15
Seasonal Allergic Conjunctivitis
Î Mild allergic conjunctivitis can be treated with an over-the-counter
(OTC) antihistamine/vasoconstrictor agent or with the more effective
second-generation topical histamine H
1
-receptor antagonists.
(I++, G, S)
Î If the condition is frequently recurrent or persistent, mast-cell
stabilizers can be utilized. (III, I, D)
Î Many new medications combine antihistamine activity with mast-cell
stabilizing properties and can be utilized for either acute or chronic
disease. (I-, M, D)
Î If the symptoms are not adequately controlled, a brief course (1–2
weeks) of low-potency topical corticosteroids can be added to the
regimen. (III, I, D)
Î The lowest potency and frequency of corticosteroid administration that
relieves the patient's symptoms should be used. (III, I, D)
Î Ketorolac has been FDA-approved for the treatment of allergic
conjunctivitis. (I-, M, D)
Î Additional measures include using artificial tears, which dilute
allergens and treat co-existing tear deficiency, cool compresses, oral
antihistamines, and allergen avoidance. (III, I, D)
Î Frequent clothes washing and bathing/showering before bedtime may
also be helpful. (III, I, D)
Î Consultation with an allergist or dermatologist may be helpful for
patients who have disease that cannot be adequately controlled with
topical medications and oral antihistamines. (III, I, D)
Î The use of topical mast cell inhibitors can also be helpful in alleviating
the symptoms of allergic rhinitis. (I-, M, D)
Î Intranasal corticosteroid therapy, however, is not effective for the
treatment of seasonal allergic conjunctivitis. (I-, M, D)
Î Frequency of follow-up visits is based on the severity of disease
presentation, etiology, and treatment. (III, I, D)
Î A follow-up visit should include an interval history, measurement of
visual acuity, and slit-lamp biomicroscopy. (III, I, D)
Î If corticosteroids are used in chronic or recurrent conjunctivitis,
baseline and periodic measurement of IOP and pupillary dilation
should be performed to evaluate for cataract and glaucoma. (III, I, D)
