Eye allergy

 The season that is more common than the permanent type and spring or autumn, which is accompanied by nasal problems and affects both sexes equally, is the case of atopy, where plant pollen is the main cause.
It is bilateral and itchy, and they have tears, redness, and itching, and they have no vision problems at all, and they also have coma, 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, and occasional blackness under the eyes (allergic shiner).

The symptoms are not the same in both eyes, of course, not on one side, because the infections are unilateral for the first few days, then they become bilateral, and there is almost no itching in the infection, and the lymph nodes behind the ear in the bacterial infection are so tight in the early morning that the eye cannot be opened. Dryness The eye feels like a foreign body and red, but it doesn’t 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.

• Avoiding allergens  
• Not scratching and cold water compresses and keeping the drops in the refrigerator and freely using artificial tears and local treatment are more important and effective than oral antihistamines (don’t give the old generation that reduces tears)
• Antihistamine eye drops should be used from one to four times a day, and if it is severe, we should add second-generation antihistamine and non-steroidal pain reliever, and in rare, very severe cases, or the lack of normal results, we should use coronet eye drops. Eye pressure month and year for cataract, no nasal spray enters the tear duct, and if there is an effect, it is due to systemic absorption.
  Antihistamine drops
• Antazoline
• Stabilizing mast cell drops and antihistamine
• Olopatadine and Zadetin, Azalastine and Alcaftadine
• Stabilizing mast cell drops
• Cromolyn / Le Doxamide Vandrocromil Vepo Tustin Vepimirol

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 5 years of age, 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, it gets worse seasonally or with certain substances. 1 and 4 are combust and have a high total AJ, they have a positive skin test.

Clinical signs

Chronic and bilateral, both genders equal and above 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 scar, and subcapsular cataract with special vision problems. After contact with cat fur and dog hair, eyelid eczema and leathery and red swelling of the eyelid, ectropion of the eyelid and complete inability to close the eyes, falling off the end of the eyebrow (madrosis), lateral canthal wound, and the upper eyelid is swollen and pale from the inside, and papillary hypertrophy is seen in the lower eyelid. In the phrenics and symble-feron (adhesion of two conjunctivae from Lead and Globe), the white dots of the transatas in the border of the limus in the field of the corneal gelatinosapetlium becomes a dot, which is the main cause of the vision problem. Iris vividness and anterior subcapsular cataracts and at the bottom of the eye, there is a possibility of retinal detachment, especially after cataract surgery.

The combination 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 per capita
.
Antihistamines and mast cell stabilizers are more effective in combination or independently, and we also have ophthalmic cyclosporine and tacrolimus,
we should give maximum new generation antihistamines, in addition to the above treatments, and rarely, oral corten 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 repeated and chronic recurrence of herpes,
the cause of blindness is corneal involvement, which sometimes extends to the border of the transplant, scarring, secondary infection, and new angiogenesis. It is pathogenic
 and in the differential diagnosis of contact dermatitis and pemphicoid and infection and blepharitis.

These also have allergies, almost as much as 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 adulthood, it is spring asthma (mostly true), but we also have cases of other seasons or permanent ones, mostly in the East. It is in middle and west Africa, they don’t have eyelids and eczema.

Clinical signs

Mainly in boys (under 20 years old), bilateral and chronic and in hot and dry areas, very severe itching and severe photophobia (both severe) and stringy vomiting and papillae of stone debris, corneal scarring, and threat to vision and foreign body sensation, vptosis and blepharospasm, and in the tarsal, stone debris The papilla is clear and the eyelid. The eyelashes are not involved at all, the skin is healthy, and they do not have blepharism. Trantas dot white accumulation can be seen in the limbus, and they do not have iris involvement, vividness, or cataracts.

Abstinence, even if the skin test is negative, and immunotherapy gives the least results, unless it has an effect on their breathing, cold water compresses, and migration to cool and slightly dry areas, or good ventilation at home, in
recurrences and seasonal attacks, cortenate up to 8 times for 8 days, but in the chronic phase, do not give cortenate, olapatadine, and Oral azilastine and ketotifen,
new generation antihistamines and non-steroid analgesics, and finally, a short course of oral corticosteroids for vision problems,
tacrolimus and cyclosporine drops are also effective,
drops, but preferably, antibiotic eye cream with corticosteroids, if the cornea is injured, and referral to an ophthalmologist for surgery Cornea or cryosurgery of stones or cornea transplant.
We also have lactoba silus eye drop probiotic and it is effective.

 One of the side effects of using contact lenses, whether hard, soft, or rigid, and especially if you wear them every day and a lot, especially at night when you sleep, up to 20% of contact lens wearers get infected, which starts several months after wearing the lenses,
a little more than usual. Respiratory allergy plays a background role, but frequent irritation 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 prosthesis (athrogenic) of both genders and occurs at any time, low mucoid secretion. and low itching, lack of vision problems and feeling of foreign bodies, and contact lens intolerance

Clinical signs

After removing the lens, itching gets worse, burning redness, morning sickness and photophobia, sometimes blurred vision, accumulation of protein on the lens, or displacement and disturbance of the lens, or… and in the end, dry eyes are added.

Cessation of contact lens use or significant reduction and combined anti-allergenic and mast cell stabilizing drops and even corten drops.