Symptoms and treatment of allergic conjunctivitis in a child. Allergic conjunctivitis, symptoms and treatment in adults and children Allergic conjunctivitis in a child treatment drops

According to the logic of the name, it affects those people who have increased sensitivity to any allergen. Allergy itself is a rather unpredictable problem that can “climb out” in a variety of places in the body. Since the conjunctiva of the eye comes into contact with the outside world in the forefront, it is also the first to be attacked by allergens.

Most often, the conjunctiva perceives plant pollen as an allergen. For this reason, this type of conjunctivitis can be perceived as a seasonal disease. However, in addition to pollen, allergy sufferers also have reactions to pet hair, dust, and medications. And this is not the whole list.

The impact of allergens on the conjunctiva of the eye can be guessed almost immediately by the appearance of severe itching - one is tempted to rub the eyes. In some cases, itching is accompanied by pain and slight swelling of the eyelids. And this problem can become chronic.

For reference. Allergic conjunctivitis is the appearance of an inflammatory reaction of the mucous membrane of the eye in response to exposure to allergens. For the development of allergic conjunctivitis, an increased, genetically determined sensitivity to a given allergen is required.

The main symptoms of allergic conjunctivitis are the appearance of lacrimation, itching of the eyelids and conjunctiva, redness of the mucous membrane, swelling of the eyelids, and the appearance of inflammatory formations (papillae and follicles) on the conjunctiva. In severe cases of allergic conjunctivitis, damage to the cornea (allergic keratoconjunctivitis) may occur, accompanied by visual impairment.

Attention. According to statistics, ophthalmological allergies (allergic conjunctivitis, allergic keratoconjunctivitis, etc.) of varying severity are observed in approximately twenty percent of the population.

In the structure of allergic lesions of the eye, conjunctivitis accounts for about ninety percent of all ophthalmic allergies.

Due to the presence of a genetic predisposition, allergic conjunctivitis is often combined with other diseases of an allergic nature (bronchial asthma, allergic rhinitis, pharyngitis, atopic dermatitis, etc.).

The disease code for allergic conjunctivitis according to ICD10 is H10.1 (acute atopic conjunctivitis).

Causes of development of allergic conjunctivitis

The main cause of allergic conjunctivitis is pollen. In this regard, most patients experience a pronounced seasonality of the disease (spring, late summer or early autumn), caused by the flowering of ragweed, poplar, plantain, wormwood, quinoa, etc.

Also, the cause of the development of allergic conjunctivitis may be:

• dust;
• animal hair;
• cockroaches;
• cosmetics (mascara, eye shadow, makeup remover, etc.);
• contact lenses and solutions for their storage;
• medicines (eye drops, ophthalmic ointments, gels), etc.

Classification of allergic conjunctivitis

The disease can occur in acute and chronic forms.

According to the clinical form and the causative agent of the inflammatory process, allergic conjunctivitis is divided into:

• hay fever seasonal allergic conjunctivitis;
• spring conjunctivitis and keratoconjunctivitis;
• large papillary allergic conjunctivitis;
• drug-induced conjunctivitis;
• chronic allergic conjunctivitis and keratoconjunctivitis.

For reference. Depending on the pathogen, allergic conjunctivitis can be permanent (caused by exposure to dust or other factors that the patient encounters regularly) or seasonal.

Seasonal hay fever allergic conjunctivitis (also called hay fever or pollen allergy) is divided into three types, according to the type of pollen causing the allergy.

The first type of seasonal allergic conjunctivitis includes inflammation caused by flowering trees and exposure to their pollen. The second type includes allergies caused by meadow grass pollen. The third type is allergic conjunctivitis caused by weed pollen.

Allergic conjunctivitis - symptoms

The main common manifestations of all allergic conjunctivitis are:

• pronounced hyperemia of the mucous membrane of the eye;
• severe redness of the eyelids;
• swelling of the eyelids and conjunctiva;
• complaints of itching, burning, pain in the eyes;
• itching of the eyelids;
• the appearance of profuse lacrimation;
• absence of purulent discharge from the eyes;
• blurred vision;
• the appearance of inflammatory formations on the mucous membrane of the eyes (pathological papillae and follicles).

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In most cases, allergic conjunctivitis is combined with allergic symptoms:

• rhinitis (complaints of constant nasal congestion, nasal voice, constant itching in the nose, discharge of copious mucous discharge from the nose, sneezing, characteristic redness of the tip of the nose, etc.);
• pharyngitis (sore throat, cough, dry throat, hoarseness, choking, etc.).

Attention. Allergic conjunctivitis in children occurs in the same way as in adults. There are no fundamental differences in symptoms. However, in young children, allergic conjunctivitis is more often complicated by the addition of a bacterial infection. This is due to the fact that due to severe itching, they constantly rub their eyes and often introduce pathogenic microorganisms to the mucous membrane.

It should be noted that allergic conjunctivitis is similar in clinical picture to viral conjunctivitis, therefore, in order to avoid errors in diagnosis, making a diagnosis, carrying out differential diagnosis and prescribing treatment should be carried out exclusively by an ophthalmologist and allergist.

Just like viral conjunctivitis, allergic conjunctivitis can be combined with symptoms of rhinitis and pharyngitis, but with allergies there is no fever, pain in muscles and joints, or swollen lymph nodes.

Allergic conjunctivitis - how to treat it

Treatment of allergic conjunctivitis should be prescribed by ophthalmologists and allergists. According to indications, can be used:

• specific hyposensitization by allergens;
• antihistamine eye drops;
• vasoconstrictor eye drops;
• tear substitutes;
• eye drops with interferons;
• eye drops and ointments with glucocorticosteroids;
• drops with mast cell stabilizers.

Allergic conjunctivitis - eye drops with antihistamines

The most commonly used agents are drops:

• Okumetil (combined eye drops with diphenhydramine, naphazoline and zinc sulfate). They have antihistamine, vasoconstrictor, decongestant, antiseptic and anti-inflammatory effects;
• Opatanol (antihistamine drops with olopatadine);
• Cromohexal (antihistamine drops with a mast cell membrane stabilizer - cromoglycic acid);
• Lecrolin (antiallergic eye drops with sodium cromoglycate (mast cell stabilizer));
• Allergodil (antiallergic drops with azelastine).

Allergic conjunctivitis - eye drops with a vasoconstrictor effect

To narrow blood vessels and reduce the severity of edema, vasoconstrictor eye drops are used:

• with tetrizoline (Tizin, Vizin, Montevisin, Octilia, etc.);
• combined drops with naphazoline and pheniramine (Opcon-A);
• combined drops with antazoline and naphazoline (Alergofthal);
• comb. drops with antazoline and tetrizoline (Spersallerg).

If necessary, vasoconstrictor nasal drops (Naphthyzin) are additionally prescribed.

Allergic conjunctivitis - eye drops with glucocorticosteroids

In most cases, hormonal drops are used:

• Betazon (drops with betamethasone);
• Dexona, Dexoftan, Dexamethasonelong (drops with dexamethasone).

Hay fever seasonal allergic conjunctivitis

Hayallergic allergic conjunctivitis is called seasonal ophthalmological allergies that develop due to exposure to pollen allergens on the mucous membrane during the flowering of trees, flowers, herbs, cereals, etc. This type of allergic conjunctivitis is one of the most common.

Diagnosis of hay fever conjunctivitis, as a rule, is not difficult, since the appearance of symptoms of the disease has a clear connection with exposure to the allergen. To clarify the diagnosis, use:

• intradermal allergen test;
• cytological studies of scrapings from the conjunctiva of the eyes.

A significant role in the diagnosis of allergic conjunctivitis is played by collecting an anamnesis of the disease (the presence of a hereditary allergic history in the patient, concomitant atopic conditions, seasonality of symptoms, etc.).

For reference. In most cases, patients with hay fever allergic conjunctivitis are diagnosed with concomitant allergic rhinitis, pharyngitis, dermatitis, bronchitis, and bronchial asthma.

Pollinous conjunctivitis begins acutely, with damage to both eyes at once. Patients complain of the appearance of:

• unbearable burning and itching of the eyelids;
• severe and constant lacrimation;
• burning and itching under the eyelids;
• increased sensitivity to light;
• swelling of the eyelids and conjunctiva;
• redness of the eyelids and conjunctiva.

