How does allergic conjunctivitis manifest? Allergic conjunctivitis, symptoms and treatment in adults and children. How does it manifest in children?

In 2013 Russian Association allergists and clinical immunologists voiced disappointing data. According to foreign epidemiological studies, from 15 to 40% of adults on Earth constantly or occasionally experience manifestations of allergic eye diseases. Over the past years, their prevalence has not decreased, but only increased, especially among children. The symptoms of allergic conjunctivitis, the principles of its detection and treatment are discussed in the proposed material.

Conjunctivitis – inflammatory process, developing in the thin mucous membrane lining the eyelids from the inside and eyeball outside. If such inflammation is caused by an allergic reaction, conjunctivitis is called allergic.

Any allergy, including eye allergies, is an inadequate, exaggerated response immune system to some specific protein or external influence.

The most common triggers for allergic conjunctivitis are:

• pollen of flowering plants;
• dust mites;
• smoke and other air pollution;
• fungal spores;
• skin secretions, saliva and animal hair;
• Perfumes and cosmetics;
• eye drops and solutions for contact lenses.

A person whose body demonstrates hypersensitivity to these irritants is called sensitized. His immune cells when encountering an allergen, they trigger a complex cascade molecular reactions. Histamine, cytokines, prostaglandins, and platelet activating factor are sequentially released. As a result, inflammation develops.

Types of disease

Depending on the nature of the course and etiology, allergic conjunctivitis is divided into two large groups - seasonal and year-round:

Sometimes not only the conjunctiva, but also the underlying cornea is involved in the inflammatory process. In this case, they talk about the development of allergic keratoconjunctivitis. If sensitization is the result bacterial infection eyes, a separate diagnosis is made - phlyctenulous keratoconjunctivitis or phlyctenulosis.

Symptoms of allergic conjunctivitis

Are common external signs both seasonal and year-round conjunctivitis– redness and debilitating itching of the eyes. Usually both eyes are affected at the same time.

However, other symptoms and indicators may differ slightly:

It usually doesn’t take long from exposure to an allergen to the onset of symptoms. The first signs may appear within a few minutes.

Often unbearable itching forces the patient to rub his eyes with his hands, which can lead to infection. In this case, purulent discharge accumulating in the inner corner eyes.

In severe cases of the disease, there is pain and pain in the eyes, a feeling of dryness, sand under the eyelids. Sometimes photophobia develops.

Allergic keratoconjunctivitis has its own characteristics. It is accompanied by the appearance of yellowish-white nodules, the so-called “Trantas grains”.

How to accurately diagnose?

An accurate diagnosis of the disease is made jointly by two doctors - an allergist and an ophthalmologist. Before treating allergic conjunctivitis, the ophthalmologist must exclude other eye diseases: conjunctivitis with systemic, infectious and autoimmune diseases, uveitis, blepharoconjunctivitis, glaucoma.

If an allergic nature of conjunctivitis is suspected, the following tests are first prescribed:

• blood analysis;
• examination of tear fluid for eosinophils;
• sowing of discharged secretions for microflora.

If the symptoms are mild, it is advisable to prescribe a test for Demodex, a microscopic eyelash mite. To do this, a scraping is taken from the edge of the eyelids.

After differential diagnosis and a diagnosis of “allergic conjunctivitis” is made, the patient is referred to an allergist, who must find the cause of the disease.

This can be done using three types of tests:

Skin tests and provocative tests are done only during the period of remission of the disease. A blood test for IgE is taken at any time, regardless of the presence of an exacerbation. However, it may require additional research.

Treatment of allergic conjunctivitis

After identifying the provoking allergen, treatment for allergic conjunctivitis is prescribed. Basically, it is performed on an outpatient basis. Hospitalization is indicated only for a complicated form of the disease that threatens vision loss.

In adults

Competent treatment of the disease should proceed in three directions: elimination measures (excluding contact with the allergen), local drug therapy, and immunotherapy.

Drug treatment includes the prescription of a complex of several groups of drugs:

Sometimes a one-time appointment is advisable antihistamines not only in the form of drops, but also tablet preparations. At the same time, it makes sense to give preference to new generation medications with a high safety profile - for example, Xyzal. The standard dosage regimen is 1 tablet once a day. Contraindications – increased sensitivity, pregnancy, lactation, renal failure.

