Book chapter
Allergic disorders of the conjunctiva
Conjunctivitis: symptoms, treatment, and prevention, pp.1-73
2010
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The allergic response is an over-reaction of the body's immune system to innocuous foreign substances or allergens, such as airborne pollen, animal dander, house dust mite, that the body perceives as a potential threat or undesirable. It is a malady that is estimated to affect approximately 20 % of the population. Of this subset, at least 20% suffer from a specific subset of signs and symptoms known as ocular allergy. Both systemic allergy and ocular allergy have a significant impact on the quality of life of the individual. Allergic diseases involve antibody- and/or T-lymphocyte mediated mechanisms.
Allergic disorders of the conjunctiva are characterized by specific responses such as: 1) an IgE-mast cell mediated response, as seen in allergic conjunctivitis and 2) chronic mast cell activation and eosinophil/T-lymphocyte mediated response, as seen in giant papillary conjunctivitis, vernal keratoconjunctivitis and atopic keratoconjunctivitis. Traditionally, the signs and symptoms of ocular allergy include itching, tearing, redness, chemosis and eyelid edema. The mechanism of allergic eye disease includes: 1) allergen-induced immunoglobulin E (IgE) production and mast cell sensitization; 2) IgE-mediated mast cell degranulation and the release of preformed mediators and chemotactic factors; and 3) persistent mast cell activation and Th2-mediated delayed-type hypersensitivity (DTH) reaction, involving the actions of newly formed mediators and chemotactic factors that incite the recruitment of additional inflammatory cells, which then leads to the allergen-induced late phase allergic response.
The management of allergic disorders of the conjunctiva is aimed at avoiding exposure to allergen, preventing the release of mediators of allergy, controlling the allergic inflammatory cascade and preventing ocular surface damage. The clinician should recommend non-pharmacologic and pharmacologic therapeutic regimens that address the acute presentation of ocular allergy and provide prophylaxis aimed at providing long-term maintenance therapy. The clinician may use pharmaceutical agents that prevent mast cell degranulation; block the histamine receptors; inhibit the arachidonic acid cascade; inhibit T-lymphocyte activation; inhibit IgE production by activated B-lymphocytes; and block the action of cyclooxygenase and/or inhibit Lipoxygenase.
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Details
- Title
- Allergic disorders of the conjunctiva
- Creators
- De Gaulle I Chigbu - Drexel University, Pennsylvania College of Optometry (PCO)Andrew Gurwood - Drexel University, The Eye Institute (TEI)
- Contributors
- Anna R Sallinger (Editor)
- Publication Details
- Conjunctivitis: symptoms, treatment, and prevention, pp.1-73
- Series
- Eye and Vision Research Developments
- Publisher
- Nova Biomedical Books
- Edition
- 1st
- Number of pages
- 73
- Resource Type
- Book chapter
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO); The Eye Institute (TEI)
- Identifiers
- 9781616683214; 991022040868004721
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- Web of Science research areas
- Ophthalmology