Swelling of the conjunctiva can be so severe that it seems as if the cornea is “sinking” into it.

Due to severe swelling of the eyelids, patients may experience difficulty opening their eyes and constantly squint. The appearance of marginal pathological infiltrates in the cornea is also often noted. Subsequently, superficial pathological papillae and follicles may undergo ulceration, leading to the formation of ulcers and corneal erosions.

For reference. In the chronic course of the inflammatory process, there is constant moderate itching of the eyelids and conjunctiva, scanty mucous discharge from the eyes and a constant pinkish tint of the eyelids and conjunctiva. The occurrence of moderate persistent pathological infiltration of the mucous membrane is also characteristic.

Diagnosis of hay fever allergic conjunctivitis

To diagnose the disease and clarify the type of allergen that caused allergic conjunctivitis, ophthalmological skin tests with allergens are performed:

• scarification;
• scarification and application;
• electrophoresis;
• drip;
• application;
• prick test (used most often), etc.

Allergic conjunctivitis in most cases develops in preschool children. This disease is diagnosed much less frequently in schoolchildren.

Pathology is an additional symptom of allergy and is most often accompanied by the appearance of allergic rhinitis, cough and other signs of a negative reaction from the child’s body to certain stimuli.

In some cases, allergic conjunctivitis may develop in a child as an independent disease. Treatment of this pathological process must be carried out under the supervision of specialists. Otherwise, serious complications are possible.

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Concept and characteristics

Allergic conjunctivitis in children - photo:

Allergic conjunctivitis is type of inflammatory process, developing in the conjunctival membrane of the eye. This pathology is provoked by a certain allergen, which causes a negative reaction in the child’s body.

The inflammatory process affects the inner surface of the eyelid and sclera. This type of conjunctivitis is always accompanied by additional symptoms indicating the progression of the allergy.

Causes

Allergic conjunctivitis in children can develop due to genetic predisposition or individual characteristics body.

In most cases, this pathology is a negative reaction to specific allergens.

Irritants can be in the environment, food, or enter the body through other means. For example, provoke allergies Some types of infections can cause conjunctivitis.

The following can trigger the development of allergic conjunctivitis: factors:

Classification

In medical practice, there are several classifications of allergic conjunctivitis. According to the nature of the occurrence, the pathological process can be year-round, periodic and contact.

In the first case, the appearance of symptoms of the disease can appear regardless of the time of year, in the second, outbreaks of the disease are observed mainly in the spring or winter.

The contact form develops immediately after a child is exposed to a certain allergen.

Children's allergic conjunctivitis is divided into the following types:

Symptoms and signs

Symptoms of allergic conjunctivitis can appear instantly after contact with an allergen or within 24 hours. The intensity of the pathological process depends on the individual characteristics of the child’s body and the form of the disease.

Signs of conjunctivitis appear in both eyes. The inflammatory process always begins with photophobia and increased lacrimation.

Additional symptoms are developing at a rapid pace. Symptoms of the disease manifest themselves in the following conditions:

How to distinguish it from other forms?

Allergic conjunctivitis can be determined and the allergen that provokes the development of this disease can be identified not only through laboratory tests. Parents need to analyze factors that affect the child before the first symptoms of pathology.

For example, if conjunctivitis occurs at the same time of year, after eating certain foods or upon contact with animals, then the likelihood of the baby having an allergy is almost one hundred percent.

Peculiarities allergic conjunctivitis:

• symptoms of the disease can be seasonal or constant;
• conjunctivitis of other forms can affect one eye (the allergic form always appears in both eyes);
• the inflammatory process is complemented by other signs of allergy (runny nose, cough, etc.).

Complications and consequences

Allergic conjunctivitis can not only acquire a chronic form, but also provoke serious pathologies of the visual organs.

Some of the diseases considered to be the consequences of this inflammatory process are practically untreatable. The risk of complications can be reduced only by timely and complete treatment of conjunctivitis.

Complications of allergic conjunctivitis The following conditions may occur:

• corneal ulcer;
• significant decrease in vision;
• addition of a bacterial infection;
• retinal disinsertion;
• keratitis

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Diagnostics

Diagnosis of allergic conjunctivitis should include mandatory consultation with allergist and pediatric ophthalmologist.

After examining the child, doctors prescribe certain examination procedures.

When identifying allergic conjunctivitis, it is important to carry out differential diagnosis from other varieties of this disease. The presence of an allergy is indicated by additional symptoms of the inflammatory process.

Methods for diagnosing allergic conjunctivitis include the following procedures:

• general blood and urine analysis;
• blood test from a vein;
• skin testing;
• blood test for immunoglobulin;
• examination of tear fluid;
• bacteriological examination of mucous secretions.

Treatment methods

How to treat allergic conjunctivitis in a child? Therapy for allergic conjunctivitis is carried out in several stages.

First, the allergen that needs to be treated must be identified. exclude contact with the child. Then medications are prescribed to eliminate the symptoms of the disease and strengthen local immunity.

You can supplement the course of treatment with some traditional medicine recipes that help speed up the baby’s recovery process and alleviate his general condition.

Drugs

Drug therapy for allergic conjunctivitis is prescribed according to the intensity of symptoms inflammatory process and the individual characteristics of the child’s body.

A doctor should select the necessary medications.

The wrong choice of medications can reduce the effectiveness of the course of treatment and cause prolonged therapy.

For allergic type conjunctivitis, the following may be prescribed: types of drugs:

• drops with a membrane-stabilizing effect (Ketotifen, Lecrolin);
• antihistamines (Zyrtec, Loratadine, Claritin);
• tear drops (Inoksa, Defislez);
• mast cell stabilizers in the form of drops (Krom-Allerg, Lodoxamide);
• histamine receptor blockers (Allergodil, Opatanol).

Folk remedies

Traditional medicine works well relief of the child's condition, reducing the intensity of the inflammatory process and accelerating recovery.

When choosing alternative medicine recipes, it is important to consider the child’s tendency to allergies. You should not experiment with products that contain potentially dangerous components that fall into the category of possible allergens.

Examples of folk remedies:

Prevention

There are no special preventive measures to prevent the development of allergic conjunctivitis in children. The disease may develop suddenly or against the background of an existing allergy at the baby's.

If a child is prone to a negative reaction to certain allergens, then the best way to prevent conjunctivitis is to avoid contact with them.

Particular attention should be paid to the lifestyle and health of the baby from a very early age. Disease prevention includes the following recommendations:

The most common complication of allergic conjunctivitis is decreased visual acuity in a child. To prevent negative consequences, it is necessary to contact an ophthalmologist in a timely manner.

If a child is suspected of having an allergy, it is necessary to examine them and identify the factor that causes the manifestation of the inflammatory process.

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About allergic conjunctivitis, its symptoms, course of the disease, treatment and preventive measures in this video:

We kindly ask you not to self-medicate. Make an appointment with a doctor!

Eye damage often develops as a result of allergic reactions to many irritants. Watery eyes, itching, and redness of the eyelids cause noticeable discomfort. Pediatricians often diagnose allergic conjunctivitis in a child, ophthalmologists sound the alarm: most little allergy sufferers have problems with their eyes.

What to do if the body reacts violently to pollen, wool, and cosmetics? How to protect your eyes from irritants? What medications quickly relieve negative symptoms? The answers are in the article.

General information about the disease

Allergic conjunctivitis (AK) is an inflammation of the conjunctiva of the eyes of an allergic nature. The cause of tissue damage is the action of the irritant. In case of an allergic reaction, lacrimation, itching, and hyperemia of the eyelids appear.

After the allergen penetrates the conjunctival area, an active release of histamine, bradykidin, leukotrienes, and prostaglandins occurs. Inflammatory mediators during secretion provoke swelling of the mucous membrane, itching, tears are released profusely, and other negative manifestations are noticeable.

According to the international classification of diseases, periodically updated by WHO specialists, hypersensitivity reactions are also included in the list of diseases. Allergic conjunctivitis ICD code 10 – H10. The classifier indicates several subtypes, including H10.4 - chronic conjunctivitis, and H 10.1 - acute atopic conjunctivitis.

Causes of development and probable allergens

Many systemic immunological pathologies often give negative reactions to the organs of vision. An abundance of capillaries, delicate tissues, high workload, exposure to external irritants and precipitation - a combination of factors explains frequent eye damage.