Simultaneously with drug therapy, it is necessary to take measures to stabilize the immune system.

In this regard, the appointment of an allergen is promising - specific immunotherapy.

The idea is to repeatedly administer small doses of the allergen at gradual increase dosage. Over time, addiction develops and symptoms are minimized or disappear.

In children

Allergic conjunctivitis the child begins to manifest itself, as a rule, at the age of 3-4 years or later. At risk are children with a family history of children with any form of allergies.

The principles of treating children do not have any significant features. Doctors prescribe antihistamine drops for allergic conjunctivitis, tear substitutes and cromoglycic acid preparations. The only important difference is a more cautious approach to prescribing corticosteroids.

If the child’s disease often recurs, the doctor may prescribe a course of Histaglobulin injections. The specific dosage and number of injections are calculated based on the condition of the baby and his body weight.

The only thing that can be allowed is cool compresses on the eyes, soaked in clean water. All kinds of instillation of honey solutions, washing with aloe decoction or milk lead to the development severe complications, infections and even loss of vision.

Possible complications

At timely treatment, and strict control of allergic conjunctivitis has favorable prognosis. Despite the fact that the disease is chronic, it can be easily managed without significant loss of quality of life.

However, in advanced cases or with inadequate use of medications, complications may develop:

• the addition of a viral or bacterial infection;
• conjunctival atrophy;
• corneal ulcers;
• dry eye syndrome;
• blepharitis;
• cataract;
• retinal disinsertion.

Due to this, special meaning take preventive measures aimed at preventing the development of the disease.

Disease prevention

Allergies are often seen as something inevitable. However, according to the clinical recommendations of the Association of Allergists and Immunologists, the prevention of allergic lesions of the conjunctiva is quite possible. For this purpose, complexes of both primary and secondary measures have been developed.

Primary prevention is the prevention of the development of allergic conjunctivitis in people who have not previously been ill.

It is as follows:

• correct good nutrition during pregnancy, strict adherence to medical recommendations and regimen;
• ensuring the longest possible period breastfeeding and competent selection of breast milk substitutes;
• complete cessation of active and passive smoking;
• avoidance of unsystematic reception pharmaceuticals And eye drops;
• maintaining visual hygiene: protecting eyes from dirt, low-quality cosmetics, excessively bright light, injuries, chemical or thermal burns, overwork, correct use contact lenses;
• maintaining home hygiene: wet cleaning, washing linen and soft toys at a temperature not lower than 600C, avoiding carpeting, regular ventilation.

Secondary prevention measures are aimed at preventing exacerbations of conjunctivitis in allergy sufferers:

• identification of the spectrum of allergens that provoke inflammation of the conjunctiva;
• for those suffering from allergies to pollen - refusal to take medicines based on plant raw materials, from using phytocosmetics, closing windows during the day during the peak flowering of plants, wearing sunglasses, refusal of summer walks in hot or windy weather, swimming in open water;
• for those suffering from allergies to medications - avoid using medications with active substance causing a reaction;
• for those suffering from sensitivity to household allergens - adequate ventilation of the room, daily wet cleaning, use of vacuum cleaners, change of bed linen 2 times a week, use of dustproof covers, hypoallergenic fabrics;
• for those suffering from allergies to pets - refusal to keep them in the house, visit circuses, zoos, buy fur coats and woolen items;
• careful use of cosmetics and perfumes, products for scenting bed linen, clothing and premises;
• exclusion of active and passive smoking;
• maintaining visual hygiene;
• regular medical examination and compliance with the recommendations of the attending physician;
• training in allergy schools.

All patients with allergic conjunctivitis must receive a “Patient’s Passport” allergic disease» according to form No. 135/у.

It makes sense to keep this document with you at all times, especially on long trips.

Compliance with preventive measures will avoid both the development of allergic conjunctivitis and its unpleasant consequences.

Allergic conjunctivitis is an inflammation of the conjunctiva (the outer transparent mucous membrane of the eye) caused by an allergic reaction of the body (immune response to foreign substance– allergen).

Young people, regardless of gender, are much more likely to suffer from this disease. There are no exact statistical data, since in most cases such conjunctivitis accompanies other manifestations of allergies.

According to studies, symptoms of conjunctivitis occur in approximately 20-40 percent of people with other allergic pathologies.

