Amoxicillin 250 mg tablet

Topical vasoconstrictor eye medications twice daily have minimal side effects, unlike nasal vasoconstrictor medications, but rebound vasodilation encourages overuse. Mast cell stabilisers are generally well tolerated, however, as they can take three to seven days to show an effect, they should be used to prevent symptoms before they occur and can be used as long as necessary.

Mast cell stabilisers/antihistamines are fast acting, effective and generally well tolerated.

Steroid eye drops - are effective quickly in relieving symptoms, but are associated with cataract formation, glaucoma and bacterial and viral infections of the cornea and conjunctiva. They should only be used short term,

only

Oral antihistamines (tablets) Help

some

However, they may dry the eyes, nose and mouth, and may cause blurred vision. Antihistamines are usually contraindicated in glaucoma and advice should be sought from an eye specialist.

Allergen immunotherapy for specific allergens May benefit people with persistent, severe allergic conjunctivitis.

However, relief of eye symptoms takes longer than nasal symptoms.

Inflammation of the cornea can also be associated with allergy. The cornea has very few blood vessels (that is why it is clear), and is seldom involved in an allergic reaction. However, there are a number of causes of small pinpoint defects in the cornea, a condition called epithelial keratitis, which is usually due to drug and chemical exposure, for example: Drug toxicity and drug allergy.

Contact sensitivity to topical eye medications such as neomycin, idoxuridine, atropine and derivatives, thiomersal and some topical anaesthetics. Specific conditions involving the cornea, which are associated with allergy are listed below.

A combined inflammation of the conjunctiva and cornea, most often associated with atopic dermatitis/eczema. Usually results in red, scaly and weeping skin of the eyelids. Secondary infection with Staphylococcus aureus is common and may cause infection of the eyelash follicles.

The conjunctiva may be swollen, red and with a tenacious clear or pus containing discharge.

The condition can persist for many years and causes severe photophobia, weeping and itching. If the photophobia is severe, it can be difficult for people to open their eyes in direct sunlight. Conjunctival scarring may occur if the persistent condition is not treated properly.

An inherited cone shaped thinning of the cornea frequently associated with atopic dermatitis.

Vision is distorted due to the varying thickness of the cornea.

Contact lenses may be necessary but they have particular problems in this condition. Rigid lenses are necessary for good vision but they may irritate the inflamed conjunctiva.

It is important to consult an eye specialist should this condition be suspected. May be associated with the severe form of atopic dermatitis in about 8-10% of sufferers. Occurs in children and young adults, even in the absence of steroid therapy.

Usually affects both eyes and is severe, occurring seasonally and mainly in children.

Results in nipple shaped protrusions on the inner aspect of the upper eyelid, often described as cobblestones and a stringy, tenacious mucus discharge.

Frequently associated with allergic rhinitis, atopic dermatitis or asthma.

It may be associated with a single

allergen

Usually starts in late childhood and is more common in boys than girls. However the prevalence equals in the twenties and is rarely seen after the age of thirty. Rarely seen in cold climates, more often in tropical and temperate climates.

Treatment consists of intermittent short courses of topical or systemic steroids with ongoing topical cromolyn or antihistamine preparations. Sleeping in an air-conditioned room, ice packs and cold compresses can help.

Moving to a cool climate is desirable, if possible.

Many cosmetics (especially nail polish), will cause a contact allergy of the eyelids, which may occur in only one eye Other causes include antibiotics (particularly neomycin) and the preservative thiomersal (a preservative in eye drops).

Some plants will also cause contact allergy, including Grevillea 'Robyn Gordon', African violets and a number of bulbs. Since the Rhus tree has been declared a noxious weed the number of cases of this serious contact allergy has declined. Usually there is an initial improvement of the condition after prescribed eye drops are used and then a continuing deterioration, only improved by ceasing the eye drops.

Bathing the eyes with cooled boiled water will give comfort as the condition improves. A doctor will usually use patch testing to confirm the diagnosis and inquire about whether any non-prescribed or herbal drops have been used. Giant Papillary and Giant Follicular conjunctivitis (GPC or GFC), can occur in contact lens wearers and is similar in appearance to vernal keratoconjunctivitis. It usually occurs in soft contact lens wearers, but is occasionally seen in hard lens wearers, and may be due to the lens material itself, or the lens cleansing material, which contains thiomersal. Sometimes the condition improves with a decreased wearing time, occasionally changing the lens to another polymer or soaking the lens in sterile water after an antibacterial solution. An allergic reaction (including anaphylaxis, the most severe form of allergic reaction) to a food,

insect

Individuals who are at risk of anaphylaxis should be referred to a clinical immunology/allergy specialist. Eating of foods containing monosodium glutamate or the preservative sodium metabisulfite will occasionallycause swelling and redness of the eye.

However this is not a true allergic reaction and therefore symptoms will be less severe.

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.

ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice.

The content of ASCIA resources is not influenced by any commercial organisations.