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Specialist gives pearls on how to avoid mistakes in diagnosis, treatment of ocular allergies
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PARIS — Misdiagnosed and inadequately treated ocular allergies often turn into severe, chronic conditions that heavily affect a patient’s quality of life, according to one specialist.
Thanh Hoang-Xuan, MD, said that vernal keratoconjunctivitis is often not properly diagnosed because doctors do not flip the patient’s eyelids.
Thanh Hoang-Xuan
“In this way, they miss to see the giant papillae, which are a characteristic sign of this condition. These children have difficulties in opening their eyes, and doctors don’t want to make them cry by performing this maneuver,” he said at the meeting of the French Society of Ophthalmology.
In terms of treatment, vernal conjunctivitis requires frequent lubrication and washing out of pollens and allergens.
“Lubricating drops are often prescribed two to three times a day, while at least eight instillations are necessary,” Hoang-Xuan said.
Long-term, low-dose steroid therapy is a common but incorrect approach because it induces adverse effects. A short shot with a high level of instillation is preferred, and cyclosporin should also be used to decrease the dose of steroids.
In adult patients, the diagnosis of atopic keratoconjunctivitis can be delayed by more than 10 years because other symptoms of allergy, such as asthma and eczema, are not investigated.
“These patients end up being treated for a long time with antibiotic and antiviral drops containing preservatives, to which they are highly sensitive,” Hoang-Xuan said. “They don’t need these drops, and their condition gets worse.”
Disclosure: Hoang-Xuan has no relevant financial disclosures.