Causes

The basis of this pathology is the mechanism of hypersensitivity immediate type. That is, the symptoms of allergic conjunctivitis occur immediately after contact with substances causing allergies. Anatomical features The eyes are such that allergens easily penetrate the mucous membranes, causing an inflammatory process there.

There are three groups of the most common substances that can provoke the development of allergic conjunctivitis:

• household, such as house and library dust, house dust mites, feathers from pillows;
• epidermal, for example, animal hair, bird feathers, animal dander, fish food, etc.
• pollenaceae, pollen from various plants.

When an allergen gets into the eyes, an inflammatory reaction immediately develops. Severe itching, lacrimation, redness of the conjunctiva and swelling occur. In some cases, photophobia may also develop.

The danger of allergic conjunctivitis is that in the absence adequate treatment An infection may accompany an allergy. If there is an infection, pus may drain from the corner of the eye.

Symptoms

When allergic conjunctivitis occurs, symptoms can appear at different speeds, either a few minutes after contact with the allergen or a day later.

In most cases, the reaction occurs in both eyes. Allergic conjunctivitis in one eye is considered atypical, although this manifestation also occurs. One eye may be affected if, for example, the allergen was brought into it by hand.

The main symptoms of allergic type conjunctivitis;

• redness of the eyes.
• severe or tolerable persistent itching.
• copious and uncontrollable tearing.
• a burning sensation in the eyes.
• clear or white discharge, which thickens over time and greatly bothers the patient.
• photophobia.
• blurred picture perceived by vision.

If the disease is severe, photophobia may develop. Allergic conjunctivitis in children is accompanied by the same symptoms as in adults. Moreover, as a rule, the above-mentioned ocular manifestations are combined with nasal ones, and the development eye allergies accompanied by the development of rhinoconjunctivitis in 85% of cases. Often, eye symptoms given pathological condition They bother older patients and children much more than nasal ones.

Chronic form

If allergic conjunctivitis lasts from six months to a year, then we are talking about chronic form diseases. IN in this case clinical manifestations are minimal, but persistent in nature.

As a rule, chronic conjunctivitis associated with allergic reactions is accompanied by bronchial asthma and eczema.

Allergic conjunctivitis in children

Allergic conjunctivitis in children in early age occurs quite rarely. Usually the disease is accompanied allergic rhinitis. Children who suffer from AK often experience other manifestations of allergies (diathesis, atopic dermatitis).

It is in children that food allergies are often triggered. After confirming the diagnosis, it is possible to carry out allergen-specific therapy, which is most effective at an early age.

We offer for viewing detailed photos to find out what this disease looks like.

Prevention

Unfortunately, specific prophylaxis to prevent the development of allergic conjunctivitis has not been developed due to the fact that there is not yet a unified theory of why allergies as such develop.

Methods of secondary prevention, aimed at preventing exacerbations of an existing disease, come down to eliminating the allergen from environment(see Diet and lifestyle features for allergic conjunctivitis) and adequate treatment.

Treatment of allergic conjunctivitis

When allergic conjunctivitis is diagnosed, treatment should be carried out in three directions at once:

• immediate cessation of contact with the allergen;
• local therapy with antihistamines, and in severe cases and corticosteroids;
• immunotherapy.

In mild cases, it is prescribed only local treatment, and when severe course illness is necessary complex therapy. The doctor can also prescribe specific immunotherapy and symptomatic drug therapy; in case of a protracted process, antimicrobial agents are prescribed prophylactically.

Approximate treatment regimen for allergic conjunctivitis:

1. Oral administration is indicated - Loratadine, Cetrin, Telfast. They allow you to block the action of histamine and some other inflammatory mediators, which prevents the manifestation of allergy symptoms.
2. Application – Lecrolin, Opatanol, Histimet. You need to bury them in your eyes up to four times a day, but this ensures quick effect and delivery of the drug to the target organ.
3. It is advisable to use eye drops mast cell stabilizers. Among such drops we can highlight: High-Krom (not for children under 4 years old), CromoHexal, Lecrolin, Krom-Allerg, Lodoxamide.
4. Some people can develop dry eye syndrome, when physiological reasons Tear production decreases or stops altogether. In this case, with allergic conjunctivitis, treatment is indicated with tear substitutes - Inoxa, Oksial, Vidisik, Oftogel, Visin, Systane.