The cause of allergic conjunctivitis is increased sensitivity to certain allergens, which is inherent at the genetic level. According to statistics, about 15% of adults and children on the planet have a confirmed diagnosis of “allergic conjunctivitis.”

In children, irritation of the conjunctiva most often occurs under the influence of pollen from certain plants. Allergen particles are so small (0.03–0.04 mm) that they easily penetrate tissue and irritate sensitive receptors.

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Pollen from the following wild/houseplants and trees is dangerous (list No. 1):

• ambrosia;
• loboda;
• sagebrush;
• lily;
• spurge;
• ferns;
• all types of geraniums;
• rhododendron;
• poplar;
• alder;
• birch.

There are other allergens that trigger a negative reaction in children (list No. 2):

• bird feather;
• eye cosmetics;
• dust mites;
• spices, certain products;
• cat and dog hair;
• medicines;
• contact lenses;
• room dust;
• paints, varnishes;
• toxic substances with a pungent odor.

On a note! Acute seasonal conjunctivitis is most often caused by pollen from grasses, trees, and weeds (list No. 1). Mold spores often provoke severe irritation not only of the respiratory tract, but also of the eyes. The year-round form of conjunctivitis, usually of a chronic nature, is caused by contact with other allergens (list No. 2).

Varieties

Doctors diagnose several types of AK (allergic conjunctivitis) in children:

• hay fever conjunctivitis;
• allergies to medications;
• large capillary conjunctivitis;
• allergic conjunctivitis in chronic form;
• vernal keratoconjunctivitis.

Based on the nature of the flow, the following types of AC are distinguished:

• acute unspecified;
• acute atopic;
• unspecified;
• chronic;
• other types of disease.

Based on the time of exacerbation, two types of AK are distinguished:

• year-round (the body’s negative response does not depend on the time of year);
• seasonal (doctors record acute reactions, deterioration of the condition in spring and summer).

Symptoms and signs

It is not difficult to recognize allergic conjunctivitis in children: the disease has many clear signs. With the seasonal variety, the symptoms intensify with the beginning of the flowering of allergenic plants; with the year-round form, the child’s eyes are inflamed for a long period, at any time.

Main features:

• burning in the eyes;
• severe itching;
• redness, swelling of the conjunctiva;
• the eyeball is slightly swollen;
• liquid, transparent discharge from the eyes (appears in year-round and seasonal forms of allergic disease in children);
• with a severe reaction, visual acuity decreases.

Additional signs:

• copious, active secretion of mucus from the nose. The content is transparent, the intensity does not change at different times of the day;
• painful ulcers on the eyelids, decreased vision, thick mucous discharge with the spring type of conjunctivitis.

Note to parents! Most often, both eyes are affected in children with allergies, but sometimes severe symptoms are more noticeable on one side.

Diagnostics

If an allergic lesion of the conjunctiva is suspected, the child should be examined by doctors:

• pediatrician;
• pediatric ophthalmologist;
• allergist-immunologist;
• otolaryngologist.

To clarify the diagnosis, allergy tests are carried out, the doctor talks with the parents, studies the nature of the disease, the time of the first signs. An important point is to clarify whether parents suffer from allergic reactions. A detailed picture of the pathology is important for making an accurate diagnosis.

Several mandatory studies are carried out:

• blood test (if an allergy is suspected, repeated samples are taken every 10 days until the diagnosis is clarified);
• cytological analysis of fluid from the eyes;
• general urine analysis;
• application, scarification tests;
• blood test for HIV and RW.

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Other types of research are often carried out:

• blood test for viruses;
• blood chemistry;
• checking for bacterial flora of discharge from the eyes;
• immunological examinations.

Effective methods and general rules of treatment

The main stages of treatment of allergic conjunctivitis:

• eliminating contact of the small patient with the irritant;
• prescribing a hypoallergenic diet;
• taking antihistamines in a form appropriate for the child’s age;
• prescribing eye drops to relieve allergy symptoms;
• supporting the body with vitamin complexes.

Important! Actively strengthening the immune system is a prerequisite for reducing the frequency of attacks and reducing the strength of negative reactions.

Medications

How to treat allergic conjunctivitis? Doctors prescribe several types of effective drugs:

• antihistamines. Duration of treatment – ​​from 10 to 14 days. For the development of acute and moderate forms of allergies, 1st generation drugs are suitable: Clemastine, Chlorpyramin. Often, the doctor prescribes 2nd and 3rd generation medications: Loratadine, Fexofenadine. Many children tolerate the effects of drugs well, Zyrtec, Fenistil,;
• antiallergic eye drops. The compositions reduce inflammation, redness, swelling, relieve itching, and reduce discomfort. The duration of use is regulated by the attending physician, based on the severity of the disease. Most often, you have to instill the drug several times a day, 2 drops for each eye. Effective compositions: Cromohexal, Optikrom, Allergodil, Histimet, Opatonol, High-Krom. When prescribing, it is important to focus on the age of the young allergy sufferer: not all drugs are suitable for young children;
• hormonal agents. The use of the compositions is recommended for severe allergic reactions. Strong medications in the form of ointments and eye drops are allowed to be used for 2 weeks, no more. Active anti-inflammatory effect, rapid reduction of symptoms. Effective remedies: Hydrocortisone ointment for application to inflamed eyelids, hydrocortisone, dexamethasone eye drops.

Note to parents:

• the SIT method (specific immunotherapy) is the most effective way to eliminate the reaction to stimuli. Treatment is carried out when the symptoms of AK subside;
• the doctor applies a minimum amount of allergen to the conjunctiva, gradually increasing the dosage;
• Over time, resistance to the irritant develops, the child does not react to the action of pollen or other allergens;
• treatment is long-term, often at least three years;
• The qualifications of the doctor, selection of the optimal dosage, monitoring the condition of the young allergy sufferer, and timely adjustment of the volume of the active substance are important.

If an allergy to plant pollen, animal dander, house dust, or other types of irritants is detected, it is important to cure the disease before the problem becomes protracted. Eliminating negative symptoms in a child with year-round allergic conjunctivitis requires a lot of strength and patience from parents.

Allergists recommend adhering to the rules of a hypoallergenic lifestyle and taking prophylactic antihistamines to reduce the severity of negative symptoms. A prerequisite is regular contact with your doctor, clarification of all details of therapy, selection of optimal drugs.

How to reduce the risk of developing allergic reactions in children? Helpful Tips:

• think through the furnishings in the house down to the smallest detail, get rid of things and objects that accumulate dust. You will have to remove carpets, runners, soft toys, thick textiles, decorative pillows on the sofa;
• Vacuum and wash the floors in the apartment every day. Organize the space so that it is easy to remove dust and dirt from any corner;
• Do not use cleaning products with a strong smell. Replace household chemicals in the form of powders and sprays with gel-like compositions and solutions. The best option is to use natural ingredients that do not irritate the eyes, respiratory organs, or skin;
• give pets to relatives or good friends. If you have a year-round form of allergies in children, you should not keep a parrot, cat or dog at home: particles of epidermis, wool, feathers, and fluff are strong irritants. The growing body still weakly resists the action of allergens; specific immunotherapy is not suitable for all allergy sufferers at a young age. For this reason, it is better to remove animals from the home;
• when allergenic plants bloom in spring, close the windows tightly, use air conditioning to clean the apartment or house (it is important to clean the filters on time, to prevent the growth of fungi and dust accumulation);
• Before going outside, put on the child special glasses that fit tightly to the face, and during flowering plants, protect the respiratory system with a medical mask.

Parents should protect their child from potential allergens if the mother or father (both spouses) are sensitive to certain irritants. When diagnosing AK in a young patient An integrated approach to treatment, creating a hypoallergenic lifestyle, and strengthening the immune system are important. It is important to find an experienced allergist-immunologist to select optimal treatment methods.

Inflammation of the mucous membranes of the eye due to allergic reactions or conjunctivitis is a common problem. But there are several symptoms for which you cannot do without a doctor. Watch the following video and learn useful information about the symptoms and treatment of allergic conjunctivitis in children:

Allergic conjunctivitis: symptoms and treatment

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

Manifestations of allergies 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 the human immune system. Drugs can only slightly alleviate negative symptoms, including the symptoms of allergic conjunctivitis.

