Allergic Conjunctivitis Management: Update on Ophthalmic Solutions.

PURPOSE OF REVIEW: The aim of this review, is to present an updated revision of topical management of SAC and PAC, based on the available scientific evidence and focused on the impact of ophthalmic solution formulations on eye surface. RECENT FINDINGS: Physicians treating ocular allergy should be aware of tear film and tear film disruption in SAC and PAC, and how eye drop composition and additives affect the physiology of the allergic eye. Seasonal and perennial allergic conjunctivitis (SAC and PAC) are the most frequent causes of ocular allergy (OA), and both conditions are underdiagnosed and undertreated. SAC and PAC are immunoglobulin E (IgE)-mediated hypersensitivity reactions. The additional tear film disruption caused by the release of inflammatory mediators increases and exacerbates the impact of signs and symptoms and may trigger damage of the ocular surface. Comorbidities are frequent, and dry eye disease in particular must be considered. Clinical guidelines for the management of SAC and PAC recommend topical therapy with antihistamines, mast cells stabilizers or dualaction agents as first-line treatment, but care should be taken, as many medications contain other compounds that may contribute to ocular surface damage.

[Surgery in severe forms of allergic eye diseases]. / Postepowanie chirurgiczne w ciezkich postaciach alergii oczu.

Surgical treatment is performed in allergic eye diseases when drug treatment fails and the disease leads to conjunctival, corneal or palpebral disorders. Surgery procedures can be divided into early (surgery on palpebral conjunctiva, surgery on cornea) and late ones (decreasing tears outflow, plastic surgery on eyelids, cul de sac).

[Clinical picture, diagnosis and therapy of allergic eye diseases]. / Obraz kliniczny, diagnostyka i leczenie alergicznych chorób oczu.

Ocular allergic disorders can be a component of systemic or local allergies. The importance of ocular allergy results from its incidence rather than from its severity, however, some of them are vision-threatening. The majority of ocular allergies affect the conjunctiva, eyelids and sometimes cornea that is exposed to the environment and is the place of interaction between allergens and immunocompetent cells. Different types of allergic disorders in the eye may have similar signs and symptoms, but each has its own pathognomonic characteristics, which help to diagnose, differentiate and choose the most suitable therapy. Ocular allergic diseases are classified into six categories: SAC, PAC, VKC, AKC, GPC and ConBC. In 2001 EAACI suggested new classification, also of allergic conjunctivitis, into IgE-mediated and non-IgE-mediated conjunctivitis. IgE-mediated conjunctivitis may be divided into intermittent and persistent conjunctivitis. Persistent allergic conjunctivitis is classified into vernal and atopic keratoconjunctivitis. Conjunctivitis contact allergy is a non-IgE form of allergic conjunctivitis. Currently available medications provide safe and effective management of most cases of ocular allergy. Drugs used in the treatment of ocular allergic disorders include mast cell stabilizers, antihistamines, steroids, NSAID's, artificial tears and others.