Severe forms of allergic conjunctivitis may require prescription topical corticosteroids(eye drops or ointments with dexamethasone, hydrocortisone), topical NSAIDs (eye drops with diclofenac). Persistently recurrent allergic conjunctivitis is the basis for specific immunotherapy.

It is worth noting that the use traditional methods for the treatment of allergic conjunctivitis is not recommended due to the fact that it may worsen the situation.

Treatment methods for seasonal allergic conjunctivitis

Often this form of allergy is acute, there is a strong burning sensation in the eyes, the person is afraid of light, he is bothered by severe itching, and the production of tears increases. The following measures need to be taken:

1. If you drop Spersallerg into your eyes, after a while you can feel how it becomes easier; the drops contain a vasoconstrictor.
2. When allergic reaction just begins, you need to take special antihistamine tablets orally.
3. In cases of chronic conjunctivitis allergic nature it is necessary to instill eye drops with Alomide and Cromohexal.

is a reactive inflammation of the conjunctiva caused by immune reactions in response to contact with an allergen. With allergic conjunctivitis, hyperemia and swelling of the eye mucosa, itching and swelling of the eyelids, lacrimation, and photophobia develop. Diagnosis is based on collection allergy history, conducting skin tests, provocative allergy tests (conjunctival, nasal, sublingual), laboratory research. Used in the treatment of allergic conjunctivitis antihistamines(orally and locally), topical corticosteroids, specific immunotherapy.

ICD-10

H10.1 Acute atopic conjunctivitis

General information

Allergic conjunctivitis occurs in approximately 15% of the population and is a significant problem in modern ophthalmology and allergology. Allergic damage to the organ of vision in 90% of cases is accompanied by the development of conjunctivitis, less often - allergic blepharitis, eyelid dermatitis, allergic keratitis, uveitis, iritis, retinitis, neuritis. Allergic conjunctivitis occurs in both sexes, mainly young. Allergic conjunctivitis is often combined with other allergies - allergic rhinitis, bronchial asthma, atopic dermatitis.

Causes

What is common in the etiology of all forms of allergic conjunctivitis is increased sensitivity to various kinds environmental factors. Due to the features anatomical structure and locations of the eye are most susceptible to contact with exogenous allergens. Depending on the etiology there are:

• Seasonal allergic conjunctivitis. Hay fever, pollen allergy) caused by pollen allergens during the flowering of grasses, trees, and cereals. Exacerbation of hay fever conjunctivitis is associated with the flowering period of plants in a particular region. Seasonal allergic conjunctivitis in 7% of patients worsens in the spring (late April - late May), in 75% - in the summer (early June - late July), in 6.3% - in the off-season (late July - mid-September), which accordingly coincides with the pollination of trees, meadow grass and weeds.
• Spring conjunctivitis. The etiology of spring conjunctivitis has been little studied. The disease worsens in spring - early summer and regresses in autumn. This form allergic conjunctivitis usually resolves spontaneously in puberty, which suggests a certain role of the endocrine factor in its development.
• Large papillary conjunctivitis. The main development factor is considered to be wearing contact lenses and ocular prostheses, prolonged contact of the mucous membrane with a foreign body of the eye, the presence of sutures that irritate the conjunctiva after cataract extraction or keratoplasty, calcium deposits in the cornea, etc. With this form of allergic conjunctivitis, the inflammatory reaction is accompanied by the formation of upper eyelid large flattened papillae.
• Drug-induced conjunctivitis develops as a local allergic reaction in response to topical (90.1%), less often systemic (9.9%) use of drugs. The occurrence of drug-induced allergic conjunctivitis is facilitated by self-medication, individual intolerance to the components of the drug, polytherapy - a combination of several drugs without taking into account their interaction. Most often, drug-induced allergic conjunctivitis is caused by the use of antibacterial and antiviral eye drops and ointments.
• Chronic allergic conjunctivitis. Accounts for more than 23% of cases of all allergic eye diseases. With minimal clinical manifestations, the course of chronic allergic conjunctivitis is persistent. Direct allergens in this case are usually house dust, animal hair, dry fish food, feathers, fluff, food products, perfumes, cosmetics and household chemicals. Chronic allergic conjunctivitis is often associated with eczema and bronchial asthma.
• Atopic keratoconjunctivitis. It is an allergic disease of multifactorial etiology. Usually develops during systemic immunological reactions, therefore it often occurs against the background of atopic dermatitis, asthma, hay fever, urticaria.

