Allergic conjunctivitis of the eye treatment in adults. Allergic conjunctivitis: treatment, symptoms, photos, in children, causes. However, in advanced cases or with inadequate use of drugs, complications may develop.

Allergic conjunctivitis is an inflammation of the mucous membrane of the eye, the conjunctiva, caused by an allergen. The disease provokes a considerable number of factors, including those related to the environment.

The presented photo gives a visual representation of allergic conjunctivitis.

Allergic conjunctivitis can often appear in both children and adults, and the symptoms of this pathology do not depend on age. The disease can develop both quickly, during 5-30 minutes, and rather slowly, within 1-2 days. The reaction is explained by the strength of immunity and the concentration of the allergen in the body:

1. swelling of the eyelids (rapid and often in both eyes);
2. the appearance of clear mucus;
3. profuse lacrimation;
4. photophobia;
5. feeling of a foreign body in the eye;
6. cut;
7. runny nose and sneezing;
8. scratching and burning.

The main thing to remember is that this pathology is not contagious, so it is not necessary to isolate the patient, but treatment should be started immediately.

The reasons

1. contact with a foreign body;
2. intolerance to any drugs;
3. wearing lenses;
4. the genetic code due to which allergic conjunctivitis is inherited;
5. postoperative stitches on the eyes;
6. chemical impact associated with environmental pollution;
7. low-quality cosmetics;
8. contact with pets.

Classification of types of allergic conjunctivitis

There are three main types:

1. Year-round (most often allergies are triggered by household chemicals, dust and wool).
2. Periodic (allergy occurs in a specific period of time, most often in the spring due to flowering).
3. Contact (pathology develops under the influence of provocative elements: solutions for lenses, ointments. In adults, this type may occur due to the use of cosmetics).

In addition to these types, there are others. Thus, an international research center, based on its research, identified 6 main clinical forms that have an ICD code 10 - H10.8 (other types):

1. Chronic perennial.
2. Drug.
3. Spring keratoconjunctivitis.
4. Atopic keratoconjunctivitis.
5. Pollinous.
6. Large capillary.

We recommend that you familiarize yourself with the following two tables in order to independently, before visiting a doctor, determine the type of conjunctivitis that you or your child has fallen ill with. Here you will find the signs and symptoms of each:

Treatment

To cure diseases, firstly, it is necessary to determine the allergen. Then eliminate it from everyday life. If you are unable to identify the cause, immediately consult a doctor who will prescribe local therapy for mild disease, and for advanced form - antihistamine treatment and antimicrobials.

Eye drops for allergic conjunctivitis are the most common doctor's prescription.

Treatment by type of allergic conjunctivitis

Let's analyze the whole treatment process depending on the type of disease detected.

Chronic

Drops Agistam 2-3 times a day or Montevizin 1-2 times a day.

Drug

Eye drops: Loratadine, Citrine and Claritin (intended for oral administration once a day); Spersallerg and Allergodil (2-3 times a day).

Spring keratoconjunctivitis

Eye drops Kromoheksal or Agistam. Sometimes their reception is combined with Mexidex, which includes dexamethasone. With changes in the cornea, Alomid is prescribed 2-3 times a day. In case of an acute allergic reaction, Allergodil is used simultaneously with Maxidex 2 times a day.

Atopic keratoconjunctivitis

Atopic keratoconjunctivitis is most often a hereditary pathology that requires long-term treatment. Opatanol eye drops are used 2 times a day for a month, with exacerbation Polinadim 2 times a day for one week.

pollinous

Antihistamine medicines for oral administration. Antistin (or Antazalin) (eye drops 0.5%) can be used as a local drug. This medicine can be used alone or in combination with Naphazoline (0.05%) or Promoline (2%). In the chronic course of hay fever, it is better to take Alomid or Lekrolin, 2 times a day, 3 weeks. In acute - Spersallerg or Allergoftal 2-3 times a day.

Large capillary

The most important thing in this case is to completely remove the foreign body from the eye. After that, Lecromin or Alomid ZL can be instilled into the eyes 2 times per knock (until the symptoms completely disappear).

General list of drugs

• Allegra, Klargotin, Lorizan, Claritin - antihistamine drugs for oral administration;
• Ketotifen, Kromoheksal - drops that stabilize the eye membrane;
• Histamine receptor blockers intended for persons over twelve years of age - Histimet and Opatanol;
• Hi-Krom eye drops (children over four years old), Alomid (over two years old), Lekrolin, Ledoxamide and Krom-Allerg are used to stabilize mast cells, which help prevent the production of histamine;
• With dry eyes, drugs are prescribed that replace the lacrimal fluid: Oksial, Alcon Pharmaceuticals, Systein Gel, Systein Balance, Oftagel, Vidisik, Optiv;
• If the cornea becomes inflamed, then drops with the Hilo-chest of vitamins are prescribed;
• In a severe form of pathology, the doctor, as a rule, prescribes drugs containing dexamethasone, hydrocortisone, or diclofenac.