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 pathologies.

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:

Atopic keratoconjuntivitis (diagnosed mainly in adults).

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 body’s individual reaction to allergens. This implies a difference in the time the first symptoms appear - from half an hour to 1-2 days.

Simultaneously with conjunctivitis, allergic rhinitis is often diagnosed; its symptoms are a runny nose, secretion of large amounts of mucus, which further irritate the mucous membranes of the eyes.

There is severe itching, burning in the eyelid area, and lacrimation. The intensity of the itching is so high that the patient constantly experiences discomfort.

Trying to soothe the itching, children tend to scratch their eyes. At the same time, pathogenic microorganisms enter the mucous membrane, which further aggravates the course of the disease. Complex therapy for allergic conjunctivitis necessarily includes drops and ointments with antibacterial action.

The appearance of a viscous, transparent, mucous discharge is noted on the mucous membrane of the eye. The addition of a bacterial component leads to the appearance of pus in the corners of the eyes, causing the eyelids to 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 washes the mucous membrane of the eye, leads to the child feeling its dryness, the feeling that sand has been poured into the eyes, as well as photophobia.

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

The eyes quickly get tired and turn red.

Types of allergic conjunctivitis and provoking factors:

year-round – constantly acting allergens: house dust, feathers of ornamental birds, pet hair, household chemicals;

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

contact – cosmetics, solutions for contact lenses.

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

Types and symptoms of allergic conjunctivitis

Inflammation of the cornea, eyelids

Hay fever, goes into the chronic category if it lasts more than six months

Seasonal species, appears when trees, grasses, and flowers bloom

Has no seasonality

Not only the skin of the eyelids is affected, but also the retina and optic nerve

Exacerbations in summer and spring

Occasionally in children from 3 years of age, more often from 14 years of age

The cornea of ​​the eye is affected

Sticky and viscous mucus

From complete absence to significant manifestations

Over the age of 40

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Treatment of allergic conjunctivitis

After eliminating the allergen from the patient’s environment, the doctor prescribes local or systemic therapy for allergic manifestations. Additionally, immunotherapy is prescribed and the symptoms of the disease are relieved, including using antimicrobial drugs.

Tablets and drops for allergic conjunctivitis:

Drugs with antihistamine action - Loratidine, Zyrtec, Claritin, Telfast, Cetrin. Some of the funds are not used to treat children.

Drops that stabilize the state of the cell membrane - Zaditen (Ketotifen), Lecrolin (Cromohexal).

Eye drops that block histamine receptors - Allergodill, Opatanol, Visin allergy, Histimet.

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

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

Complex forms of allergic conjunctivitis can be treated with eye drops containing corticosteroids, most often containing hydrocortisone or dexamethasone. Hormonal treatment can lead to unpredictable complications for the body, so such drugs require a balanced approach, precise dosage, and gradual withdrawal.

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

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

Treatment of seasonal conjunctivitis (hay fever)

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

Treatment of disease manifestations:

To quickly relieve symptoms, Allergodil or Spersallerg is instilled. In most cases, relief occurs 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. For severe manifestations, antihistamines are used orally.

Subacute or acute course of the disease is stopped with Cromohexal or Alomide eye drops, using 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 body. Symptoms of the disease are usually somewhat smoothed out, 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, body and hair care products.

Treatment is carried out with drops of Dexamethasone, Spersallerg (1-2 times a day), Alomide, Kromhexal (2-3 times a day).

Treatment of vernal keratoconjunctivitis

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

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

If there are changes in the cornea, erosions, infiltrates, or keratitis appear on it, instillations with Alomide are used, using the drug 2-3 times a day.

Acute manifestations of allergies are treated with 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, a relationship has been identified between allergies and any bacterial or viral conjunctivitis, regardless of the factors that caused them. It is believed that in the clinical picture of fungal, herpetic, chlamydial, adenoviral conjunctivitis, there are also manifestations of allergies. Its role is especially great in the course of chronic conjunctivitis.

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

Based on this, when treating these types of inflammation of the mucous membrane, eye drops with antiallergic properties are always prescribed.

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

Treatment of drug-induced allergic conjunctivitis

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

Even drugs for the treatment of ophthalmic pathologies can cause drug-induced conjunctivitis. It appears on the skin of the eyelids, on the conjunctiva, and on the cornea of ​​the eye. Most often, the cause of this reaction is a preservative in eye drops; the reaction to it can be delayed and appear 2-4 weeks after the agent penetrates the immune system.

At the beginning of treatment, contact with the allergen is limited, the doctor prescribes an oral antihistamine - Cetrin, Claritin, Loratidin (once a day), eye drops Spersallerg, Allergodil for the acute course of the process, or Alomide, Kromhexal for the chronic form of drug-induced conjunctivitis.

Conjunctivitis is an inflammatory process that occurs on the mucous membrane of the eye. The term “conjunctivitis” cannot be considered a full name of the pathology without mentioning the cause or nature of the infectious lesion, for example, “chronic conjunctivitis” or “allergic conjunctivitis”. This is the full name used in the medical history.

Conjunctivitis is an inflammation of the mucous membrane of the eye that occurs as a result of exposure to various negative factors. For various reasons, adults suffer from this pathology more often than children. Conjunctivitis is often provoked by pathogenic microorganisms, viruses, and fungi. Simultaneously with the appearance of conjunctivitis, the patient may suffer.

Constantly increased eye pressure leads to the development of glaucoma, which leads to a decrease in visual acuity, and subsequently to blindness. Most often, the disease develops in older people, so such patients should be especially careful if pressing pain in the eyes occurs.

Depending on what exactly caused the itching in the eye area, irritation can affect not only the mucous membrane, but also the eyelids. In some situations, itching in the eyes is provoked by allergic components that are located in the air. Similar substances, or.

Eye inflammation is a complex adaptive reaction of a compensatory nature in response to factors from both the external and internal environment. It can be localized both in the eye itself and in the periocular area. The severity of inflammation depends on the cause that caused it. The reaction of the eye to a stimulus.

The information on the site is intended for informational purposes only and does not encourage self-treatment; consultation with a doctor is required!

Allergic conjunctivitis (AC) ? This is a disease of an allergic nature, in which inflammation of the conjunctiva of the eyes occurs (the conjunctiva is a thin membrane lining the inside of the upper and lower eyelids, covering the eyeball).

The disease is more common among children prone to allergies. This could be any food allergy, atopic dermatitis, bronchial asthma, etc.

AK is not a hereditary disease, but the predisposition to the allergy itself is inherited. Most sick children have close relatives who have had any allergic disease in the past or currently.

Most common trigger allergens:

• plant pollen,
• pollen from flowering trees,
• pet hair,
• bird feather,
• room dust,
• house mites,
• paint and varnish products,
• contact lenses,
• eye cosmetics,
• medications.

Development of the disease

The allergen reaches the conjunctiva in two ways: by direct application to the outer membranes of the eye (when wearing contact lenses, when using low-quality cosmetics) and through the air (plant pollen, room dust).

In the first case, the manifestations of the disease may be one-sided (for example, right-sided allergic conjunctivitis when mascara gets into the eye for coloring eyelashes). In the second case, the pathological process affects both eyes.

• redness of the conjunctiva of the eyes,
• itching, pain in the eyes,
• feeling of sand, foreign body in the eyes,
• swelling of the eyelids,
• mucous discharge from the conjunctival sac,
• rarely decreased visual acuity.

Diagnostics

The diagnosis and treatment of this disease is carried out by doctors of two specialties: an ophthalmologist and an allergist-immunologist.

In most cases, the diagnosis is made based on external symptoms. Often the disease has a certain seasonality. In some cases, the child’s parents indicate a specific allergen, contact with which leads to the development of AK.

To completely confirm the diagnosis, a tear fluid examination is performed. The detection of a large number of eosinophils (>10%) clearly indicates an allergic nature.

A clinical blood test may also reveal an increase in allergy cells (>5%). However, peripheral blood does not always respond. The absence of eosinophilia (increased eosinophil levels) does not completely refute the suspected diagnosis.

When allergy manifestations are combined, and in addition to conjunctivitis there are other manifestations (for example, watery runny nose, difficulty breathing, shortness of breath), it makes sense to conduct skin tests. They are carried out with the aim of identifying a significant allergen and exclusively during the period of subsidence of clinical manifestations. Using small incisions, the most common allergens are applied to the area of ​​the inner forearm. Those that cause an allergy in a child will provoke the development of swelling and inflammation at the sites of their application.