Pathogenesis

The pathogenesis of allergic conjunctivitis is based on an IgE-mediated hypersensitivity reaction. The triggering factor for allergic conjunctivitis is direct contact of the allergen with the conjunctiva, leading to degranulation of mast cells, activation of lymphocytes and eosinophils and a clinical response followed by an inflammatory-allergic reaction. Mediators released by mast cells (histamine, serotonin, leukotrienes, etc.) cause the development characteristic symptoms allergic conjunctivitis.

The severity of allergic conjunctivitis depends on the concentration of the allergen and the reactivity of the body. The rate of development of a hypersensitivity reaction in allergic conjunctivitis can be immediate (within 30 minutes from the moment of contact with the allergen) or delayed (after 24-48 or more hours). This classification of allergic conjunctivitis is practically significant for choosing drug therapy.

Classification

Allergic eye lesions can occur in the form of hay fever conjunctivitis, vernal keratoconjunctivitis, large papillary conjunctivitis, drug conjunctivitis, chronic allergic conjunctivitis, atopic keratoconjunctivitis. Allergic conjunctivitis can be acute, subacute or chronic; by time of occurrence - seasonal or year-round.

Symptoms of allergic conjunctivitis

Allergies usually affect both eyes. Symptoms develop within a period of several minutes to 1-2 days from the moment of exposure to the allergen. Allergic conjunctivitis is characterized by severe itching eyes, burning under the eyelids, lacrimation, swelling and hyperemia of the conjunctiva; in severe cases – development of photophobia, blepharospasm, ptosis.

The itching in allergic conjunctivitis is so intense that it forces the patient to constantly rub his eyes, which, in turn, further intensifies other clinical manifestations. Small papillae or follicles may form on the mucosa. The discharge from the eyes is usually mucous, transparent, sometimes viscous, thread-like. When the infection develops, a purulent secretion appears in the corners of the eyes.

In some forms of allergic conjunctivitis (vernal and atopic keratoconjunctivitis), damage to the cornea occurs. In case of drug allergies, damage to the skin of the eyelids, cornea, retina, choroid, optic nerve. Spicy medicinal conjunctivitis sometimes gets worse anaphylactic shock, Quincke's edema, acute urticaria, systemic capillary toxicosis.

In chronic allergic conjunctivitis, the symptoms are poorly expressed: complaints of periodic itching of the eyelids, burning of the eyes, redness of the eyelids, lacrimation, moderate amount separated. Chronic allergic conjunctivitis is said to occur if the disease lasts 6-12 months.

Diagnostics

In the diagnosis and treatment of allergic conjunctivitis, coordinated interaction between the treating ophthalmologist and the allergist-immunologist is important. If the history shows a clear connection between conjunctivitis and exposure to an external allergen, the diagnosis is usually not in doubt. To confirm the diagnosis, the following is carried out:

• Ophthalmological examination. Detects changes in the conjunctiva (edema, hyperemia, papillary hyperplasia, etc.). Microscopic examination Conjunctival scraping for allergic conjunctivitis allows you to detect eosinophils (10% and above). In the blood, an increase in IgE of more than 100-150 IU is typical.
• Allergy examination. To determine the cause of allergic conjunctivitis, tests are carried out: elimination, when against the background of clinical manifestations, contact with the suspected allergen is excluded, and exposure, which consists of repeated exposure to this allergen after the symptoms subside. After the acute symptoms subside allergic manifestations For conjunctivitis, skin allergic tests (application, scarification, electrophoresis, prick test) are performed. During the period of remission, they resort to provocative tests - conjunctival, sublingual and nasal.
• Laboratory examination. In case of chronic allergic conjunctivitis, examination of eyelashes for demodex is indicated. If you suspect infectious lesion the eye is held bacteriological examination smear from the conjunctiva for microflora.

Treatment of allergic conjunctivitis

The basic principles of treatment of allergic conjunctivitis include: elimination (exclusion) of the allergen, local and systemic desensitizing therapy, symptomatic drug therapy, specific immunotherapy, prevention secondary infections and complications. In case of large papillary conjunctivitis, it is necessary to stop wearing contact lenses, eye prostheses, and remove postoperative sutures or removal of a foreign body.