Folk methods of treatment

Check out the video, which presents some folk methods for the treatment of conjunctivitis (including allergic):

1. Decoction of tea rose. Take one cup of boiling water and brew 1 teaspoon of rose petals with it. Leave the decoction for about 30 minutes. After, remove the rose petals with cheesecloth. Use the infusion to wash the eyes for 2 weeks (no more than 10 times a day).
2. Rosehip infusion. To one glass of water, add 10 grams of chopped rose hips. Cook the resulting mass over low heat for about 10-15 minutes. How to prepare the infusion, it will need to be left for about two days. Then strain the decoction and rinse your eyes up to 6 times a day. The full course is 10 days.
3. Dill juice against conjunctivitis. Squeeze a few drops of dill juice on a cotton pad and apply it to the inflamed area, leaving it there for about 15 minutes. For best results, repeat this procedure about 4 times a day for one week.
4. Bay leaf. Boil a glass of water (250 ml), then add a few bay leaves to the boiling water. Boil them for 30 minutes, and then remove from the broth. Once the medicine has cooled, you can use it to wash your eyes. You need to do this about 5 times a day. As a preventive measure, you can also make lotions at night (keep out for about 30 minutes).
5. Cornflower flowers. Brew cornflower petals in the same way as you usually brew tea, namely, pour 5 grams in a glass of boiled water. Take the resulting tincture inside 25 ml before meals. It is recommended to drink no more than 100 ml of infusion per day.
6. Potatoes. Take 100 g of potatoes and grate it on a fine grater. Then add one egg white to the potatoes. Mix thoroughly and apply the resulting mass to the eyes in the form of a compress. You need to keep such a compress for about 15 minutes and do it up to 5 times a day.
7. Millet against inflammation. In 200 milliliters of water, add one tablespoon of millet. Bring the mass to a boil, and then simmer for about 20 minutes. Let the resulting infusion cool, and then rinse your eyes with them at night and in the morning.

Every person encounters an allergic reaction at least once in a lifetime, and according to statistics, every third person has a stable allergy and needs pharmacological therapy. In addition to skin rashes, it can also manifest itself as pathologies of the organs of vision - allergic conjunctivitis.

In medicine, allergic conjunctivitis refers to an inflammatory process in the conjunctiva, the membrane covering the white part of the eye. The manifestation of the disease is explained by the release of histamine by mast cells, which is a stimulus for the expansion of blood vessels and increased secretion of the eyes. An allergic reaction occurs as an immune response to the appearance of a provoking factor in the body.

Forms of an allergic type of disease

The disease occurs in three forms:

• chronic;
• acute;
• subacute.

In most cases, allergic conjunctivitis is accompanied by other unpleasant allergy symptoms:

• rhinitis;
• bronchial asthma;
• atopic dermatitis.

The disease can be both seasonal and permanent.

Causes

At the heart of any allergy is a person's immune response to the allergen. In the case of allergic conjunctivitis, it most often occurs in people prone to hay fever and bronchial asthma.

The eyes, due to their structure, are easily amenable to all environmental influences and allergens from it, the symptoms of pathology develop almost immediately after exposure to a provoking factor.

The most common allergens that provoke the body's immune response are:

• plant pollen;
• particles of skin and saliva of animals;
• cosmetics;
• drugs used in dermatology;
• polluted air;
• dust mites;
• eye drops;
• contact lenses and solutions for them.

In children

It is extremely rare to meet allergic manifestations on the organs of vision in young children. The first manifestations of the disease, as a rule, are observed after an allergy in the form of atopic dermatitis or diathesis.

For children, the following forms of the disease are characteristic:

• pollinous,
• drug,
• spring, usually after 14 years.

In adults

In adults, all forms of conjunctivitis can manifest themselves, both in acute and in chronic form.

The large-papillary form of the pathology develops, as a rule, only in adults, as it occurs due to the wearing of contact lenses and eye prostheses, that is, prolonged contact of the mucous membrane with a foreign body, sutures after keratoplasty or cataract extraction can also become a cause.

"Spring conjunctivitis" is also considered a disease of adults, as it most often develops after puberty. The manifestation of this pathology has been little studied, the pathology worsens from March-April and subsides in November. Most likely, the occurrence of the disease is associated with the work of the endocrine system.

In elderly people

Elderly women and men can develop any of the forms of pathology, but atopic keratoconjunctivitis does not appear until 40-45 years of age. This form does not depend on the season, it is characterized by inflammation not only of the mucous membrane of the eye, but also of the cornea, lens and skin of the eyelids. It is often accompanied by secondary infections - corneal ulcer, fungal and herpetic keratitis.

Symptoms

Pathology in most cases manifests itself immediately in both eyes, the symptoms develop gradually over 24 to 48 hours after contact with the allergen. Symptoms appear:

• severe itching;
• burning under the eyelids;
• lacrimation;
• puffiness;
• photophobia;
• the appearance of small follicles on the mucous membrane;
• discharge from the eyes from clear to purulent;
• the whites of the eyes turn red;
• dryness and feeling of sand in the eyes;
• eye fatigue;
• pain when moving the eyeball;
• rhinitis.

Quincke's edema

In children, a secondary infection often joins the disease, due to the fact that they constantly scratch their eyes, while their hands are not always clean.

There are other symptoms that manifest themselves in a specific form of the disease:

• for spring and atopic keratoconjunctivitis, damage to the cornea of ​​\u200b\u200bthe eye is also characteristic;
• in the dosage form, pathology affects the skin of the eyelids, cornea, retina, choroids and optic nerve;
• symptoms of chronic allergic conjunctivitis are mild - periodic itching and burning.

In severe form of drug conjunctivitis, anaphylactic shock, Quincke's edema, and acute urticaria may occur.

Diagnostics

When the first symptoms of the disease appear, you should contact an ophthalmologist, and you will also need to consult an immunologist-allergist.

