Allergic Rhinitis and Conjunctivitis
Allergic rhinoconjunctivitis is a common malady that usually occurs during the pollen season or after severe fungal exposure. It is characterized by sneezing, rhinorrhea, nasal congestion, and pruritus of the nose, eyes or throat. Allergic conjunctivitis, like other allergic disorders, is a type I hypersensitivity response in which allergen binds to immunoglobulin E on the surface of mast cells, leading to the release of histamine, prostaglandins and leukotrienes, which cause itching and redness.
Signs and Symptoms: The disorder is characterized by repetitive sneezing, rhinorrhea, nasal congestion, pruritic, hay fever, hayfever. Chronic cough (postnasal drip) and headaches may occur. Symptoms may be perennial and/or seasonal in onset. Perennial symptoms occur throughout the year and may be related to dust mites or animal dander.
Aggravating factors may include grass, dust, leaves, or animals. Historical data include family history of allergy, a personal history of atopy, age at onset of symptoms, and medication use.
The examine eyes, ears, nose, throat, neck, and lungs should be examined.
Nasal mucosa will appear pale and boggy, with serous secretions, and edematous turbinates.
Ocular examination reveals injection of the bulbar conjunctiva, accompanied by a clear discharge.
Patients may exhibit darkening under their eyes (shiners) or a nasal crease under the nose from
Atopic diseases, such as eczema or asthma, are common in patients. A deviated septum, foreign body or tumor suggest alternate diagnoses. Blood pressure should be recorded, because the medications used to treat may cause hypertension.
Avoidance of allergens that precipitate symptoms is the first step in management.
Symptoms during times of high humidity implicates dust mites or mold spores as causative agents. Killing of dust mites with acaricides is effective.
Animals should be kept outdoors, windows should be kept closed, and air conditioners used. Dust-proof covers should be placed over pillows and mattress, and frequent dusting with a damp cloth is helpful.
High-efficiency particulate air (HEPA) cleaners or electronic cleaners installed in the central furnace are
Pharmacologic management of conjunctivitis begins with an antihistamine. If congestion is present, an oral decongestant is added. If antihistamines and/or decongestants do not effectively relieve symptoms, intranasal corticosteroids should be