A study of venous blood will reveal an increased IgE content, which confirms the allergic nature of the pathology.

• Maintaining a hypoallergenic lifestyle. This means taking all possible preventive measures to get rid of (or reduce the amount of) allergens in the house where the child lives. All favorite places where dust accumulates should be eliminated: carpets, rugs, soft toys. The premises must be wet cleaned daily.

All books must be stored in wardrobes behind closed doors. No cats, dogs or parrots should be kept at home. Wool, down and feathers are significant allergens for the patient; in addition, animals carry mites on themselves, which also provoke the development of allergies.

During the spring flowering period, all windows in the premises should be tightly closed. Ventilation can allow respiratory allergens to penetrate inside. To ensure fresh air flow, it is recommended to install home air conditioners.

A child with allergies should go outside wearing glasses that fit tightly to their face and, if necessary, wear a protective mask.

Allergic conjunctivitis has a high prevalence among children. Teenagers are most susceptible to its occurrence, which is associated with hormonal changes in their bodies, as well as with the start of older girls using decorative cosmetics for the eyes. However, the disease has been well studied, so in most cases it is still possible to overcome its unpleasant, painful symptoms.

Allergic conjunctivitis in a child

Allergic conjunctivitis in children begins with redness and swelling of the eyelids. The child's eyes itch and tears flow spontaneously for no reason. These may be the first signs of allergic conjunctivitis, so you should consult a doctor immediately.

In children, manifestations of allergic conjunctivitis occur in the following forms:

The causes of allergic conjunctivitis in children can be both heredity and external factors. Allergic inflammation of the conjunctiva is a fairly common disease in which eye irritation is caused by some allergen. Sometimes it is impossible to identify the irritant for a long time.

• Genetic predisposition (inherited from parents).
• Household and social aspects.
• Increased sensitivity of the body to external irritants.
• Poor immunity.

• household factor (dust, fluff, feathers, intolerance to household chemicals);
• contact with animals (more precisely, with their fur);
• medications (most often these are eye drops and gels);
• food allergens (citrus fruits, berries, honey);
• cigarette smoke making children passive smokers;
• plant pollen during the flowering period;
• foreign body in the eyes (lenses, prostheses);
• infections (viral, bacterial, fungal origin).

Symptoms of allergic conjunctivitis begin to appear in the first hours after the child comes into contact with the allergen(an irritant). The signs are clearly expressed and are almost impossible to confuse with something else:

• redness and swelling of the conjunctiva of the eye;
• itching and burning in the eyes, feeling as if sand had been poured into the eyes;
• discharge of mucus from the eyes (transparent or viscous), in which the eyes and eyelashes stick together, the mucus dries out and rolls up into yellowish lumps;
• pain in the eyes and fear of harsh, bright light (sometimes the child tries not to open his eyes at all);
• rapid eye fatigue;
• in the morning the eyelids seem to be “glued together”;
• runny nose combined with cough;
• sometimes vision is greatly reduced.

The disease first affects one eye and then the other. Children feel discomfort, so they often rub their eyes, thereby transferring the irritant from the diseased eye to the healthy one.

Classification

Allergic conjunctivitis is divided into seasonal and year-round; it can also be acute and chronic.

• Seasonal makes itself felt during the flowering period of plants, when pollen comes into contact with the mucous membrane of the eye, causes irritation and provokes disease.
• Year-round does not depend on the time of year and manifests itself with constant contact with external allergens (dust, wool, etc.)

Diagnostics

Diagnosis of allergic conjunctivitis is not difficult, but a pediatric ophthalmologist still examines the fundus and visible parts of the eye. Before prescribing treatment, the immunologist prescribes appropriate tests and finds out does the child have a genetic predisposition to the disease?.

A thorough study helps you choose the best treatment option. The main and most important stage in treatment is correct diagnosis, which allows you to identify and eliminate the irritant that leads to an exacerbation of the disease.

• Examination of tear fluid;
• Blood test (clinical, for allergens);
• Skin tests for allergens (markers).

The inflammatory process can be caused by a number of reasons:

• If the disease is caused by medications, then this drug is discontinued.
• An allergic reaction to contact of the mucous membrane with a foreign body is eliminated by removing lenses, prostheses, and postoperative sutures.
• If allergic conjunctivitis is caused by an infection or tuberculosis process, then treatment of the underlying disease is prescribed.

Treatment of allergic conjunctivitis consists of recommendations from an ophthalmologist and an allergist. Usually eye drops are sufficient, but in case of severe inflammation, antiallergic medications are also prescribed.

Eye drops

Oftadek- These are eye drops that have antimicrobial and anti-inflammatory effects; they contain a strong antiseptic. Place 2 drops in children's eyes 6 times a day.

Naphthyzin– relieves inflammation and constricts blood vessels.

Antihistamines

There are a large number of antihistamines (more than 150 types). A thorough study will help prescribe the optimal medications that will not harm the baby’s health and will help him get rid of unpleasant allergic reactions.

Folk remedies

At the first sign of allergic conjunctivitis, apply a cold compress. Self-prepared eye wash solutions have a very good effect:

• penicillin– the bottle with the powder is diluted with boiled water;
• wheat flour decoction(2 tablespoons of cereal are boiled in 500 ml of water);
• calendula infusion(flowers are brewed in a thermos and left for at least 2 hours).

Prevention

All preventive measures for allergic conjunctivitis come down to several basic rules of hygiene and healthy lifestyle.

• Children must be taught strictly maintain personal hygiene, wash your hands, change towels and linen regularly.
• As often as possible ventilate your home. The house must be clean, so that “not a speck of dust, not a speck.” After all, it is these same “specks of dust” that can cause an allergic reaction.
• Very important strengthen immunity, because a weakened body easily succumbs to any disease. Choose a good vitamin complex and make sure you take it regularly.
• Hardening- this is a method that gives amazing results. Many cases have been described in which simply pouring cold water on the most severe allergy sufferers turned children into completely healthy children.
• Try don't have any pets if there is a small allergic person growing up in the family.
• It is necessary to create the safest possible area around children, which will limit their contact with possible allergens.
• With maximum care, a healthy lifestyle and a balanced diet, your children will grow up full of strength and energy.

10 tips for parents with allergic conjunctivitis in a child

The onset of such a common allergic eye disease as atopic conjunctivitis most often occurs in childhood. In most cases, this disease accompanies the course of allergic rhinitis.

A more striking clinical picture of conjunctivitis can be observed during the flowering period in children suffering from hay fever, that is, susceptibility to pollen allergens.

Allergic conjunctivitis in a child and its types

Allergic conjunctivitis in children is formed as a result of allergic immune inflammation of the conjunctiva of the eyes when interacting with allergenic substances.

There are seasonal and year-round allergic conjunctivitis. Seasonal is observed in children during the flowering period of trees and grasses. In some cases, there is hypersensitivity to mold allergens.

Causal factors for the development of atopic conjunctivitis in a child

• House and book dust.
• Fungi.
• Animal fur and epidermis.
• Insect allergens (especially cockroaches).
• Pollen from trees and grasses.
• Medicines.
• Food allergens.

The mechanism of allergic conjunctivitis

When a child encounters an allergen, a hypersensitivity immune reaction is triggered with the production of specific antibodies.

Clinical manifestations of allergic conjunctivitis in a child

The baby's eyes turn red, puffiness and swelling of the eyelids appear, and the child is bothered by itching and watery eyes.

In some cases, a secondary infection may develop with the formation of bacterial complications. Purulent discharge appears from the eyes, the eyelids stick together.

How to suspect a child has allergic conjunctivitis?