The diagnostic examination will include the following manipulations:

• examination of the conjunctiva;
• microscopic studies;
• conjunctival scraping;
• elimination test;
• exposure test;
• bacteriological smear.

In the chronic form of the disease, an additional study of eyelashes for demodex is carried out.

Additionally, the patient may undergo additional tests:

• application;
• scarifying;
• electrophoretic;
• provocative;
• prick test.

If you suspect it is an allergic form of the disease, in no case should you self-medicate, since an incorrectly selected drug can only aggravate the pathology

Treatment

Therapy of the disease begins only after the diagnosis shows that conjunctivitis is precisely of an allergic nature. The most important thing in the treatment of allergic conjunctivitis is the exclusion of the provoking factor, however, very often it is impossible to do this.

With a mild form of the disease, local therapy with antihistamines is performed, in addition, the doctor may prescribe immunotherapy and antimicrobial agents.

Medications

For the treatment of the disease, drugs are prescribed for oral administration in the form of drops, syrups or tablets:

• Loratodin;
• Zyrtec;
• Cetrin;
• L-cet;
• Femistil;
• Diazolin.

The drugs are used from 10 days to 21 days, as a rule, at a dosage of 1 time per day, sometimes the drug is taken for up to 3 months.

An allergy to flowering trees is accompanied by terrible itching and pain in my eyes, I am treated with L-cet, unpleasant symptoms in the eyes disappear along with other symptoms.

Roman, 35 years old.

Only antihistamines in tablets cannot cope with pathology, the use of local therapy is mandatory. The following eye drops may be prescribed as topical therapy:

• membrane stabilizing - Lekrolin, Zaditen;
• histamine receptor blockers - Opatanol, Histimet, Azelastine;
• mast cell stabilizers - Hi-krom, Lekrolin, Alomid;
• with symptoms of dry eye as tear substitutes - Inoksa, Oftolik, Vezin;
• with corneal lesions, drops with vitamins - Taufon, Quinax, Catalin.

The duration of the course and the dosage of the drug in each case is individual, usually the reception lasts at least 10 days.

Non-steroidal drops with Diclofenac can also be used to relieve inflammation, which also have a good analgesic effect.

Itching and pain in the eyes occurs when using any cosmetics for the face, so anti-allergic drops are always in the medicine cabinet. Recently I have been using Diclofenac drops, they relieve inflammation well and quickly anesthetize, the itching disappears.

Rima, 32 years old.

In complex forms of pathology, drops or eye ointments with corticosteroids - dexamethasone or hydrocortisone are additionally prescribed, since hormone therapy can harm a person, you should carefully observe the dosage and not abruptly interrupt treatment.

I first encountered allergic conjunctivitis at school, since then I have been constantly treated for 15 years, the pathology is especially aggravated in May-July, only dexamethasone ointment helps.

Andrey, 25 years old.

If the patient has constant exacerbations of the disease, then the doctor selects individual immune therapy.

When choosing treatment for children or pregnant women, one should be careful, since most drugs are prohibited to them, but all such drugs exist. For example, drops with ectoine can be used as a membrane-stabilizing drug. This substance allows you to cope with the manifestation of allergies and has no side effects, so it can be used for a long time.

Allergic conjunctivitis manifested itself after buying a new mascara, it was treated for about two weeks - Cetrin tablets and Ectoin drops, I am very pleased with the latter, since the itching began to disappear after the second application.

Larisa, 40 years old.

Ophthalmologists also respond positively to drops - according to their recommendations, drops can be used both in combination with other means, and in monotherapy.

Folk remedies

Unfortunately, folk recipes cannot cope with this pathology on their own. They can be used in parallel with drug treatment, but after consultation with your doctor. You can use the following recipes:

1. Aloe juice - it is necessary to moisten a cotton swab and put it in the form of a compress for 10 minutes on the eyes.
2. Honey - dilute 1 tbsp. spoon in boiled water (100-150 ml), prepared liquid, instill eyes 4-5 times a day,
3. Eyebright -1 tbsp. pour a spoonful of dry grass with water and boil for 15 minutes, cool, filter - rinse your eyes up to 3 times a day,
4. Rosehip - helps well with purulent discharge, 2 tbsp. spoons of berries pour 0.5 liters of water and infuse for half an hour. In the cooled broth, moisten cotton swabs and put them on your eyes for 15 minutes. Repeat the procedure at least 4 times a day.

They can alleviate the symptoms of pathology, but to cope with it on their own, no.

Other Methods

The most radical method of treatment is allergen-specific therapy. It is used if there are no contraindications, but a causally significant allergen has been identified. The therapy consists in administering small doses of the allergen to the patient, gradually increasing the concentration, this therapy is aimed at developing addiction to the allergen and the symptoms are noticeably reduced or disappear altogether.

Prevention

Unfortunately, there are no specific preventive measures to prevent the development of pathology.

Secondary prevention is aimed at minimizing the possibility of exacerbation of the disease, for this, if possible, allergens are excluded.

To exclude the appearance of a large-capillary form, you should buy only certified contact lenses and solutions and containers for them, the same applies to various eye cosmetics.

Patients prone to this type of allergy should visit an allergist and an ophthalmologist at least once a year.

It is difficult to find a person who has not experienced at least once an atypical reaction to food, dust, wool lint, flowering plants, cosmetics, perfumes, and even to natural factors familiar from childhood, such as cold and sun.