For allergic conjunctivitis, oral antihistamines (claritin, ketotifen, etc.) and the use of antiallergic eye drops (levocabastine, azelastine, olopatadine) 2-4 times a day are prescribed. Topical use of cromoglycic acid derivatives (mast cell stabilizers) in the form of drops is also indicated. When dry eye syndrome develops, tear substitutes are prescribed; if the cornea is damaged, use eye drops with dexpanthenol and vitamins.

Severe forms of allergic conjunctivitis may require the use of topical corticosteroids (eye drops or ointments with dexamethasone, hydrocortisone), topical NSAIDs (eye drops with diclofenac). Persistently recurrent allergic conjunctivitis is the basis for specific immunotherapy.

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 occur 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.

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

The patient is also prescribed immunostimulating therapy. But the most important condition for successful treatment of conjunctivitis is to limit, or better yet completely eliminate, contact with the allergen.

Clinical picture

WHAT DOCTORS SAY ABOUT EFFECTIVE METHODS OF TREATING ALLERGIES

Vice-President of the Association of Children's Allergists and Immunologists of Russia. Pediatrician, allergist-immunologist. Smolkin Yuri Solomonovich

Practical medical experience: more than 30 years

What is allergic conjunctivitis and when does it occur?

Allergies are a common disease. The number of patients increases every year. For some people, allergic reactions occur extremely rarely and are not very pronounced, while others suffer from several types of this disease and are forced to constantly monitor their lifestyle and carry medications with them for emergency relief of the reaction.

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

One form of the disease is allergic conjunctivitis, an inflammation of the eye caused by an allergic reaction. Unlike infectious conjunctivitis, allergic conjunctivitis is not contagious, is not caused by pathogenic activity, and does not require treatment with antibiotics. But in some cases to existing inflammation a bacterial infection may occur.

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

How separate disease it occurs as a result of direct contact (eye contact with an irritating substance, allergy to some local medicines or cosmetics).

Allergic conjunctivitis occurs in adults and children. Children have less control over themselves and often scratch their eyes, which is why the allergic reaction is complicated by infectious conjunctivitis.

Causes of the disease

The main factor that influences the occurrence of conjunctivitis is a special reaction of the immune system. The development of the disease is provoked by an allergen - an irritant substance. There are no universal allergens: each person has different substances that provoke the disease.

The most common cause of conjunctivitis is:

• dust;
• fur, saliva, feathers or industrial feed pets;
• plant pollen (often causes seasonal conjunctivitis);
• contact lenses or solution for them;
• for women - eye cosmetics (decorative - mascara, eyeliner, shadows, as well as skincare - anti-wrinkle creams and serums);
• medications - drops that are used to treat ophthalmic diseases;
• activity of viruses and bacteria in the upper respiratory tract, the toxins they produce (the main cause of red eyes and watery eyes during ARVI and influenza).

It is difficult to independently determine the cause of conjunctivitis in adults and children; this should be done by a doctor.

Only he can tell the difference infectious inflammation from allergies, will be able to accurately determine the type of allergen and prescribe effective treatment.

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

Signs of the disease may appear immediately after contact with the allergen, or after a period of time - from a couple of hours to 2 days. Unlike infectious conjunctivitis, allergic conjunctivitis occurs in both eyes at once (occasionally in one, but this is atypical shape diseases).

It is characterized by:

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

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

In particularly severe cases, temporary serious violations vision. Symptoms are the same in adults and children.

Types of allergic conjunctivitis

Depending on the time of occurrence and duration of the disease, the disease occurs:

1. Permanent– develops if the patient regularly comes into contact with an allergen. This is an immune response to house dust, animals.
2. Seasonal– occurs during the flowering period allergenic plants, usually in late spring and summer. During the cold season, the disease does not manifest itself.
3. Contact– occurs upon direct contact with the allergen; the rest of the time the person is absolutely healthy.

Types of diseases depending on the time of occurrence and type of allergen are presented in the table.