• Symptoms of conjunctivitis due to household hypersensitivity can appear only with close contact with the allergen during cleaning, repairs, or while staying in a dusty room.
• Watery eyes and itching of the eyes may worsen upon contact with tobacco smoke or exhaust fumes.
• With an allergy to pollen proteins, there is a very clear periodicity of symptoms. That is, redness and itching of the eyes appear strictly in certain months and even days every year.
• Deterioration of the patient's condition with pollen hypersensitivity is observed in dry, hot weather, outside the city, in the forest.
• When using cosmetic preparations with plant extracts, a child suffering from pollen allergies may experience conjunctivitis and skin rashes.
• If you are allergic to fungi, the symptoms of conjunctivitis in a child worsen in the spring and autumn, while staying in damp areas, after rain.
• When eating yeast baked goods, kvass, or cheese, children with fungal hypersensitivity may experience symptoms of conjunctivitis.
• The presence of an allergy to dust does not exclude the presence of pollen and fungal hypersensitivity in a child. In this case, the symptoms bother the baby throughout the year with frequent exacerbations during the flowering period of the plants.

By eliminating encounters with the allergen, the symptoms of conjunctivitis disappear.

Diagnosis of atopic conjunctivitis in children

Let's take a closer look at them.

1. General blood analysis.
2. Cytology of a smear from the conjunctiva.
3. A swab from the conjunctiva of the eye for bacterial culture.
4. Allergy testing using skin tests.
5. Determination of specific antibodies to allergens in the blood.
6. Provocative tests with allergens.

What eye diseases should allergic conjunctivitis be distinguished from?

• Allergic keratoconjunctivitis. Children under five years of age often get sick. A distinctive feature of the disease is photophobia. Both eyes are most often affected, combined with skin rashes. The disease is scary due to its complications in the form of cataracts and retinal detachment.
• Viral and bacterial conjunctivitis. The symptoms are the same as for allergic conjunctivitis. Virological and bacteriological examination reveals the pathogen.
• Spring catarrh. It is more often registered in boys over 4 years of age. Symptoms of conjunctivitis appear in the summer-spring period under insolation conditions. The upper eyelids are affected, photophobia appears.
• Dry keratoconjunctivitis. More often found as part of Sjögren's syndrome. Characterized by photophobia, blurred vision, and dry conjunctiva.

A sick child needs consultation with a pediatric ophthalmologist and an allergist-immunologist.

Treatment is carried out on an outpatient basis, but in some severe cases it is recommended hospitalization.

1. The first and most important stage of therapy is to isolate the child from the causative allergen. The allergist will give you recommendations on a hypoallergenic lifestyle and diet, which will need to be strictly followed.
2. When an allergen is identified based on the results of skin tests, allergen-specific immunotherapy (ASIT) is prescribed. Currently, this therapy is the only way to permanently protect a child from allergy symptoms. ASIT is injectable and sublingual. For children, the second method is preferable.
3. Local therapy. For mild symptoms, it is recommended to use cromoglycic acid in the form of eye drops. Local antihistamines Azelastine and Diphenhydramine can also be used. In severe cases with extensive lesions, dDexamethasone drops 0.1% are used. If a secondary infection occurs, drops containing an antibiotic are added to the treatment.
4. Basic treatment. To relieve itchy eyes, antihistamines are used in age-specific dosages: Zodak, Zyrtec, Xyzal, Erius. Leukotriene receptor antagonists (Singulair) are used in preparation for the flowering season. Important! Treatment of complicated forms of conjunctivitis is carried out by an ophthalmologist.
5. Further therapy.

In year-round form, consultations with an allergist are carried out as planned. Parents are recommended to attend classes at an allergy school, where they can get all the necessary information on organizing everyday life.

Disease prognosis

In the vast majority of cases, the prognosis is favorable. When the causative allergen is identified and ASIT is performed, recovery is observed in 90% of children. In advanced forms and late seeking medical help, there are frequent cases of severe complications, including blindness.

Memo to parents of children suffering from hay fever

1. Hay fever is a disease caused by plant pollen. Pollen contains a protein that very often leads to allergic reactions. Pollen grains are carried by the wind, and during the flowering period the concentration of allergens in the air becomes enormous. For the European part of Russia, the flowering period of trees begins in mid-April and ends in June. Cereals bloom in June-July. Weeds in August-September.
2. For patients with hay fever, it is mandatory to follow an elimination diet. If you are sensitized to tree pollen allergens, you should avoid eating apples and stone fruits, carrots, and celery. If you are allergic to cereals, you should not eat kvass, bran, cereals, or porridge. If you are hypersensitive to weeds, avoid mayonnaise, melons, watermelons, halva, and sunflower seeds.
3. Beware of using cosmetics that contain plant extracts.
4. The use of herbal medicines is prohibited.
5. During the flowering period, the best solution is to go to an area with a different dust calendar - Crimea, Turkey, Egypt, Greece.
6. During the flowering period, it is not recommended to take the child out of town, to the country, or to visit parks.
7. You should install an air purifier with a HEPA filter at home.
8. The child should take a shower every time he goes outside.
9. As often as possible during the flowering period, you should wash your nose, eyes, and gargle. Important! During the period of plant dusting, a patient with hay fever is prohibited from vaccination or surgery.
10. The child should avoid heavy physical and psycho-emotional stress during the flowering period of plants.

Graduated from the Kirov State Medical Academy in 2011. Professional retraining at the Kazan State Medical Academy in the specialty of allergology-immunology in 2014. I work at the Kirov Regional Clinical Hospital as an allergist-immunologist. I specialize in allergic diseases and immunodeficiency conditions in adults and children.

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Allergic conjunctivitis in children

Allergic conjunctivitis in children– an inflammatory process in the conjunctival membrane of the eye, which is a reaction to a particular antigen that sensitizes the body. The development of allergic conjunctivitis in children is accompanied by local swelling, itching and redness of the eyes, lacrimation, and photophobia. Diagnosis of allergic conjunctivitis in children is carried out by a pediatric ophthalmologist and allergist; includes microscopic examination of tear fluid, total IgE, CBC, and skin testing. Therapy of allergic conjunctivitis in children requires eliminating contact with the allergen, prescribing antihistamines in the form of eye drops and orally, and conducting specific immunotherapy.

Allergic conjunctivitis in children

Allergic conjunctivitis in children is a common disease in pediatrics, which is the subject of study in pediatric ophthalmology and allergology. Allergic conjunctivitis in a child is characterized by inflammation of the mucous membrane covering the sclera and the inner surface of the eyelid, caused by the body's hypersensitivity to any allergen. In most cases, the manifestation of allergic conjunctivitis in children occurs at the age of 3-4 years. Among school-age children, allergic conjunctivitis occurs in 3-5% of cases. Allergic conjunctivitis in children usually accompanies other allergic manifestations: allergic rhinitis, hay fever, atopic dermatitis, bronchial asthma, etc.

Causes of allergic conjunctivitis in children

Allergic conjunctivitis in children is based on increased individual sensitivity to certain environmental factors - allergens. Such exogenous factors can be allergens: household (house and library dust, mites, pillow feathers, household chemicals), pollen (pollen from flowering trees and herbs), epidermal (dander and animal hair, pet food), food (food - citrus fruits, chocolate, honey, berries, etc.), medicinal (medicines).

It has been established that allergic eye diseases in young children are more often caused by genetic and social factors, and in older children - by previous household, food, and epidermal sensitization, the severity of which largely determines the severity of allergic conjunctivitis.

Classification of allergic conjunctivitis in children

Taking into account the etiopathogenetic mechanisms, the following forms of allergic conjunctivitis in children are distinguished: hay (hay fever), macropapillary (hyperpapillary), drug, tuberculosis-allergic, infectious-allergic and spring catarrh,

Hay conjunctivitis in children is an allergic eye disease caused by pollen from grasses, cereals, and trees. It has a seasonal dependence and occurs during the flowering of those plants to whose pollen the body is sensitized. With hay fever (hay fever), allergic conjunctivitis in children is combined with urticaria, asthmatic bronchitis, atopic or contact dermatitis, Quincke's edema, dyspeptic disorders, and headaches.

Spring conjunctivitis most often occurs in boys aged 5-12 years. This form of allergic conjunctivitis in children has a persistent chronic course; exacerbations occur mainly in the sunny season. Spring catarrh can occur in conjunctival, limbal and mixed forms.

The occurrence of hyperpapillary conjunctivitis is associated with contact irritation of the conjunctiva by foreign bodies (contact lenses, ocular prostheses, sutures). On examination, giant papillae (1 mm or more) are revealed on the conjunctiva of the upper eyelid.

Drug-induced allergic conjunctivitis in children develops due to the use of various eye drops. Allergies can occur both to the main active ingredient and to the preservatives used in the drops; Allergic conjunctivitis in children occurs especially often when antibacterial eye drops and anesthetics are instilled.

