Aim: To evaluate the efficacy of tear substitute in achieving the eye relieve and comfortability in patients with chronic seasonal allergic conjunctivitis i.e. Spring catarrh and analysis of the outcome results.
Design: Prospective randomized study.
Patients and method: 240 patients with seasonal allergic conjunctivitis complicating with dry eye are randomized in 3 groups. Group I received antihistaminic in the form of Epinastine hydrochloride 0.5 mg per mL (Relestat®, Allergan®) twice daily in between the attacks while group II received tear substitutes in the form of Carboxymethylcellulose and glycerin ( Optive®, Allergan®) twice daily, while group III received combination of the two drugs. All patients gave complete history and examined as regard visual acuity, refraction, IOP, slit lamp examination, tear film break up time (BUT) and Schirmer test. The outcome measures were the eye comfortability and relieve in the form of relieve of eye burning and blurring , reduction in signs of the allergic conjunctivitis especially the eye redness.
Results: 240 patients with mean age 16.3±2.4 years. Female to male ratio was 1:1. 40 patients were excluded from the study mainly due to non compliance. Complete patient comfortability in 46.5% of patients and partial comfortability in 33.8% of patients. These percent to 60.6% and 21.3% respectively if antihistaminic were added to tear substitutes. Relieve of burning sensation, tear substitutes alone can achieve this in 53 (74.6 %) patients and in 52 (85.2%) of patients if antihistaminic was added.
Conclusion: Chronic allergy and dry eye are two faces of the same coin. At a time, allergy may fade away but dry eye persists .The patient with chronic allergy will never feel complete eye relieve except with addition of tear substitutes. Patients should continue tear substitutes during the attack. It is advised that if the ophthalmologists wants to prescribe a single drug for follow up use to the chronic allergic patient, the drug of choice is tear substitutes. Dry eye disease is the missing already present disease in chronic allergy. This study advisd that patients with chronic allergy should avoid exposure to sun, wind, dust or smoke in order not to aggrevate dry eye. This study proved that tear substitutes perscription in chronic allergy not only achieve eye relieve but also improve the quality of vision. Till now, the chronic allergy-dry eye complex is still unfinished business and further studies are needed to solve the chronic allergy-dry eye puzzple.