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Ask the right questions to uncover allergy patients
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They are often patients that we see daily and scenarios with which we are all too familiar. It might be a 22-year-old contact lens wearer who complains of itching, lens awareness and mucus discharge. Or a 14-year-old who describes red, watery and itchy eyes while playing soccer each spring. Or a 38-year-old who experiences scratchy, red, itchy eyes while raking leaves in the fall. It might even be a 53-year-old who reports grittiness, burning and light sensitivity in association with a mid-winter dermatitis flare-up. Four individuals — each of a different age, in a different environment and at a different time of year. Yet they all share something in common. Allergy.
An elusive condition
Indeed, ocular allergies can manifest in a variety of ways. It is for precisely this reason that they can be so elusive, for both the patient and the provider.
Take the 14-year-old soccer player with seasonal allergic conjunctivitis. If his annual examination is at a relatively symptom-free time such as the late fall, his condition might go largely undetected. Unless we ask the right questions.
The 22-year-old contact lens wearer with giant papillary conjunctivitis might misconstrue her symptoms as a recurring infection and simply discontinue lens wear. Unless we make the proper diagnosis.
The 53-year-old atopic keratoconjunctivitis patient might not fully understand the severity of his condition. Unless we educate him.
In each of these situations our role is a critical one. We must ask the right questions, make the correct diagnosis, initiate treatment and educate our patients. Only then is their well being assured.
Better diagnostic criteria, therapy
Fortunately, there is no better time than today for managing ocular allergies. With a better appreciation of the many “faces” of ocular allergies — seasonal, perennial, contact lens related, vernal or atopic — we can more readily make the proper differential diagnosis. With a greater understanding of the ocular allergy cascade we are able to “stage” therapy in a more clinically relevant way. Finally, given the wide array of therapeutic options at our disposal we can treat the vast majority of ocular allergies efficiently and effectively.
So with the ocular allergy season right around the corner, we must keep two things in mind. First and foremost, ocular allergies affect many of our patients — at different times, in different places and with different presentations. And, second, we have what we need — the knowledge and medications — to make this a more comfortable year for our patients.