Infectious-allergic conjunctivitis in children is associated with sensitization of the body to microbial allergens: bacterial, viral, fungal exotoxins. In this case, the pathogen itself is not detected in the conjunctiva of the eye.

Tuberculosis-allergic eye damage occurs as keratoconjunctivitis, with simultaneous damage to the conjunctiva and cornea. This form of allergosis is a consequence of an allergic reaction to waste products of Mycobacterium tuberculosis circulating in the blood.

Symptoms of allergic conjunctivitis in children

Typically, symptoms of allergic conjunctivitis in a child develop within a few minutes or one day after interaction with the allergen. In this case, both eyes are involved in reactive inflammation.

The child's eyelids swell, the conjunctiva becomes hyperemic and swollen, lacrimation occurs, and in severe conjunctivitis, photophobia occurs. The leading subjective symptom of allergic conjunctivitis in children is intense itching, which forces the child to constantly scratch his eyes, further intensifying all manifestations of the disease.

Transparent mucous (sometimes sticky or filmy) discharge constantly accumulates in the conjunctival cavity. Purulent discharge in uncomplicated allergic conjunctivitis in children is usually absent, and occurs only when an infectious component is attached.

Allergic conjunctivitis in children can occur acutely (with a rapid onset and rapid end) or chronically (long-term, sluggish, with periodic exacerbations). The nature of the course is determined by the causally significant allergen and the frequency of contact with it.

Diagnosis of allergic conjunctivitis in children

Diagnosis of allergic conjunctivitis in children is carried out by a pediatric ophthalmologist and an allergist-immunologist. Reliable diagnostic criteria for allergic conjunctivitis in children include: the presence of an allergic history, the connection of the occurrence of the disease with certain external factors (flowering, contact with animals, consumption of certain foods, etc.), characteristic clinical symptoms.

To confirm the diagnosis, a microscopic examination of the tear fluid is performed, where, in allergic conjunctivitis in children, over 10% of eosinophils are detected. With the allergic nature of the disease, an increased level of total IgE and eosinophilia are also detected compared to the age norm. In the presence of purulent secretion, a bacteriological examination of the discharge from the conjunctival cavity is carried out. The manifestation of a systemic allergic reaction necessitates an examination of the child’s gastrointestinal tract, a stool test for helminth eggs, and a scraping for enterobiasis.

The direct cause of allergic conjunctivitis in children can be identified through skin allergy tests and a blood test for specific IgE.

Differential diagnosis of allergic conjunctivitis in children is carried out with demodicosis, fungal, bacterial, autoimmune conjunctivitis.

Treatment of allergic conjunctivitis in children

An indispensable condition for successful treatment of allergic conjunctivitis in children are elimination measures that involve eliminating contact with the allergen.

The pathogenetic basis for the treatment of allergic conjunctivitis in children is antihistamines in the form of tablets and instillation of eye drops in age-specific dosages and concentrations. If the disease persists, topical NSAIDs and corticosteroids are prescribed.

Allergen-specific therapy is possible, which is most effective in children. It involves the introduction of small doses of the allergen in increasing concentrations, which is accompanied by gradual adaptation to this allergen, a decrease or disappearance of the symptoms of allergic conjunctivitis in children.

Forecast and prevention of allergic conjunctivitis in children

If allergic conjunctivitis in children is not diagnosed in a timely manner, the cornea and other eye tissues may become involved in the inflammatory process, which can lead to a decrease in visual acuity and the development of difficult-to-treat forms of eye diseases (keratitis, corneal ulcers). Identification and elimination of the allergen, as well as specific immunotherapy, can prevent relapses of allergies.

Specific prevention of allergic conjunctivitis in children has not been developed. Attention should be paid to strengthening the child’s general immunity, conducting preventive courses of desensitizing therapy during periods of exacerbation of the disease, and avoiding contact with known allergens.

Today it is difficult to find a person who has not experienced allergy symptoms at least once. Allergic reactions in both adults and children can be triggered by anything - dust, pet hair, certain products, chemicals used in everyday life. The body can react to these irritants in different ways, including conjunctivitis, that is, inflammation of the conjunctiva of the eye. This disease causes severe discomfort to the child and is fraught with complications, so it is important to identify the cause of the allergy in time and eliminate it.

What is pathology

The disease develops due to the body's hypersensitivity to some allergen and is manifested by reactive inflammation of the mucous membrane lining the sclera and the inner surface of the eyelids. This process, as a rule, occurs together with other signs of allergies - hay fever (allergic rhinitis), asthma, dermatitis. Sometimes the disease occurs in isolation. In any case, it is not contagious and cannot be transmitted to others.

Most often, children three to four years old suffer from the pathology; in children of middle school age, manifestations of allergic conjunctivitis are diagnosed in 5% of cases.

Allergic conjunctivitis is a reactive inflammation of the conjunctiva in response to the action of an allergen to which the body is sensitive

Symptoms of the disease can occur at certain times of the year or be constant (year-round) and have different severity. Depending on this, there are several flow options:

• spicy;
• subacute;
• chronic.

Research by allergists suggests that in the youngest children the cause of pathology is genetic predisposition and social factors, and in older patients the negative reaction is due to preliminary sensitization (increased sensitivity) of the body to the action of initially harmless substances that have turned into strong allergens.

Types of disease

Depending on what triggered the reaction, there are several forms of the disease:

1. Hay fever (seasonal allergic rhinoconjunctivitis, sometimes called hay fever) occurs during the flowering of some plants.
2. Spring conjunctivitis, or spring catarrh, is observed mainly in boys 5–12 years old in the spring months, when there is a lot of sunlight. This type is chronic, long-term and has 3 forms:
   • conjunctival;
   • limbal;
   • mixed.
3. The medicinal type is associated with the use of certain drugs.
4. Phlyctenulous (scrofulous) keratoconjunctivitis is of a tuberculous-allergic nature and occurs most often in children under 3 years of age, including infants.
5. Large-papillary (large-papillary, hyperpapillary) type of disease occurs when the eye comes into constant contact with a foreign body.
6. The infectious-allergic type occurs due to increased sensitivity of the body to exotoxins produced by microbes: bacteria, fungi, viruses. In this case, the pathogen itself is not present in the tissues of the eye.

Video - what happens with allergic conjunctivitis

Causes and development factors

The development of any form of the disease is based on individual hypersensitivity to certain substances - allergens. A variety of factors can act as such provocateurs, for example:

• household chemicals;
• pet fur or feathers;
• house dust and the microscopic dust mites that live in it;
• fungal (mold) and bacterial spores.

Such allergens provoke the development of year-round chronic conjunctivitis. An unventilated room and infrequent wet cleaning are factors that aggravate the condition of a child with this form of the disease.

Hay conjunctivitis occurs as a reaction to the flowering of plants to which the body is hypersensitive. These can be cereals, wormwood, ragweed, poplar, hazel, birch, alder and others.

The medicinal type of the disease develops as a result of the use of eye drops or ointments. A provocateur can be both the active substance and various preservatives that are used in these products. Most often, children are allergic to antibacterial drops and anesthetics.

Large-papillary conjunctivitis causes constant contact of the mucous membrane with foreign bodies - postoperative sutures, contact lenses, prostheses.

The tuberculosis-allergic form occurs due to the reaction of the child’s body to Mycobacterium tuberculosis, or rather, to the products of their vital activity, which are carried throughout the body through the bloodstream.

The contact type of pathology develops when the eyes are directly exposed to allergens:

• cosmetics;
• disinfectant solutions for contact lenses;
• cleansers;
• herbal infusions and decoctions that mothers sometimes use to wash their babies and wash their eyes.

In some cases, allergic manifestations may be caused by harmful fumes, smoke, gases, or may occur as a result of eating certain foods: chocolate, citrus fruits, honey, milk, etc. Such reactions do not occur in isolation, but are combined with rhinitis or dermatitis.