Allergy manifestations are diagnosed on the skin, digestive and respiratory organs. The most expressive symptoms are allergic rhinitis and conjunctivitis. At the present stage, immunology is not able to act on the cause of an inadequate response of human immunity. Drugs can only slightly alleviate negative symptoms, including the symptoms of allergic conjunctivitis.

Characteristics of the pathology:

Allergic conjunctivitis is a reaction of the immune system to the introduction into the human body of a factor that provokes an immune response.

Symptoms of the disease appear seasonally or continuously. There are acute, subacute and chronic course of the pathology.

Basic principles of treatment:

Elimination of the provoking factor;

The use of eye drops with antihistamine properties;

Simultaneous use of immunomodulators.

Types of allergic conjunctivitis:

pollinous,

Drug,

Chronic,

Spring,

Atopic keratoconjunctivitis (diagnosed mainly in adults).

Symptoms of allergic conjunctivitis in children

The higher the concentration of an agent foreign to the immune system, the more pronounced the symptoms of the pathology. An equally important factor is the individual reaction of the body to allergens. This implies a difference in the time of appearance of the first symptoms - from half an hour to 1-2 days.

Disease manifestations:

Simultaneously with conjunctivitis, allergic rhinitis is often diagnosed, its symptoms are a runny nose, the release of a large amount of mucus, which further irritates the mucous membrane of the eye.

There is a strong itching, burning sensation in the eyelids, lacrimation. The intensity of itching is so high that the patient constantly experiences discomfort.

In an attempt to soothe itching, children tend to scratch their eyes. At the same time, pathogenic microorganisms enter the mucosa, which further aggravates the course of the disease. The complex therapy of allergic conjunctivitis necessarily includes drops and ointments with antibacterial action.

On the mucous membrane of the eye, the appearance of a viscous, transparent, mucous discharge is noted. The addition of a bacterial component leads to the appearance of pus in the corners of the eyes, from which the eyelids stick together after sleep.

An additional symptom is the appearance of small follicles or papillae on the mucous membrane of the eye.

A decrease in the amount of tears produced, which normally bathes the mucous membrane of the eye, leads to a child feeling its dryness, a feeling that sand has been poured into the eyes, as well as photophobia.

Partial atrophy of the conjunctiva brings pain and discomfort when moving the eyeball.

Eyes get tired quickly, they turn red.

Types of allergic conjunctivitis and provoking factors:

year-round - permanent allergens: house dust, feathers of decorative birds, pet hair, household chemicals;

periodic - allergens that appear during the flowering season of plants;

contact - cosmetics, solutions for contact lenses.

To prescribe an effective treatment, it is necessary to eliminate the effect of the allergen, that is, close cooperation between the ophthalmologist, dermatologist and allergist is required.

Types and symptoms of allergic conjunctivitis

After the allergen is excluded from the patient's environment, the doctor prescribes local or systemic therapy for allergic manifestations. In addition, immunotherapy is prescribed, the symptoms of the disease are relieved, including the use of antimicrobial drugs.

Tablets and drops from allergic conjunctivitis:

Drugs with antihistamine action - Loratidin, Zyrtec, Claritin, Telfast, Tsetrin. Part of the funds is not used to treat children.

Drops that stabilize the state of the cell membrane - Zaditen (Ketotifen), Lekrolin (Kromoheksal).

Eye drops that block histamine receptors - Allergodill, Opatanol, Vizin Allergy, Histimet.

To block the production of histamine, eye drops with mast cell stabilizers are used - Lekrolin, Krom-allerg, Lodoxamide (not used in children under 2 years old), Hi-krom (contraindicated for children under 4 years old).

To correct the production of tears (“dry eye syndrome”), which is absent for various reasons, tear substitutes are used: Oksial, Oftogel, Sistein, Defislez, Oftolik, Vizin pure tear, Inoksa, Vidisik, natural tear. This effect is observed in elderly patients with allergic conjunctivitis. Joining the process of inflammation and the cornea requires the appointment of eye drops with vitamins and dexpanthenol: Quinax, Khrustalin, Katahrom, Catalin, Ujala, Emoksipin, Vita-Yodurol.

Difficult forms of allergic conjunctivitis are stopped by eye drops with corticosteroids, most often they include hydrocortisone or dexamethasone. Hormonal treatment can lead to unpredictable complications for the body, so such drugs require a balanced approach, accurate dosage, and gradual withdrawal.

Eye drops with a non-steroidal component and anti-inflammatory effect contain Diclofenac.

With frequent recurrences of allergic conjunctivitis, specific immunotherapy is performed.

Treatment of seasonal conjunctivitis (hay fever)

Children and adults who react sharply to the flowering of flowers, trees, cereals and weeds feel a sharp onset of hay fever - severe itching, lacrimation, burning of the eyelids, photophobia.

Treatment of manifestations of the disease:

For quick relief of symptoms, Allergodil or Spersallerg are instilled. In most cases, relief comes after a quarter of an hour. Spersallerg contains a vasoconstrictor component.

The frequency of use in the acute period is 3-4 times a day, after a few days - 2 times a day. With severe manifestations, oral antihistamines are used.

Subacute or acute course of the disease is stopped with eye drops of Cromohexal or Alomid, applying them 3-4 times a day.

Treatment of chronic allergic conjunctivitis

It develops with a tendency to allergic reactions, the course of the disease depends on the individual characteristics of the organism. The symptoms of the disease are usually somewhat smoothed, although itching, burning of the eyelids, and tearing are always diagnosed.

The causes of this form of the disease are allergies to food, wool, dust, household chemicals, skin care, body and hair.

