Seasonal
allergic conjunctivitis (SAC) and perennial
allergic conjunctivitis (PAC) as well as intermittent and persistent
allergic rhinitis are widespread diseases. Because a combined occurrence of ocular and nasal symptoms is very common the summarising term allergic rhinoconjunctivitis is frequently used. SAC and PAC representing the two acute forms of
allergic conjunctivitis account for more than 90 % of all cases of
allergic conjunctivitis. Compared to the chronic forms of
allergic conjunctivitis their course of disease is milder. Nevertheless because of their high prevalence and the proven influence on patients' quality of life they possess clinical and socioeconomic relevance. Allergic rhinoconjunctivitis is caused by a type 1
IgE-mediated hypersensitivity reaction that is provoked by aeroallergens in the majority of cases. The pathognomonic sign is
itching. Besides, typical ocular findings are chemosis, conjunctival injection, watery secretion and lid swelling. Otorhinolaryngologists' findings include
rhinorrhea, postnasal drip and
sneezing. Problems in breathing through the nose resulting from
nasal obstruction can cause impaired nighttime sleep and
daytime somnolence. In addition to a reduction of
allergen exposure by modification of environment and life style factors, in mild forms of SAC and PAC
artificial tears are recommended. Topical
antihistamines can generate rapid relief from acute symptoms and
itching. Topical mast cell stabilisers however provide long-term effects. Dual action drugs that combine
antihistamines and mast cell stabilisers show increased patient compliance due to reduced application frequency. Use of topical
steroids should be cautious and only temporary. For prolonged treatment periods unpreserved
anti-allergic eye-drops should be preferred. Combined topical
antihistamines and new-generation topical nasal
steroids often used by otorhinolaryngologists demonstrate a good safety profile without systemic side effects. In summary, allergic rhinoconjunctivitis represents a common disease pattern that can be treated effectively. Once it is diagnosed correctly targeted treatment results in improved patients' quality of life quickly.