Photo gallery - factors provoking the disease

Spring catarrh worsens during the sunny season Ragweed pollen is a very strong allergen, the cause of seasonal conjunctivitis. Chronic allergic conjunctivitis can be caused by mites living in house dust Drug-induced allergic conjunctivitis may be caused by eye drops Contact with animals can provoke the development of allergic inflammation of the conjunctiva Contact lens solution may cause an allergic reaction Mycobacterium tuberculosis is the cause of the tuberculosis-allergic form of conjunctivitis Allergic conjunctivitis often worsens during the poplar flowering period The development of hyperpapillary conjunctivitis can be provoked by contact lenses

Symptoms of the disease in a child: swelling of the eyelids, lacrimation, itching

The speed and severity of the manifestations of the disease depend on the number of allergic agents entering the body and on the strength of the protective reaction, which can be either immediate or delayed. In the first case, reactive inflammation develops literally in a few minutes, in the second - after 1–2 days. Both eyes always suffer. The process can be acute - with a rapid onset and relatively rapid subsidence of symptoms, or it can be sluggish in nature with regular exacerbations.

Main symptoms:

• swelling and hyperemia of the conjunctiva and eyelids;
• increased lacrimation;
• severe itching and burning in the eyes, sometimes photophobia.

The child rubs and scratches his eyes, thereby further intensifying the symptoms. First, a transparent exudate is released from the eyes, then sticky, sometimes filmy. There is no purulent discharge during an allergic reaction; this is only possible if an infection occurs, and this can happen due to the fact that the child constantly rubs his eyes.

At the height of the disease, the amount of exudate decreases and other symptoms are observed:

• sensation of sand or foreign body in the eyes due to dry mucous membranes;
• photophobia (increased symptoms in bright light);
• sharp pain when moving the eyes;
• a veil before the eyes;
• impaired visual acuity due to conjunctival edema.

Depending on the cause of the allergy and the form of the disease, additional symptoms characteristic of this type of conjunctivitis are added to the main symptoms:

Features of the course in a newborn and infant

A newborn baby's eyes may become sour. This is manifested by sticking of the eyelids after sleep, the formation of dry whitish crusts on them. But there is no swelling of the eyelids or redness of the conjunctiva. This condition is not conjunctivitis; after washing the eyes with boiled water, everything returns to normal. In newborn babies, the lacrimal glands do not function, and the ducts that connect the lacrimal sacs to the nasal cavity are insufficient. Therefore, all signs will disappear by 1.5–2 months.

Parents should be alert to the following symptoms:

• redness of the conjunctiva and eyelids;
• edema;
• lacrimation;
• discharge from the eyes;
• photophobia;
• pain and itching in the eyes, to which the baby reacts with anxiety, agitation, loud screaming, crying, refusal to eat, and poor sleep.

Diagnostics

Having noticed the first signs of conjunctivitis, parents should consult an ophthalmologist, who will make a diagnosis based on an external examination and will definitely refer you to an allergist. If necessary, the child should be examined by an immunologist, dermatologist, or infectious disease specialist.

At the first stage of diagnosis, doctors collect information about the sick baby: complaints, the connection between the stimulus and the patient’s reaction, conduct an examination, and prescribe a laboratory examination.

A clinical blood test reveals an increased level of eosinophils, which indicates an allergic reaction.

When examining secretions from the eyes under a microscope, eosinophils are also detected (more than 10%).

A blood test is performed for specific immunoglobulin E, as well as skin allergy tests to determine the cause of the disease: patch or scarification test, prick test. Skin tests are performed on children after 4 years of age.

If eye damage is a symptom of a systemic allergic reaction, additional stool tests are performed for worm eggs and scrapings for enterobiasis.

The pathology must be differentiated from demodicosis and other types of inflammation of the conjunctiva: bacterial, viral, fungal.

Differences between allergic conjunctivitis and other types - table

Treatment of the disease

The patient should be treated by an ophthalmologist together with an allergist-immunologist. Therapy is carried out in three main directions at once:

• stopping contact with the allergic agent;
• in mild cases - local antihistamines, in severe cases - antiallergic drugs orally, and hormonal drugs - topically;
• correction of immunity.

To alleviate the baby’s condition, in addition to drug therapy, it is recommended to apply cool compresses to the eyelids, remove sources of bright light in the room, and curtain the windows.

Medicines: eye drops, antihistamines in the form of tablets, syrups

Mild cases of the disease require topical application of antiallergic eye drops (histamine blockers):

• Allergodil (from 4 years);
• Opatanol (from 3 years of age, can be used for a long time, up to 4 months);
• Lecrolin (from 4 years old);
• Histimet (from 12 years old);
• Spersalerg (from 2 years of age, no more than 1 drop per day).

The persistent course of the disease requires the use of other drugs:

• antihistamines in drops (stabilizers of mast cell membranes):
  • Hi-Krom (prescribed from 4 years of age);
  • Alokomide (Lodoxamide, not prescribed until 2 years);
  • Cromohexal (from 5 years);
  • Lecrolin, Krom-Allerg and Zaditen (Ketatifen) - these drugs are prescribed from 4 years of age;
• antihistamines orally in tablets or syrups:
  • Claritin (Loratadine) - from 2 years;
  • Erius from 1 year or Eden from 6 months (the active ingredient of the drugs is desloratadine);
  • Cetrin in syrup or Zyrtec is prescribed from 2 years of age (the active ingredient is cytirizine);
  • Telfast - from 12 years old;
• eye drops or ointments with corticosteroids - Descamethasone or Hydrocortisone, Medrizone.

In addition to these drugs, they may additionally prescribe:

• tear substitutes to moisturize the conjunctiva and relieve irritation:
  • Visine;
  • Oftogel;
  • Vidisik;
• vasoconstrictors in drops, mainly with oxymetazoline;
• to restore the cornea, vitamin-containing preparations, antioxidants:
  • Oftan Katahrom;
  • Emoxipin;
• anti-inflammatory drops:
  • Diclofenac;
  • Indocollier. They try not to prescribe them to children under 6 years of age;
• local antibiotics in case of infection.

Constant relapses of the disease require the use of immunotherapy drugs in remission, for example, Histaglobulin, containing histamine and human immunoglobulin, is prescribed. Cyclosporine, which inhibits the action of T-lymphocytes, is effective for seasonal conjunctivitis.

Some cases of the disease require allergen-specific therapy, which consists of periodic administration of doses of the allergen, starting with the minimum and increasing. Such treatment ultimately ensures the complete elimination or weakening of the symptoms of the pathology.

All medications and their dosage should be selected by a pediatrician, since medications for treating allergies have many contraindications and prescribing them independently may not only not bring results, but also complicate the child’s condition.

Photo gallery: drugs for treatment

Erius syrup - an antihistamine for children from 1 year of age
Systane is used for dry and irritated eyes Allergodil drops have an antiallergic effect Histaglobulin is used for recurrent allergic conjunctivitis Visoptik helps eliminate the symptoms of allergic conjunctivitis in children after 3 years of age Indocollir drops have anti-inflammatory and analgesic effects Krom-Allerg drops are prescribed for the prevention and treatment of allergic conjunctivitis
Dexamethasone drops are used to treat spring catarrh and severe other forms of allergic conjunctivitis.

Doctor Komarovsky about allergy medications - video

Folk remedies

When using traditional methods, you need to be sure that they will not cause an even greater allergic reaction.

Prognosis and complications

If the child’s parents sought medical help in time, the correct treatment tactics were selected, and in general the prognosis of the disease is favorable. A late diagnosis and lack of treatment can lead to the development of complications - inflammation of the cornea and other eye structures, and this can lead to decreased vision and the onset of intractable eye diseases - corneal ulcers, keratitis. An associated infection can cause bacterial conjunctivitis.

Preventive actions

There is no specific prevention of the disease. It is necessary to strengthen the child’s immunity, try not to come into contact with known allergens, and conduct courses of preventive therapy during the season of possible exacerbation.

In addition, you must follow these rules:

• carry out regular wet cleaning of residential premises and ventilation;
• purchase bedding with hypoallergenic fillings;
• exclude from the children's diet foods that can provoke a reaction:
  • citrus;
  • chocolate;
  • products with preservatives, dyes;
• try not to use household chemicals at home, replace them with harmless products (soda, baby soap).

If your baby is prone to the disease, you should regularly visit an allergist. Parents should always have on hand an antiallergic drug prescribed by a doctor.

Symptoms of allergic conjunctivitis in a child cannot be ignored. Parents should definitely show their baby to an ophthalmologist and an allergist. A properly selected individual treatment regimen will help eliminate the symptoms of the disease, and the baby will be healthy again.