Forms of the disease

Allergic conjunctivitis occurs:

1. Spicy– a primary or one-time allergic reaction that occurs during a single or rare contact with an allergen. The disease occurs quickly, and when proper treatment- passes quickly. Signs of conjunctivitis are pronounced, present severe inflammation and swelling. Drug-induced and contact conjunctivitis, as well as infectious conjunctivitis (against the background of ARVI), often occur in this form.
2. Chronic occurs when the patient is in contact with an allergen for a long time or constantly. Symptoms are less pronounced than with acute form, but complete sensitization does not occur. Eye inflammation is often accompanied by skin symptoms(eczema) and bronchial asthma. Allergy to house dust and other household allergens occurs in this form.

If you solve the underlying problem that caused the atypical immune reaction, the allergy itself will go away in most cases.

How to treat conjunctivitis?

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 and identify the allergen. Often, the results of allergy tests contradict obvious allergens, when in a person the seasonal form does not occur exactly during the flowering period of the allergen plant.

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

General principles of treatment

The treatment regimen for allergic conjunctivitis includes:

1. Local agents – antihistamines and anti-inflammatory (eye drops).
2. Prescribing antihistamines.
3. Immunotherapy.
4. Complete limitation of contact with the allergen.

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 limit yourself to local treatment only.

Eye drops that are used to treat allergic conjunctivitis:

1. Mast cell stabilizers (active substance – cromoglycic acid). They help relieve the main symptoms, reduce redness and swelling. The main drugs in this group are Kromohexal, Krom-Allerg, Alomide. These products are well suited for adults, but there are a number of restrictions for children.
2. Histamine receptor blockers (Histimed, Opatanol, Azelastine, Visin Allergy) are contraindicated in children under 12 years of age.
3. For dry eye syndrome, especially in older patients, drops are prescribed to moisturize the mucous membrane (Vizin, Vidisik, Oftogel).
4. To restore the cornea, drops with vitamins are prescribed (Taufon, Khrustalin, Quinax).

If the allergic reaction is very severe and cannot be controlled 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 eye drops based on the nonsteroidal anti-inflammatory substance, diclofenac, are prescribed to relieve inflammation.

Oral antihistamines (tablets and syrups):

To cure conjunctivitis, use antihistamines general action. These medications are necessary if eye inflammation is accompanied by a runny nose, skin or respiratory manifestations. The main drugs are Loratadine, Telfast, Cetrin, etc.

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

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

Video

Allergic conjunctivitis is an inflammation of the mucous membrane of the eye, conjunctiva, caused by any allergen. Provokes disease a considerable amount factors, including those related to ecology.

The presented photo gives a visual idea of ​​allergic conjunctivitis

Allergic conjunctivitis can often appear in both children and adults, and the symptoms of this pathology do not depend on age. The disease can develop either quickly, over 5-30 minutes, or rather slowly, over 1-2 days. The reaction is explained by the strength of the immune system and the concentration of the allergen in the body:

1. swelling of the eyelids (quick and often in both eyes);
2. the appearance of clear mucus;
3. profuse lacrimation;
4. photophobia;
5. feeling of a foreign body in the eye;
6. pain;
7. runny nose and sneezing;
8. itching and burning.

The main thing to remember is that this pathology is not contagious, so there is no need to isolate the patient, but treatment should begin immediately.

Causes

1. contact with a foreign body;
2. intolerance to any drugs;
3. wearing lenses;
4. genetic code, due to which allergic conjunctivitis is transmitted hereditarily;
5. postoperative sutures on the eyes;
6. chemical exposure associated with environmental pollution;
7. poor quality cosmetics;
8. contact with pets.

Classification of types of allergic conjunctivitis

There are three main types:

1. Year-round (most often allergies are caused by household chemicals, dust and wool).
2. Periodic (allergy occurs during a specific period of time, most often in the spring due to flowering).
3. Contact (pathology develops under the influence of provoking elements: solutions for lenses, ointments. In adults, this type can occur due to the use of cosmetics).

In addition to these types, there are others. Thus, an international research center, based on its research, identified 6 main clinical forms, which have a code according to ICD 10 - H10.8 (other types):

1. Chronic year-round.
2. Drug.
3. Vernal keratoconjunctivitis.
4. Atopic keratoconjunctivitis.
5. Hay fever.
6. Large capillary.

We recommend that you familiarize yourself with the following two tables in order to independently, before visiting a doctor, determine the type of conjunctivitis that you or your child has. Here you will find the signs and symptoms of each:

Treatment

To cure diseases, first, it is necessary to identify the allergen. Then exclude it from Everyday life. If you are unable to identify the cause, contact your doctor immediately, who will prescribe local therapy at mild degree diseases, and neglected form- antihistamine treatment and antimicrobial drugs.

