Allergic conjunctivitis closely related to allergic rhinitis and asthma (Sublingual immunotherapy show some promise in terms of treatment

At the spring meeting of the American Academy of Allergy, Asthma, and Immunology Annual Dr Sara Axelrod, resident in medicine at the University of Medicine and Dentistry of New Jersey in Newark reported that data from the National Health and Nutrition Examination Survey III found that 40% of the population in the survey reported at least one occurrence of ocular allergy symptoms. Over 20,010 people took part in the survey with 59% answering questions relevant to allergy.

Ocular allergy is often ignored because “people don’t ask about the eye even as it is just seen as the upper part of the respiratory system,” said Dr Sergio Bonini of the Department of Medicine at the Second University of Naples, who led a seminar on ocular allergy.

Another study at the AAAAI meeting estimated that about half of the $3.4 to $4.8 billion in annual direct costs for allergic rhinitis are actually attributed to ocular symptoms. Ocular allergy expenses also compose half of the $3.1 to $4.3 billion in annual indirect costs for allergic rhinitis. This study likened the burden of ocular allergy symptoms to nasal congestion, as nearly half of the allergic rhinitis symptoms are caused by ocular allergy

A third study from the University of Paraná, Curtiba, Brazil presented at the meeting tracked the prevalence of allergic conjunctivitis in asthmatic children and reported that physician registry of allergic conjunctivitis was found in 16% of the 1,549 patients studied, although 43.9% of patients actually complained of at least one symptom suggestive of ocular allergy. The Brazilian investigators even proposed in a poster presentation that allergic conjunctivitis, rhinitis, and asthma may be part of the same disease. As many as two thirds of the asthmatic patients they studied had symptoms of allergic rhinoconjunctivitis which suggests a close relationship between allergic diseases and that conjunctivitis should be included in the concept of ‘one airway disease’.

For a fuller report

Sublingual immunotherapy for treating allergic conjunctivitis.
Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S.
Department of Allergy and Respiratory Medicine, Royal Brompton Hospital, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK, SW3 6LY.

Allergic ocular symptoms, although frequently trivialised, are common and represent an important comorbidity of allergic rhinitis. Sublingual Immunotherapy (SLIT) is an effective and well-tolerated treatment for allergic rhinitis, but its effects on symptoms of ocular allergy have not been well established.

Overall, SLIT is moderately effective in reducing total and individual ocular symptom scores in participants with ARC and AC. There were however some concerns about the overall quality of the evidence-base, this relating to inadequate descriptions of allocation concealment in some studies, statistical heterogeneity and the possibility of publication bias. There is a need for further large rigorously designed studies that study long-term effectiveness after discontinuation of treatment and establish the cost-effectiveness of SLIT.

More research into rhinitis

First Published November 2009 Update July 2011

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