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Speaker: Look past ocular itching to diagnose allergic conjunctivitis
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WAIKOLOA, Hawaii — Ocular itching is the most common symptom of allergic conjunctivitis, but proper diagnosis is most often determined by patient history and physical examination, according to a speaker here.
“Itch is the most symptom of ocular allergy, but patients do not always come in complaining of itch,” Jodi I. Luchs, MD, FACS, said at Hawaiian Eye. “When patients come in, they may not have a lot of clinical signs. Their eyes may look very white and quiet, so it is important for us to key in on that history to make the diagnosis.”
Jodi I. Luchs
Ocular surface diseases frequently share the same signs and symptoms. Common signs and symptoms are foreign body sensation, dry ocular surface, itchy eyes, photosensitivity, hyperemia, chemosis, tearing and lid swelling, he said.
Other methods to help with the diagnosis of ocular surface disease are in-office allergy skin testing and tear film IgE testing.
“We now have the availability of in-office allergy testing, which we can perform to help rule in or rule out the contribution of allergy to patients’ ocular surface disease,” Luchs said.
Nonpharmacological options for treating allergic conjunctivitis are avoidance, compresses and artificial tears, he said.
“When avoidance measures do not work, we move to therapeutic options, pharmacologic options, and the most common classic drugs that are currently available include combination antihistamine mast-cell stabilizer drugs,” Luchs said.
The available antihistamine mast-cell stabilizer drugs include olopatadine, ketotifen, azalastine, epinastine, bepotastine and alcaftadine.
“Don’t forget about co-managing with an allergist which can be very helpful to manage those patients with severe allergic disease,” he said. – by Nhu Te
Reference:
Luchs J. Ocular allergic disease therapeutic update: Beyond itch. Presented at: Hawaiian Eye 2016 meeting; Jan. 16-22, 2016; Waikoloa, Hawaii.
Disclosure: Luchs reports he is a consultant to Allergan, Bausch + Lomb, EyeGate, Nicox, Doctors Allergy Rx, Optos, TearLab and Shire. He is a clinical researcher for Allergan, Alcon, Bausch + Lomb, Shire, Eleven and Auven. He has ownership interest in CXLO, Insightful Solutions, RPS and Omega Ophthalmics.