Treatment is carried out with drops with Dexamethasone, Spersallerg (1-2 times a day), Alomid, Kromheksal (2-3 times a day).

The disease is most common in children of older preschool age, and in boys more often than in girls. It becomes chronic, affecting both eyes at once. A characteristic symptom is the appearance of a small proliferation of cartilaginous tissue of the eyelids in the form of small papillae. In rare cases, the growths are so large that the eyelid is deformed. These manifestations are seasonal, they are more pronounced in spring, somewhat smoothed out in autumn.

Treatment:

Eye drops Alomid, Kromheksal, Maxidex (contain Dexamethasone) are effective.

With changes in the cornea, the appearance of erosions, infiltrates, keratitis on it, instillations with Alomid are used, using the drug 2-3 times a day.

Acute manifestations are stopped by Allergodil in combination with Maxidex drops.

The complex treatment regimen includes antihistamines (Cetrin, Zodak, Claritin), administered orally, and Histoglobulin injections.

Treatment of allergic reactions in infectious conjunctivitis

According to research in ophthalmology, the relationship between allergies and any bacterial or viral conjunctivitis has been revealed, regardless of the factors that caused them. It is believed that in the clinical picture of fungal, herpetic, chlamydial, adenoviral conjunctivitis, allergy manifestations also occur. Its role is especially great in the course of chronic conjunctivitis.

Antibiotics, antiviral agents, antiseptics, which are part of the complex therapy of a bacterial or viral form of pathology, create a significant toxic effect on the body, provoke its immune response.

Based on this, in the treatment of these types of mucosal inflammation, eye drops with anti-allergic properties are always prescribed.

It is advisable to treat the acute course of the disease with drops of Allergodil, Spersallerg, chronic - Alomid, Kromheksal (2 times a day).

Most drugs are chemical compounds that are alien to the tissues and cells of the human body. His immune system reacts to the invasion of foreign agents in the only way it can. The proportion of drug allergies among all types of conjunctivitis is about 30%. It is provoked not only by tablets, but also by ointments, gels and creams for topical use.

Even drugs for the treatment of ophthalmic pathologies can cause drug conjunctivitis. It manifests itself on the skin of the eyelids, on the conjunctiva, on the cornea of ​​​​the eye. The most common cause of this reaction is the preservative of eye drops, the reaction to it can be delayed and appear 2-4 weeks after the penetration of the agent into the immune system.

At the beginning of treatment, contact with the allergen is limited, the doctor prescribes an oral antihistamine - Cetrin, Claritin, Loratidine (1 time per day), eye drops Spersallerg, Allergodil in the acute course of the process, or Alomid, Kromheksal in the chronic form of drug conjunctivitis.

Greetings, dear readers and readers! Allergic conjunctivitis is a condition in which the connective membrane of the eye becomes inflamed.

In many cases, this eye disease develops in parallel with other allergic diseases, which makes it difficult to diagnose it at the initial stages.

Allergic conjunctivitis in adults can occur as a result of the reaction of the eyes to wearing contact lenses, taking certain medications, allergies to animals, etc. The peculiarity of this unpleasant form of pathology is that both eyes are affected at once.

Today I will tell you about what methods of treatment of this disease offers modern ophthalmology.

What factors provoke the development of allergic conjunctivitis and how does the disease manifest itself?

There are the following factors that provoke the appearance of conjunctivitis of allergic origin:

1. Household. This very first group of allergens includes household well-known dust, dust mites, feathers, down, etc.
2. epidermal. Wool of various animals, bird feathers, food for fish.
3. Pollen. The strongest allergens are the pollen of plants whose flowering begins in spring, and poplar fluff.
4. Chemical. Washing detergents, powder, perfumes, air fresheners, cosmetics, etc.

Symptoms of allergic conjunctivitis are manifested in the form of:

• unbearable itching and burning in the eyes;
• increased tearing;
• inflammation and redness of the conjunctiva;
• mucous or purulent discharge;
• rapid visual fatigue;
• hypersensitivity to bright light sources.

Another clear sign indicating allergic conjunctivitis is swelling in the lower eyelid. In addition to these symptoms, the patient may be bothered by coughing. In the acute form of the disease, the symptoms are pronounced, and chronic allergic conjunctivitis proceeds more calmly (lasts for 6-12 months).

Symptoms of this ophthalmic pathology appear immediately after contact with allergens, which quickly penetrate the mucous membrane of the eye, resulting in inflammation.

What is the treatment of eye pathology based on?

The process of treatment of the allergic form of conjunctivitis is quite lengthy. This is due not only to the difficulty of diagnosing a problem in the early stages of development, but also to the fact that the drugs used during therapy do not immediately have the desired effect.

Treatment of an allergic type of conjunctivitis is carried out using the following groups of drugs:

1. Antihistamines. Patients suffering from such an ailment are prescribed 2nd generation antihistamines (Claritin, Cetrin, Kestin) and 3rd generation (Erius, Xizal, Telfast). Take 1 tablet daily for 2 weeks. If necessary, the treatment course can be extended up to 2-3 months. These antihistamines have a beneficial effect on the entire body, stopping allergic manifestations.
2. Topical corticosteroids. The indication for the appointment of this pharmacological group of drugs is severe inflammation and severe complications that have developed against the background of this type of conjunctivitis. They are prescribed if the inflammatory process does not go away after taking other medicines.

This drug group is represented by steroid ointments and drops, which include such active substances as dexamethasone and hydrocortisone. Before use, be sure to consult a specialist, since the above medicines are hormonal.

