Eye Allergy

Allergic conjunctivitis

The season that is more common than the permanent type is spring or autumn, which is accompanied by nasal problems and affects both sexes equally, and there are cases of atopy, in which plant pollen is the main cause,
and it is bilateral and similar, and they have tears, redness, and itching, and vision problems at all. They don’t have it, and they also have chemosis, and a feeling of fullness in the eyes and pressure from the inside on the eyelids, a little sensitive to light, and a little blurred vision from time to time, and blackness under the eyes (allergic shiner).

Differential diagnosis

 The symptoms are not the same in both eyes, although not unilaterally, because the infections are one-sided for the first few days, then they become bilateral, and there is almost no itching in the infected, and the lymph nodes behind the ear in the infected and bacterial are so hard in the early morning that the eyes cannot be opened.
Dry eye that feels like a foreign body and redness but does not itch at all.
In the differential diagnosis of the permanent type of dry eye and drug side effects (preservatives) or permanent medicamentosa allergic conjunctivitis, which is the same as seasonal, except in most days of the year.

treatment

Avoiding allergens – not scratching and cold water compresses and keeping drops in the refrigerator and freely using artificial tears and local treatment are more important and effective than oral antihistamines (do not give the old generation that reduces tears)
eye drops of antihistamine from one to It should be used four times a day, and if it is severe, we should add second-generation antihistamine and non-steroidal pain reliever eye drops, and in rare, very severe cases, or in the absence of normal results, we should take the help of Corton eye drops, which if used for a long time, eye pressure every three months. And every year,
no nasal spray enters the tear duct for cataract, and if there is an effect, it is due to systemic absorption.

Antazolin antihistamine drops , vantihistamine
mast cell stabilizer drops, olopatadine
and zadetin, azalastine and alcaftadine, cromolyn-lo doxamide, vandrocromil, vpotestin, and pimirolast mast cell
stabilizer drops.

Atopic keratoconjunctivitis

In the field of atopy, especially atopic dermatitis, nearly half of them will develop or have this disease, that is, even though they had eczema under the age of 5, it will return in the eyelids and corneas, 65% of them also have respiratory allergies at the same time, and even if it is permanent, seasonally or with Some substances get worse and it is type 1 and 4 combs and has a high total AJ, they have a positive skin test.

Chronic and bilateral clinical symptoms
of both genders, equal and over 20 years to 50 years old, the first complaint is very severe itching around the eyes or eyelids, then eye redness and watery discharge, but mostly mucoid (vomiting), photophobia, blurred vision, eye pain, eyelid eczema, conjunctival scarring, and subcapsular cataracts. with vision problems, especially after contact with wool and cat fur and dog hair,
eyelid eczema and leathery, red swelling of the eyelid, ectropion of the eyelid, complete inability to close the eyes and falling off of the end of the eyebrow (madrosis) and lateral canthal wound and the upper eyelid, pale and swollen from the inside The lower eyelid shows papillary hypertrophy in the phrenics and cymbals (adhesion of the two conjunctivae from lead and globe), transtas white dots in the border of the limus, in the field of gelatinous
corneal optelium, which is the main cause of vision problems. And 155 infection with herpes and 15% of keratoconus gives
the involvement of the iris, vividness, and the anterior subcapsular cataract at the bottom of the eye, there is a possibility of retinal detachment, especially after cataract surgery.

The combination treatment
of antihistamine and vasoconstrictor is a good symptom temporarily, but four times a day, Corten drops are necessary for a maximum of 10 days, which is the first line of treatment, but the risk of long-term use is arbitrary. Be careful of lying. NSAIDs are effective in tearing, itching, and photophobia.
Antihistamine drops and mast cell stabilizers are more effective in combination or independently, and we also have cyclosporine and eye tacrolimus drops,
give maximum new generation antihistamines in addition to the above treatments and rarely oral cortin that is a threat to vision or severe eyelid eczema or the lack of plasmaphoresis results immunotherapy with Allergen, blepharitis, staph should also be treated with antibiotics,
don’t forget artificial tears,
acyclovir ointment in herpes attack and tablets for prophylaxis in cases of frequent and chronic recurrence, so the cause of blindness is corneal involvement, which sometimes extends to the border of the transplant, and scarring, secondary infection, and angiogenesis. New is problematic and in the differential diagnosis of contact dermatitis and pemphicoid and infection and blepharitis
 

Vernal keratoconjunctivitis

These also have allergies, almost like the others (about half of the cases) and mostly the onset is under the age of 10 and does not last more than a few years, and until the end of puberty, it is called spring (mostly true), but we also have cases from other seasons or permanent, mostly in the East. It is in middle and west Africa, they don’t have eyelids and eczema

The main clinical symptoms
in boys (under 20 years old) are bilateral and chronic and in hot and dry areas, very severe itching and severe photophobia (both severe) and stringy vomiting and papillae with stone debris, corneal scarring, and vision threat and feeling of a foreign body, vptosis, blepharospasm, and tarsal papillae with clear papillae debris. is and eyelids Avoid
vernal treatment
even if the skin test is negative and immunotherapy gives the least results, unless it has an effect on their breathing. Do not give olapatadine and azilastine and vectotifen.
New generation oral antihistamines and non-steroidal painkillers and finally a short course of oral corten for vision problems, tacrolimus drops and cyclosporine are also effective, drops but preferably
antibiotic eye cream with corten if the cornea is ulcerated and referral to an ophthalmologist for surgery Cornea or cryosurgery of stones or cornea transplant.
We also have lactoba silus probiotic eye drops and they are effective

Giant papillary conjunctivitis

 One of the side effects of using contact lenses, whether hard, soft, or rigid, and especially if you wear contact lenses every day, especially at night while sleeping, and up to 20% of contact lens wearers are infected, which starts several months after wearing the lenses,
a little more than usual in terms of allergies. Respiratory has a background role, but repeated stimulation with every blink eventually becomes a problem, the thickness of the conjunctiva and seeing the large papilla, and after manipulation of the eyes with a two-sided (athrogenic) prosthesis of both genders, it occurs at any time, low mucoid secretion and low itching. The problem of vision and sensation of foreign body and contact lens intolerance

Clinical symptoms
after removing the lens, itchiness worsens, burning redness, morning sickness and photophobia, blurred vision, accumulation of protein on the lens, or displacement and disturbance of the lens, or… and in the end, dry eyes are added.

The treatment
of stopping the use of contact lenses or a significant reduction and combined anti-allergenic and mast cell stabilizing drops and even corten drops