eye
• farsightedness - blurred images near
• astigmatism – pathology of the cornea (curvature)
• dry eye syndrome: dry mucous membranes, burning, foreign body sensation, photophobia
• iritis, keratitis
• acquired strabismus
• cataract

Which doctor should I contact?

Allergic conjunctivitis is treated by two specialists: an allergist-immunologist and an ophthalmologist, so you need to contact them. The doctor will prescribe everything necessary research to confirm the allergic nature of the disease and prescribe effective treatment.

Diagnostics

Conjunctivitis is not difficult to diagnose due to its characteristic clinical picture and vivid symptoms. But it’s more difficult to determine the nature of the disease, because there are many types of conjunctivitis and they all differ in treatment and recommendations. It is very important to collect a history of the disease, which is carried out by a doctor.

What is important is the established fact of the patient’s interaction with some unusual substances, the seasonality of the occurrence of eye symptoms, the presence of signs of intoxication of the body, which mainly accompanies bacterial or conjunctivitis. viral etiology. For differential diagnosis with conjunctivitis caused by fungi, viruses or bacteria, a smear is taken to look for the pathogen. To do this, you need a special tool that looks like a cotton swab.

They collect material from the mucous membrane of the affected eye. This smear is then sent to the laboratory, where at the same time the material can be tested for sensitivity to antibiotics in case of bacterial contamination. With cytological laboratory research with conjunctivitis of an allergic nature, the number of eosinophils and basophils prevails in the smear. If the disease passes through the patient without complications, then dystrophic changes no cells are observed in the smear.

Treatment

Therapy for conjunctivitis should be carried out even despite the subsidence of symptoms after eliminating exposure to the allergen. This will help avoid complications. Applicable A complex approach, which provides the best rate of recovery for sore eyes.

Non-drug methods

1. It is advisable to avoid contact lenses for the entire duration of treatment. Despite the fact that progress does not stand still, the lens represents foreign body, which also prevents your eyes from breathing fully. Symptoms of the disease may worsen, so it is better to use glasses for conjunctivitis. After completing the course of treatment, you should not wear old lenses: they can be a source of infection, especially in the case of complicated allergic conjunctivitis.
2. To relieve the symptoms of dry eye, it is advisable to use lubricant eye drops. To purchase them you do not need a prescription from a doctor, but be sure to read the instructions for use.
3. You should wash your hands more often, especially after touching your sore eye. This will prevent re-infection.
4. Sticky discharge, especially after waking up, should be carefully removed with a cotton pad moistened with warm boiled water.

Mast cell stabilizers

These drugs belong to alternative therapy of this pathology. The principle of action is to reduce the release of allergic reaction mediators from mast cells. They block calcium channels, the functioning of which is necessary for cell degranulation. The cell membrane gradually stabilizes.

They differ from conventional antihistamines in that they do not relieve symptoms in the short term, give delayed results and effectively control the development of symptoms over a long period of time. When prescribed mast cell stabilizers, patients experience far fewer side effects than from other groups of drugs. They begin to act after 2-3 weeks, so you can often find them being prescribed together with antihistamines.

Mast cell membrane stabilizers are prescribed in most cases in the form of eye drops. This allows the active substance to precisely reach the site of inflammation. Examples of drugs are nedocromil and sodium cromoglycate, lodoxamide. The choice of the most suitable drug is carried out by a specialist.

Antihistamines

Medicines in this group reduce allergic manifestations by reducing the release of histamine and other mediators. There are several generations of antihistamines, which differ in effectiveness, duration of action and severity of side effects. For allergic conjunctivitis, both eye drops and oral tablets can be prescribed. The following drugs may be prescribed:

• cetirizine
• levocabastine
• allergodil
• fexofenadine
• loratadine

The choice of drug should be made by a doctor during a detailed examination of the patient. It is necessary to take into account the profession, possible pregnancy, lactation period in a woman. You also need to listen to the wishes of the patient, because some drugs need to be used 4 times a day, which may be inconvenient for the patient. Elderly people suffer from memory impairment, so it is preferable for them to choose long-acting remedies.

Patients with allergic conjunctivitis are often prescribed medications double acting. It must be remembered that some antihistamines, especially 1st generation, cause drowsiness, which is dangerous for professions that require increased concentration. The chance of this side effect increases when you take large doses drugs, as well as together with alcoholic beverages.

Immunotherapy

Allergen-specific immunotherapy for at this stage is the only method that affects the cause of the allergy and eliminates it. The method consists of introducing an allergen into the sensitized organism, the dose of which gradually increases.

Long-term tolerance of the body to this allergen develops, as a result of which the symptoms of conjunctivitis are eliminated. The method has its side effects, so it should only be carried out by an allergist-immunologist.

Prevention

It is necessary to adhere to a number of rules so that the symptoms of conjunctivitis no longer bother you:

1. The most important thing is to avoid any contact with the allergen, because its effect on the conjunctiva of the eye is the main and only cause of the disease.
2. If interaction with the allergen could not be avoided, then you should immediately drip an antihistamine into your eyes, which is prescribed by the appropriate specialist.

Conclusion

If any unpleasant symptoms For eye problems, you should immediately consult a doctor. Untimely and uncontrolled reception medications capable of inflicting irreparable harm vision. By following all the necessary recommendations from a specialist, you can forget about the symptoms of allergic conjunctivitis for a long time.

Video: Allergic conjunctivitis - about the most important things