• Antiseptics, antibiotics. For the treatment of allergic conjunctivitis, ointments containing an antiseptic (based on tetracycline, gentamicin and erythromycin) are often used. They help prevent the spread of germs.
• Immunomodulating. Medicines of this group are prescribed for the chronic course of the disease. The most popular medication is Histoglobulin (in the form of injections).
• Reparants (to restore the conjunctiva). To eliminate the consequences of allergic keratitis, medications that have a healing effect are prescribed. With their help, it is possible to restore damaged eye tissues and eliminate the consequences of the disease (conjunctival sores, etc.).

An excellent drug is Solcoseryl eye gel, which must be used within 1-2 weeks after the symptoms of conjunctivitis have been eliminated. This gel contributes to the activation of metabolic processes at the cellular level, due to which the process of restoring the disturbed structure of the eye tissues is significantly accelerated.

When asked how to treat allergic conjunctivitis, most ophthalmologists will answer that the allergen must first be eliminated, and only after that it will be possible to begin conservative treatment.

One of the most popular drugs used to treat this disease are eye drops.

See the list of the most effective drops for conjunctivitis in children.

I bring to your attention the types of drops that qualified oculists recommend using for patients suffering from allergic conjunctivitis:

1. For vasoconstriction. Such drops (Vizin, Okumetil, Octilia) constrict blood vessels, due to which it is possible to achieve removal of edema and redness of the eyes.
2. Antihistamines. The main purpose of antihistamine eye drops (Lekrolin, Kromoheksal, Alokomid, Opatanol, Hi-chrome) is to block histamine. They help relieve swelling and eliminate itching.
3. Anti-inflammatory corticosteroids. Drops of this group (Dexamethasone, Prenacid, Maxidex, Hydrocortisone) are prescribed in case of an acute or severe course of the disease. They are used strictly according to the prescription of the eye doctor.
4. Tear substitutes. Cutting and burning in the eyes that occur with allergic conjunctivitis very often lead to the development of dry eye syndrome, especially in old age. To eliminate the problem, ophthalmologists advise the use of artificial tear preparations (Vizin, Oftogel, Inox, Sistein, Oksial).
5. Vitaminized. Eye drops, which include vitamins (Quinax, Katahrom, Emoksipin, Khrustalin), should be used in patients who have inflammation of the cornea due to allergic conjunctivitis.

conclusions

Allergic type of conjunctivitis is a rather serious disease that gives a person unpleasant painful sensations.

Due to the fact that its occurrence cannot be completely prevented, ophthalmologists strongly recommend seeking medical help immediately after the first symptoms of the disease appear. This will allow the specialist to select the appropriate medications, as well as draw up a competent and effective treatment regimen.

Take care of yourself and be healthy, dear friends, see you soon!

Sincerely, Olga Morozova.

In the last decade, there has been a marked increase in the frequency of various forms of allergies in children, including allergic inflammation of the mucous membrane of the eyes (conjunctiva). may be year-round, seasonal, or associated with exposure to irritants and allergens. But, regardless of its type, the symptoms of conjunctivitis (lacrimation or dry eyes, burning, pain, itching, redness) cause children a lot of suffering and require treatment, including eliminating the allergen, preventing further contact with the allergen and prescribing medications.

For drug treatment of allergic conjunctivitis, two groups of drugs are used: drugs of general action and local dosage forms (eye drops and ointments).

General medicines

Of the drugs of general action in the treatment of allergic conjunctivitis, ketotifen and antihistamines of the first, second and third generations are used.

Ketotifen(zaditen, ketasma, ketof) in the form of oral syrup (allowed from 6 months) and tablets (from 6 years) is used to eliminate and prevent itching caused by allergic conjunctivitis. Ketotifen is contraindicated in case of hypersensitivity to it. Side effects of the drug often include drowsiness, and a feeling of fatigue, dry mouth, abdominal pain, and vomiting. Less common are allergic reactions, anxiety and convulsions (especially in young children), urinary disorders.

From antihistamines in children's practice most often prescribed:

• suprastin (tablets);
• claritin (clarisens, loratadine) - in syrup and tablets;
• zirtek (zodak) - in drops, syrup and tablets;
• erius - syrup and tablets.

Antihistamines are prescribed for all types of allergic conjunctivitis and can eliminate or reduce the severity of symptoms such as swelling of the eyelids, itching and lacrimation. But they are more often used not for isolated allergic conjunctivitis, but for other allergic diseases (,), accompanied by the addition of symptoms of conjunctivitis. In children of the first year of life, suprastin is used (from a month, it has a sedative and hypnotic side effect) and zyrtec (from six months), in children older than a year, you can also use erius and claritin in syrup. For children over 6 years old, it is more convenient to use tablets.

local medicines

For topical application in the form of eye drops, gels and ointments are used:

1. artificial tears.
2. Decognestants.
3. Mast cell membrane stabilizers.
4. Drugs with multilateral action.
5. Vitamin-containing and nutritional drops.
6. Antibiotics.
7. Combined drugs.

artificial tears

Artificial tears include:

• eye drops (lacrisin, systain, oftagel, natural tear, vizin pure tear);
• eye gel (vidisik).

Preparations of this group are aqueous solutions of biologically inert polymers, which, after instillation, form a film on the surface of the eye. This film is formed not only by the preparation, but also by the elements of its own tear, which is held by the polymer. Artificial tears have an increased viscosity, due to which they do not drain immediately after instillation, but cover the cornea and conjunctiva for some time (up to 45 minutes after instillation), protecting the eye from contact with the allergen and moisturizing it.

