Allergic conjunctivitis is an excessive immune response of the eye surface to allergens such as pollen, house dust mites or animal hair. Allergic conjunctivitis manifests itself with the triad of itching-redness-watering; it can be seasonal or year-round. Diagnosis of allergic conjunctivitis is confirmed by biomicroscopy and, if necessary, specific IgE tests. Treatment of allergic conjunctivitis is primarily limited to limiting allergen exposure, followed by regular use of artificial tears and antihistamine-mast cell stabilizing drops. In severe attacks, allergic conjunctivitis may require short-term topical steroids or immunomodulatory drops; close monitoring is essential in special forms such as vernal keratoconjunctivitis. Allergic conjunctivitis is relieved by applying cold compresses at home, changing pillowcases frequently and using a vacuum cleaner with a HEPA filter. Allergic conjunctivitis is not contagious, but constant eye rubbing increases the risk of keratoconus; itching should be controlled with drops. Allergic conjunctivitis is a manageable eye surface disorder that can be maintained with regular eye doctor check-ups, allergen avoidance measures, and disciplined drop treatment.
What is Allergic Conjunctivitis?
Allergic conjunctivitis is the inflammation of the transparent membrane (conjunctiva) covering the white part of the eye and the inner surface of the eyelids after contact with allergens. Pollen, house dust mites, animal hair, or chemical vapors trigger immune cells in the conjunctiva; histamine released from mast cells initiates the trio of itching – redness – watering. While seasonal attacks usually accompany pollen density in spring and fall, perennial (year-round) attacks are due to indoor allergens. It is more common in children, individuals with atopic dermatitis or allergic rhinitis, and can significantly reduce quality of life.
Types of Allergic Conjunctivitis
Allergic conjunctivitis is divided into four basic clinical types. The seasonal form is characterized by short-term but severe itching; in the perennial form, symptoms are milder but continuous. The giant papillary form develops as giant blisters in those who use hard contact lenses or prostheses. Vernal keratoconjunctivitis is a chronic, sometimes severe form that threatens vision and is seen primarily in boys and young people. Each subtype requires different drop protocols and follow-up intervals in the treatment plan.
Symptoms of Allergic Conjunctivitis
• Intense itching is the first signal in an allergic conjunctivitis attack; microscopic damage increases as patients rub their eyes.
During allergic conjunctivitis, watering and a clear, threadlike discharge cover the surface of the eye.
Redness is common in allergic conjunctivitis lesions; veins become more visible.
• Allergic conjunctivitis can cause sensitivity to light and blurred vision in advanced stages.
Allergic conjunctivitis, especially in the vernal type, creates giant papillary swellings under the upper lid.
Causes of Allergic Conjunctivitis
Allergic conjunctivitis begins with the immune system’s IgE-mediated overreaction mechanism. Pollen spores stick to the conjunctiva via the wind in the spring; house dust mites live in pillows, carpets and plush toys all year long. Proteins found in pet hair, irritant particles in cigarette smoke and chlorine in swimming pools weaken the epithelial barrier and increase mast cell sensitivity. Existing allergic rhinitis, bronchial asthma or atopic dermatitis history makes the eye surface more vulnerable to histamine secretion.
Diagnosis of Allergic Conjunctivitis
Diagnosis of allergic conjunctivitis is often made with a detailed history and biomicroscopy of the conjunctiva. Papillary appearance on the lower surface of the eyelids, transparent watery discharge and significant vascular dilation are typical. In suspicious cases, prick tests or specific IgE immunological tests can be used to determine the responsible allergen. In atypical cases, viral – bacterial conjunctivitis, uveitis or keratitis should be excluded.
How is Allergic Conjunctivitis Treated?
Treatment of allergic conjunctivitis is based on reducing allergen exposure and suppressing inflammation on the surface of the eye. The first step is to stay away from pollen, wash household textiles at 60 °C, use a vacuum cleaner with a HEPA filter and avoid smoking environments. In the pharmacological approach, artificial tear drops dilute allergen particles, and cold compresses temporarily narrow histamine-induced vascular dilation. Long-acting antihistamine-mast cell stabilizing drops (olopatadine, ketotifen) reduce itching rapidly when used twice daily. If the complaint is severe, short-term topical steroid support is given; in severe forms such as vernal keratoconjunctivitis, cyclosporine A drops or tacrolimus ointment may be required. In giant papillary form, daily soft lenses are considered appropriate instead of hard contact lenses, and lens hygiene is meticulously taught.
Preventive Tips
To reduce the incidence of allergic conjunctivitis, monitor your pollen counter, reduce the time spent outside on windy days, and wear sunglasses with shields. Keep a pollen filter in your air conditioner; change the filter at the beginning of the season. If you are allergic to cat or dog hair, keep your pet out of the bedroom and wash them once a week. Empty and renew your contact lens solution completely with each refill; “adding on top” can lead to infection and allergen buildup.
Frequently Asked Questions
Is allergic conjunctivitis contagious?
No, unlike viral and bacterial conjunctivitis, it is not transmitted from person to person.
Will I get better immediately if I use the drops?
Antihistamine drops reduce itching within a few minutes; however, regular use is necessary for complete relief.
Should I stop wearing contact lenses?
Prescription glasses should be preferred over contact lenses until symptoms improve.
How is allergic conjunctivitis controlled in children?
Plush toys should be limited in the child’s room, and curtains and bedding that do not collect dust should be chosen. The dose of drops is adjusted under the supervision of a doctor.