Allergic conjunctivitis: prevention
In addition to being used for rapid relief, topical and systemic antihistamines are also used for preventative treatment
Posted: 27 April 2016
If you’ve missed yesterday’s episode of this week’s feature on conjunctivitis, click here.
Writer: Asha Fowells
Allergic conjunctivitis and dry eye caused by hay fever can cause major discomfort for patients during the summer months.
Antihistamines – both topical and systemic – are used for preventative treatment in addition to being employed for rapid relief, but mast cell stabilisers are also an option. Sodium cromoglicate, nedocromil sodium and lodoxamide are all available in eye drop form and are effective at controlling symptoms over a long period of time, but the need to instil drops four times a day is offputting for some.
This class of drug can be used in conjunction with antihistamines, which can be particularly valuable when waiting for a mast cell stabiliser to take effect and for those who do not maintain control on monotherapy. If symptoms persist, the mast cell stabiliser and/or antihistamine may be switched for an alternative within the same drug class, though it is also prudent to reconsider the diagnosis. Resistant cases require referral to an immunologist, and may involve specialist management options such as corticosteroids, immunosuppressants and immunotherapy.
Red flag symptoms
Certain eye symptoms can be a sign that something more serious is going on, and patients should be referred if they complain about:
• pain, rather than discomfort
• disturbed vision
• marked redness affecting one or both eyes
• fixed and dilated pupil(s)
• headache and vomiting
• any sign of ulceration of the surface of the eye.
Join us tomorrow for the fourth episode of this week’d feature on allergic conjunctivitis as we’ll be discussing dry eye syndrome