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It is important to note that blurred vision or corneal haze require urgent referral to an eye specialist.

Allergic conjunctivitis symptoms may be: Perennial (all year round) due to exposure to

dust

Seasonal due to airborne allergens such as pollen of grasses, trees and weeds.

Pollen

There are also seasonal variations in some airborne mould spores, which may cause seasonal symptoms. Treatment depends on severity and cause of symptoms. Identifying and removing the cause of allergic conjunctivitis, where possible, is ideal when an allergic cause has been confirmed from allergy testing.

For example: House dust mite minimisation measures in the bedroom (removing carpet, using barrier encasing of pillows and mattress, washing bedding in hot water).

Removing the cat from the house in sensitive individuals. It is also important to exclude the presence of a foreign body such as dust, wood chip or an insect/s.

Symptoms of allergic conjunctivitis are generally mild to moderate and respond to bathing eyes with cold water, ice packs and cold water compresses.

Topical lubricants can also help flush allergens from the tear film. However, symptoms can sometimes be extremely severe and debilitating and require medication. Treatment options include: Topical medications (eye drops) Antihistamine eye drops are effective but should not be used for longer than 6 weeks without medical advice.

Antihistamine eye drops in conjunction with a vasoconstrictor minimise itch and remove redness, but should not be used for longer than 14 days without medical advice. Topical vasoconstrictor eye medications twice daily have minimal

side

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 under medical supervision and never in the presence of herpes infections.

Oral antihistamines (tablets) Help some people when avoidance measures are difficult. 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

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 but more usually with multiple sensitivities. 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

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

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 amoxicillin 125 mg price 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 sting or bite, or medication may cause eye symptoms with swelling, itching and redness of the conjunctiva and soft tissues around the eyes. 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

they

Fermented foods rich in probiotics may not work for everyone. London: Fermented foods have become very popular, thanks to claims about their nutritional properties and reported health benefits, such as improving digestion, boosting immunity and even helping people lose weight. Some of the most popular fermented foods include kefir, kombucha, sauerkraut,

tempeh

Fermented foods are loaded with microorganisms, such as live bacteria and yeast (known as probiotics). Many, like probiotics, are harmless and are even beneficial to us.

During the process of fermentation, probiotics convert carbohydrates (starch and sugar) into alcohol and/or acids. These act as a natural preservative and give fermented foods their distinctive zest and flavour. Many factors affect fermentation, including the type of probiotic, the primary metabolites these microbes produce (such as lactic acid, or certain amino acids), and the food undergoing fermentation. For example, probiotic yogurt is produced by fermenting milk, most commonly with lactic acid bacteria which produce lactic acid. Fermented foods contain high amounts of probiotics, which are generally considered safe for the majority of people. In fact, they’ve been shown to have anti-oxidant, anti-microbial, anti-fungal, anti-inflammatory, anti-diabetic and anti-atherosclerotic activity.

However, some people might experience severe side effects after consuming fermented foods.