RESUMO
The purpose of present study is to differentiate between allergic and environment related chronic conjunctivitis on the basis of the measurement of Immunoglobulin E levels in tears and serum. Forty specimens of tear and serum from drivers were sent for Immunoglobulin E assay. Samples were divided clinically into two categories. Group A included twenty four samples [60%] who were clinically chronic conjunctivitis [chronic conjunctivitis is defined here as conjunctival inflammation of period greater than a year, remissions and relapses, with no obvious cause/ophthalmic disease and patient on or off topical treatment] and group B included sixteen samples [40%], of clinically normal [normal having no ocular symptoms] [control]. Length of service as driver, hours of daytime driving, primary ocular symptom, history of atopy or allergy, tear film break up time [BUT] were emphasized at history and ophthalmic examination. None of the subjects had clinically obvious cause of conjunctivitis. The group-A [patients] were randomly treated with fluoromethalone and artificial tears. The patients were required to record the subjective improvement. Tear Immunoglobulin E values were normal [1-2ku/L] in both A and B groups. Serum Immunoglobulin E was elevated significantly in twenty samples [84%] in group A [clinically chronic conjunctivitis] whereas, it was elevated in six samples [38%] in group B [clinically normal group]. Serum Immunoglobulin E levels were normal in 16% and 62% of group A and B respectively. The recovery was significant with fluoromethalone use at 4 weeks as compared to that of artificial tears but at 8 weeks and 12 weeks, there was no significant difference between artificial tears group and fluoromethalone group. Serum Immunoglobulin E and tear Immunoglobulin E levels can be used to investigate the cases of chronic conjunctivitis as normalcy of tear Immunoglobulin E reasonably excludes local allergy. This enables the clinician to resort to tear replacement therapy rather thanprescribing steroids with accompanying side effects. However, there is no correlation of serum Immunoglobulin E with tear Immunoglobulin E