Artificial tears relieve or eliminate symptoms such as:

• photophobia;
• burning;
• dry eyes;
• hyperemia;
• lacrimation;
• feeling of a foreign body.

In addition, they remove the irritating effect of other eye drops, and some of them are able to accelerate the epithelization (healing) of the surface tissues of the eye - with microdefects, erosions and trophic changes in the cornea. The effect of artificial tear preparations develops within 3-5 days from the start of use.

In children, the drug lacrisin is officially approved and optimal in use, which has all the positive qualities of artificial tears and is devoid of such disadvantages as a violation of the stability of the tear film and blurred vision in the short term after instillation. Systane eye drops and eye vidisic gel have a similar effect.

Of the other drugs used:

• oftagel (causes blurred vision within 1-5 minutes after instillation);
• natural tear;
• vizin pure tear.

But these drugs, unlike lacrisin, contain benzagesonium chloride, which disrupts the stability of the tear film and is therefore not recommended for children who use soft contact lenses.

Contraindications to the appointment of artificial tears preparations are individual reactions of intolerance. Side effects may include eye irritation, discomfort, and blurred vision.

Decognestants

Decognestants include eye drops:

• tetrahydrozoline (Visin);
• oxymetazoline (ocuclia, afrin).

Decognestants, or vasoconstrictors, are drugs that cause narrowing of blood vessels, as a result of which symptoms of allergic conjunctivitis such as redness of the eyes and swelling of the eyelids are removed, reduce burning, itching and tearing. Local vasoconstrictors have strict age restrictions and restrictions on dosage and frequency of administration. Preparations of this group cannot be used in children under 6 years of age, they are prescribed 2-4 times a day for 5-7, maximum - 10 days.

In children under the age of 6 years, vasoconstrictors may be prescribed under certain conditions, but only by a doctor - with caution and under strict supervision. And, since vasoconstrictors only relieve individual allergy symptoms, but do not affect histamine and other active substances of allergic inflammation, drugs with a vasoconstrictor effect are prescribed in combination with general and (or) local antihistamines.

Of the vasoconstrictors, oxymetazoline (ocuclia) gives the fastest and longest effect.

Side effects of vasoconstrictors:

• the possibility of developing a rebound effect (increased allergy symptoms with prolonged use);
• increased intraocular pressure;
• mydriasis (dilated pupil);
• increased excitability;
• nausea;
• dizziness;
• sleep disorders;
• heartbeat.

Antihistamines

For topical use in the form of eye drops, the following antihistamines are available:

• levocabastine;
• azelastine.

Topical antihistamines are among the most effective drugs for the treatment of seasonal and perennial allergic rhinitis. Eye drops containing antihistamines give a pronounced positive effect, significantly suppressing or completely eliminating all manifestations of allergic conjunctivitis (swelling, redness, itching, burning, dryness, lacrimation, etc.). Drops relieve itching very well (in more than 90% of patients), therefore, with conjunctivitis, accompanied by severe itching, their appointment is mandatory. In addition, eye drops reduce the severity of symptoms of allergic rhinitis, since the drug, after instillation through the lacrimal canal, also enters the nasal cavity.

Unlike systemic antihistamines (tablets and syrups), eye drops are free from unwanted side effects (drowsiness, etc.). The effect of the drug develops 3-5 minutes after instillation and lasts up to 10 hours.

A contraindication to the use of drops with antihistamines is only individual intolerance to the components of the drug and age restrictions (levokabastin - from 2 years old, as prescribed by a doctor, it is possible earlier; azelastine - from 4 years old). Of the side effects, a transient burning sensation is occasionally noted.

Mast cell membrane stabilizers

Mast cell stabilizers, along with topical antihistamines, are the most popular drugs for the treatment of allergic conjunctivitis. In pediatrics are used:

• sodium cromoglycate (opticrom, haikrom, lekrolin);
• cromohexal;
• lodoxamide (alomide).

Medicinal substances prevent the release of mediators (biologically active substances responsible for allergy manifestations) from mast cells. The effect of the use of membrane stabilizers in the form of eliminating or reducing the main symptoms of conjunctivitis develops gradually (within 3-4 days), but lasts longer than the effect of antihistamines.

Among the side effects of membrane stabilizers in the form of eye drops, hypersensitivity (redness of the eyes, swelling, burning and sensation of a foreign body in the eyes) can be noted. The development of hypersensitivity reactions requires immediate discontinuation of the drug and is a contraindication for its further use. The use of membrane stabilizers is also limited by age indications: preparations of sodium cromoglycate and cromogesal are not recommended for use in children under the age of 4 years, lodoxamide is allowed from 2 years of age. Some drops of the same trade name, but from different manufacturers, may contain benzalkonium chloride as a preservative: such drugs should not be instilled while wearing soft contact lenses.

Drugs with multilateral action

For allergic conjunctivitis, drops are used that contain a drug with a multilateral action - antiallergic (antihistamine), membrane stabilizing, anti-inflammatory:

• azelastine (allergodil);
• nedokromil;
• olopatadine (opatanol and patanol)
• cyclosporine a.

Allergodil blocks H-1 and H-2 histamine receptors, inhibits the degranulation of mast cells and the release of inflammatory mediators from them. The maximum effect develops after 5 days of use. Not recommended for children under 4 years old. Contraindicated in case of individual hypersensitivity.

