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Clinicians should investigate complaints of ocular itchiness
Itchy eyes may be a marker for undiagnosed ocular allergy, study results indicate.
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Ocular surface sensitivity and lid margin staining may be additional markers of ocular allergy, according to research presented by Mark Willcox, BSc, PhD, FAAO, and colleagues at the Academy of Optometry meeting in New Orleans.
The researchers sought to address the relationship between itchy eyes and allergy. A skin prick test (SPT) with 10 aeroallergens was conducted on subjects with and without itchy eyes and a previous diagnosis of ocular/nasal allergy.
Itchy eyes were reported in 35 patients, and a prior history of allergy was reported in 22 patients, according to the study. A total of 63% of subjects with itchy eyes were positive on both the SPT and Allerwatch Tear IgE (Hitachi Chemical), while only 27% who lacked itchy eyes were positive for both testing instruments.
“Our itchy eye subjects showed reduced ocular surface sensitivity and increased lid wiper epitheliopathy. We speculate that these may be caused by the frequent eye rubbing often displayed by itchy eye patients,” study co-author Isabelle Jalbert, OD, MPH, PhD, FAAO, said in an interview with Primary Care Optometry News.
Itchy eye subjects experienced the following symptoms more severely: bulbar hyperemia, lid roughness, sensitivity thresholds of cornea and conjunctiva, SPT largest wheal size and quality of life scores, according to the paper. Researchers found a worse grading of follicles, and conjunctival chemosis and lid margin staining were more common within itchy eyes.
“Our research confirms that subjects who report frequent ocular itchiness, even if they have not been previously diagnosed with ocular allergies, will have significant changes to certain aspects of their ocular surface,” Jalbert explained. “Our work highlights the importance of investigating complaints of ocular itchiness in clinical practice, as these are likely to be associated with sometimes subtle but significant changes to the ocular surface.”
Within the itchy eye group, SPT largest wheal size was worse than without itchiness prior to diagnosis of allergies, according to researchers.
“Practitioners now have another good reason to intervene and manage ocular itchiness in the hope that this may minimize or prevent some of the changes we observed,” Jalbert said.
She added that the researchers’ data “suggest that markers that might best help differentiate ‘itchy eyes’ (perhaps caused by factors other than allergy, such as dry eye) from ‘allergy’ include SPT as well as the frequency, severity and quality of life impact of the symptoms and a positive Allerwatch test. We still need to confirm these preliminary results in a separate larger sample.” – by Abigail Sutton
- Reference:
- Kolanu S, et al. Changes to the ocular surface and tear film in subjects with ocular itchiness. Presented at Academy 2015 New Orleans, October 7-10, 2015.
- For more information:
- Isabelle Jalbert OD, MPH, PhD, FAAO, is senior lecturer and acting head of the School of Optometry and Vision Science at the University of New South Wales. She can be reached at: i.jalbert@unsw.edu.au.
Disclosures: Jalbert reports no relevant financial disclosures. Equipment and consumables were provided at no or reduced cost by TearLab Corp.