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Severe ocular allergies a public health emergency in Maghreb region
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PARIS — In North Africa, ocular allergies tend to be more frequent, more severe and more difficult to treat than analogous forms in Europe, and they are often the cause of visual impairment and blindness, according to a specialist speaking here.
Epidemiological data show a high prevalence of both vernal and atopic keratoconjunctivitis in the Maghreb region. Both forms are characterized by a high tendency to develop severe corneal complications leading to high astigmatism, keratoconus, corneal scarring and eventually blindness.
Sihem Lazreg
“Progression is fast and dramatic. Vernal may evolve into atopic, and when the cornea is involved, aggravation and vision loss rapidly occur,” Sihem Lazreg, MD, said at the meeting of the French Society of Ophthalmology.
Available therapies are insufficient to manage these conditions effectively. Cyclosporine is not available in North African countries, and corticosteroids are widely used.
“They are available over the counter, and we see many cases of steroid-induced cataract and glaucoma due to prolonged, unsupervised self-administration,” Lazreg said.
Control of allergies is a public health emergency, she said. Most of these severe forms occur at a very young age, accounting for about 80% of the cases, and spontaneous regression with puberty rarely occurs. Children are more sensitive to the side effects of medications and more susceptible to lifelong complications.
Some common allergens include dust mites, accounting for 80% of the cases, pollens and pet dander. The increased severity of allergies in the region is likely to be partly climate-related, but genetic factors may also be involved.
“Maghrebian people living in France also tend to develop allergies in these more severe forms, showing a much stronger response to common allergens than native white French people,” Lazreg said. – by Michela Cimberle
Reference:
Lazreg S. Specific features of ocular allergies in tropical regions. Presented at: French Society of Ophthalmology meeting; May 7-10, 2016; Paris.
Disclosure: Lazreg reports no relevant financial disclosures.