Nedocromil used primarily to treat itching associated with allergic conjunctivitis. Allowed from 2 years. Side effects are rare (swelling, feeling of irritation). Contraindicated in hypersensitivity.

Olopatadin- is the leader in the frequency of use in allergic eye diseases. It has an immediate effect immediately after instillation, which lasts for 8 hours. Allowed from 3 years. Occasionally, the use of olopatadine may be accompanied by a slight burning sensation.

Cyclosporin A gives a positive effect in the treatment of severe allergic eye diseases (spring keratoconjunctivitis and atopic keratoconjunctivitis). It is also used in cases where allergic eye damage is not amenable to any other therapy. The drug is contraindicated in the presence of hypersensitivity to it; in case of accession of a bacterial infection (purulent conjunctivitis); in violation of the function of the kidneys, liver; with arterial hypertension. May cause severe side effects (tremor, weakness, headache, negative effects on the kidneys, increased blood pressure, etc.).

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs do not belong to the main antiallergic drugs and are not always used. However, they are able to eliminate itching and pain in the eyes caused by allergies, reduce swelling. In pediatrics, they are not officially allowed due to insufficient knowledge of the effect on the child's body, but they are still used - mainly for the complex treatment of severe spring keratoconjunctivitis. According to individual indications, the ophthalmologist may prescribe the drug diclofenac sodium in the form of eye drops (naklof) to the child.

Side effects: burning sensation, itching, redness, blurred vision after instillation, with prolonged use, the formation of corneal ulcers is possible. Naklof is contraindicated in the presence of hypersensitivity to diclofenac and aspirin.

Corticosteroids

Topical corticosteroids are very effective in the treatment of allergic diseases. They have a high anti-inflammatory activity, but are not the first-line drugs in the treatment of allergic conjunctivitis due to side effects (increased intraocular pressure, infections). In children, topical corticosteroids in the form of eye drops and ointments are prescribed in case of failure of other drugs and in chronic allergic eye diseases.

Preparations of topical corticosteroids in pediatric ophthalmology:

• dexamethasone - eye drops (dexapos, maxidex);
• hydrocortisone - eye ointment.

In children, corticosteroid drugs are used only as directed by a doctor, and in the case of long-term use (from 10 days), periodic ophthalmological examination with monitoring of intraocular pressure is recommended.

Vitamin-containing and nutritional drops

These include drops that provide vitamins and other important nutrients to the cornea and other tissues of the eye, thereby accelerating the healing process of microtraumas, erosions and ulcers.

In children, emoxipin is most often used.

Antibiotics

Eye drops and ointments containing an antibacterial drug are prescribed only in case of a secondary bacterial infection and the development of purulent conjunctivitis. The most popular are the following:

• tobrex - eye drops;
• Levomycetin - eye drops and ointment;
• gentamicin - drops and ointment;
• tetracycline - eye ointment;
• tsiprolet - eye drops;
• miramistin (solution for topical use) and okomistin - eye drops.

Combined drugs

For the treatment of allergic conjunctivitis, many combination preparations are produced that contain several active substances at once and thus have several actions at the same time. The effect of combined drugs and side effects are due to their components. Below we consider some of the drugs.

Allergoftal- eye drops with vasoconstrictor (due to naphazoline hydrochloride) and antihistamine (due to antazoline phosphate) action. Contraindicated in young children (up to 6 years), with arterial hypertension, heart disease, the presence of intolerance to one of the components.

Spersallerg- eye drops containing a vasoconstrictor (tetrazoline hydrochloride) and an antihistamine (antazoline hydrochloride). It can be used in young children (according to the annotation - from 2 years old, as prescribed by an ophthalmologist, it is possible even earlier).

Cromozil(drops) - they include a vasoconstrictor (tetrazoline hydrochloride) and a mast cell membrane stabilizer (sodium cromoglycate). It has a minimum of side effects and is used almost without restrictions. Compatible with soft contact lenses.

Nafcon A(drops) - includes a vasoconstrictor (naphazoline hydrochloride) and an antihistamine (pheniramine maleate). Allowed from 12 years old.

Garazon(drops) - contains a corticosteroid (beclamethasone) and an antibiotic (gentamicin). Allowed from 2 years.

Okumetil(drops) - contains a vasoconstrictor (nafazolin), an antihistamine (diphenhydramine) and an antiseptic (zinc sulfate). Allowed from 2 years.

Treatment regimen

The treatment regimen, the dosage of the drug, the frequency of its administration and the duration of use are determined individually for each child. Appointments should be made by an allergist or an ophthalmologist, ideally consultations (including repeated ones) of both specialists are desirable.

Generally speaking, for the treatment of moderate seasonal allergic conjunctivitis in children, the following schemes are most effective and relatively safe:

• systemic antihistamine (long-term) + local antihistamine (from 10 days) + artificial tears (long-term) + vasoconstrictor (short course, if necessary);
• systemic antihistamine (long-term, during the allergy period) + local mast cell membrane stabilizer (long-term, 2 weeks before the onset of allergy - if the allergen plant and its flowering period are known) + vasoconstrictor (short course, if necessary).

Conclusion

Treatment of allergic conjunctivitis in a child should be carried out only on medical prescription, after examination and examination, when the allergic origin of conjunctivitis is confirmed. A prerequisite is the identification of a causally significant allergen and the implementation of measures for its elimination (elimination), since in many cases this is enough for the child to recover, and drug treatment will not be required, or its volume will be reduced.