Allergic conjunctivitis at children – inflammatory process in a conjunctival cover of an eye, being reactions to this or that anti-gene sensibilizing an organism. Development of allergic conjunctivitis in children is followed local puffiness, an itch and reddening of eyes, dacryagogue, a photophobia. Diagnosis of allergic conjunctivitis at children is carried out by the children's ophthalmologist and the allergist; includes a microscopic research of plaintive liquid, the general IgE, OAK, statement of skin tests. Therapy of allergic conjunctivitis demands from children elimination of contact with allergen, purpose of antihistaminic medicines in the form of eye drops and inside, carrying out a specific immunotherapy.
Allergic conjunctivitis at children
Allergic conjunctivitis at children – a frequent disease in pediatrics which serves as a subject of studying of children's ophthalmology and allergology. Allergic conjunctivitis at the child is characterized by the inflammation of the mucous membrane covering to a skler and an internal surface of a century, caused by hypersensitivity of an organism to any allergen. In most cases the demonstration of allergic conjunctivitis at children is the share of age of 3-4 years. Allergic conjunctivitis occurs among children of school age in 3-5% of cases. Allergic conjunctivitis at children usually accompanies other allergic manifestations: to allergic rhinitis, pollinoz, atopic dermatitis, bronchial asthma, etc.
The reasons of allergic conjunctivitis at children
At children the increased individual sensitivity to these or those factors of the external environment – to allergens is the cornerstone of allergic conjunctivitis. Allergens can act as such exogenous factors: household (house and library dust, pincers, a feather of pillows, household chemicals), pollen (pollen of the blossoming trees and herbs), epidermalny (dandruff and hair of animals, sterns for pets), food (food - a citrus, chocolate, honey, berries, etc.), medicinal (medicines).
In certain cases foreign matters of an eye, and also allergens of a bacterial, virus, fungal and parasitic origin become the reason of development of allergic conjunctivitis in children.
It is established that allergic diseases of eyes at children of early age are more often caused by genetic and social factors, and at children of advanced age – the previous household, food, epidermalny sensitization which expressiveness in many respects defines weight of a course of allergic conjunctivitis.
Classification of allergic conjunctivitis at children
Taking into account etiopatogenetichesky mechanisms distinguish the following forms of allergic conjunctivitis at children: hay (polynosic), krupnososochkovy (hyper papillary), medicinal, tubercular and allergic, infectious and allergic and spring Qatar,
Polynosic conjunctivitis at children is the allergic disease of eyes caused by pollen of herbs, cereals, trees. Has seasonal dependence, arises during blossoming of those plants to which pollen an organism. At a polynosic allergoz (hay fever) allergic conjunctivitis at children is combined with urticaria, astmoidny bronchitis, atopic or contact dermatitis, Quincke's hypostasis, dispepsichesky frustration, headaches.
Spring conjunctivitis arises at boys at the age of 5-12 years more often. This form of allergic conjunctivitis at children has a persistent chronic current; aggravations happen mainly in solar season. Spring Qatar can proceed in the conjunctival, limbalny and mixed form.
Developing of hyper papillary conjunctivitis is connected with contact irritation of a conjunctiva foreign matters (contact lenses, eye artificial limbs, seams). On a conjunctiva of an upper eyelid at survey huge nipples come to light (from 1 and more than a mm).
Medicinal allergic conjunctivitis at children develops against the background of use of various eye drops. The allergy can arise both on the main active ingredient, and on the preservatives used in drops; especially often allergic conjunctivitis at children arises at instillation of antibacterial eye drops and anesthetics.
Infectious and allergic conjunctivitis at children is connected with an organism sensitization to microbic allergens: to bacterial, virus, fungal ekzotoksina. At the same time the activator in a conjunctiva of an eye is not found.
Tubercular and allergic damage of eyes proceeds as a keratokonjyunktivit, with simultaneous defeat of a conjunctiva and cornea. This form of an allergoz is a consequence of allergic reaction to the waste products of mikobakteriya of tuberculosis circulating in blood.
Symptoms of allergic conjunctivitis at children
Usually symptoms of allergic conjunctivitis at the child develop within several minutes or one days after interaction with allergen. At the same time both eyes are involved in a jet inflammation at once.
Eyelids of the child swell up, the conjunctiva becomes hyperemic and edematous, there is dacryagogue, and at heavy conjunctivitis – a photophobia. The leading subjective symptom of allergic conjunctivitis at children is the intensive itch that forces the child to comb constantly eyes, strengthening all displays of a disease even more.
In a conjunctival cavity mucous transparent (sometimes sticky or filmy) separated constantly accumulates. Purulent allocations at uncomplicated allergic conjunctivitis at children usually are absent, and arise only at accession of an infectious component.
Allergic conjunctivitis at children can sharply proceed (with quick start and the fast termination) or chronically (it is long, it faded, with periodic aggravations). Character of a current is defined by causal and significant allergen and frequency of contact with it.
Diagnosis of allergic conjunctivitis at children
Diagnosis of allergic conjunctivitis at children is carried out by the children's ophthalmologist and the allergist-immunologist. At children treat reliable diagnostic criteria of allergic conjunctivitis: existence of the allergologichesky anamnesis, communication of developing of a disease with certain external factors (blossoming, contact with animals, use of a certain foodstuff etc.), characteristic clinical symptoms.
For confirmation of the diagnosis the microscopic research of plaintive liquid where at allergic conjunctivitis at children, over 10% of eosinophils are found is conducted. At the allergic nature of a disease the level of the general IgE increased in comparison with age norm, an eozinofiliya also comes to light. In the presence of a purulent secret the bacteriological research separated from a conjunctival cavity is conducted. Manifestation system allergic reaction causes need of inspection of a GIT of the child, carrying out the analysis a calla on eggs of helminths, scrape on .
Treatment of allergic conjunctivitis at children
As indispensable condition of successful therapy of allergic conjunctivitis at children serve the eliminative actions assuming an exception of contact with allergen.
The pathogenetic basis of treatment of allergic conjunctivitis at children is made by antihistaminic medicines in the form of the tableted medicines and instillations of eye drops in age dosages and concentration. At the persistent course of a disease topichesky NPVP and corticosteroids are appointed.
Performing allergenspetsifichesky therapy which is most effective at children is possible. She assumes introduction of small doses of allergen in the increasing concentration that is followed by gradual accustoming to this allergen, reduction or disappearance of symptoms of allergic conjunctivitis at children.
The forecast and prevention of allergic conjunctivitis at children
At untimely diagnosis of allergic conjunctivitis at children the cornea and other tissues of an eye can be involved in inflammatory process that is fraught with decrease in visual acuity and development of the forms of diseases of eyes which are difficult giving in to treatment (a keratita, cornea ulcers). Identification and elimination of allergen, and also carrying out a specific immunotherapy allows to prevent an allergy recurrence.
Specific prevention of allergic conjunctivitis at children is not developed. It is necessary to pay attention to strengthening of the general immunity of the child, to conduct preventive courses of the desensibilizing therapy during seasons of an exacerbation of a disease, to avoid contacts with the known allergens.