Allergic reactions in humans have different signs and symptoms. Ocular allergic conditions range from subtle symptoms such as itching, tearing of the eyes, accompanied by mild hyperemia to extensive inflammatory reactions. The most common symptoms are itching, burning and watering the eyes, with the secretion being watery. In most cases, previous allergic conditions are anamnestic. The most important symptoms characteristic of allergic conjunctivitis are swelling, red, edematous eyelids, conjunctival papillae, non-palpable pre-ocular lymph node.
Allergic reactions are hyperreactivity of the immune system to foreign substances – so-called immunogens or allergens. The answer may be innate or acquired. A key component of the ocular allergic reaction is mast cells. When mast cells interact with specific allergens, they degranulate by disposing of chemical mediators in surrounding tissues. The main mediators are histamine (which increases vascular permeability, induces vasodilation, itching, bronchospasm and increased mucous secretion), neutral proteases (which generate other inflammatory mediators); arachidonic acid (a major component of the cyclooxygenase pathway).
Because there are different types of ocular inflammatory reactions, treatment is mainly aimed at reducing symptoms. The most effective treatment for allergic conjunctivitis is the elimination of the allergic factor, although this is not always possible. It is recommended that students apply compresses, the use of artificial tears and lubricants that can wash away the allergen.
Topical decongestants cause vasoconstriction, reducing hyperemia, hemostasis, and other symptoms, delaying the release of mediators in the tissues. Topical antihistamines – Emadine and Livostin, as well as oral antihistamines, are also good choices. Mast cell stabilizers such as Alamast, Alocril, Alomide, etc. inhibit histamine release but are delayed. The most commonly used drugs are a combination of antihistamines and mast cell stabilizers – ketotifen, azelastine. The latter are extremely suitable for the treatment of seasonal allergies.
Topical non-steroidal anti-inflammatory drugs such as ketorolac and voltaren are indicated in moderate inflammatory reactions. In severe allergies, topical steroids such as prednisolone, loteprednol may be used. Loteprednol is a topical steroid specifically designed for allergic eye inflammation. It is effective even in very severe cases and studies have shown it to be relatively safe for long-term use in eye allergies. The monitoring of patients using the drug for more than 10 days is recommended.