Eye drops for allergic conjunctivitis are the most common doctor's prescription.

Treatment by type of allergic conjunctivitis

Let's look at the entire treatment process depending on the type of disease detected.

Chronic

Agistam drops 2-3 times a day or Montevisin 1-2 times a day.

Drug

Eye drops: Loratadine, Citrine and Claritin (intended for oral administration once a day); Spersallerg and Allergodil (2-3 times a day).

Vernal keratoconjunctivitis

Eye drops Cromohexal or Agistam. Sometimes their use is combined with Mexidex, which contains dexamethasone. For changes in the cornea, Alomide is prescribed 2-3 times a day. In case of acute allergic reaction, Allergodil is used simultaneously with Maxidex 2 times a day.

Atopic keratoconjunctivitis

Atopic keratoconjunctivitis is most often a hereditary pathology that requires long-term treatment. Opatanol eye drops are used 2 times a day for a month, in case of exacerbation Polinadim 2 times a day for one week.

Hay fever

Antihistamines for oral administration. Like a drug local action You can use Antistin (or Antazalin) (eye drops 0.5%). This medicine can be used either alone or in combination with Naphazoline (0.05%) or Promoline (2%). At chronic course For hay fever, it is better to take Alomide or Lecrolin, 2 times a day, 3 weeks. In acute cases - Spersallerg or Allergoftal 2-3 times a day.

Large capillary

The most important thing in this case is to completely remove the foreign body from the eye. After this, you can drop Lecromin or Alomide ZhL into your eyes 2 times per knock (until the symptoms completely disappear).

General list of drugs

• Allegra, Clargotine, Lorizan, Claritin - antihistamines for oral administration;
• Ketotifen, Cromohexal - drops that stabilize the eye membrane;
• Histamine receptor blockers intended for persons over twelve years of age - Histimet and Opatanol;
• Eye drops Hi-Krom (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, Oftagel, Vidisik, Optiv;
• If the cornea becomes inflamed, then drops with the Hilo-chest vitamin complex are prescribed;
• In severe cases of pathology, the doctor usually prescribes drugs containing dexamethasone, hydrocortisone or diclofenac.

Traditional methods of treatment

Check out the video, which presents some traditional methods of treating conjunctivitis (including allergic):

1. Tea rose decoction. Take one glass of boiling water and brew 1 teaspoon of rose petals with it. Leave the decoction for about 30 minutes. Afterwards, remove the rose petals using gauze. Use the infusion to wash your eyes for 2 weeks (no more than 10 times a day).
2. Rosehip infusion. Add 10 grams of chopped rose hips to one glass of water. Cook the resulting mass over low heat for about 10-15 minutes. Once the infusion is prepared, it will need to be left for about two days. Then strain the broth and rinse your eyes up to 6 times a day. Full course is 10 days.
3. Dill juice against conjunctivitis. Squeeze a few drops of juice from the dill stems onto a cotton pad and apply it to the inflamed area, leaving it there for about 15 minutes. For better effect repeat this procedure about 4 times a day for one week.
4. Bay leaf. Boil a glass of water (250 ml), then add a few bay leaves to the boiling water. Boil them for 30 minutes and then remove from the broth. Once the medicine has cooled, you can use it to wash your eyes. This should be done about 5 times a day. As a preventative measure, you can also apply lotions at night (keep for about 30 minutes).
5. Cornflower flowers. Brew cornflower petals in the same way as you usually brew tea, namely, pour 5 grams of boiled water into a glass. Take the resulting tincture 25 ml orally before meals. It is recommended to drink no more than 100 ml of infusion per day.
6. Potato. Take 100 grams of potatoes and grate them on a fine grater. Then add the white of one egg to the potatoes. Mix thoroughly and apply the resulting mixture to your eyes as a compress. You need to keep this compress for about 15 minutes and do it up to 5 times a day.
7. Millet against inflammation. Add one tablespoon of millet to 200 milliliters of water. Bring the mixture to a boil and then simmer over low heat for about 20 minutes. Let the resulting infusion cool, and then rinse your eyes with it at night and in the morning.