Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis.

Abstract

OBJECTIVE:

To investigate whether artificial tears and cold compress alone or in combination provide a treatment benefit and whether they were as effective as or could enhance topical antiallergic medication.

DESIGN:

Randomized, masked clinical trial.

PARTICIPANTS:

Eighteen subjects (mean age, 29.5±11.0 years) allergic to grass pollen.

INTERVENTION:

Controlled exposure to grass pollen using an environmental chamber to stimulate an ocular allergic reaction followed by application of artificial tears (ATs), 5 minutes of cold compress (CC), ATs combined with CC, or no treatment applied at each separate visit in random order. A subset of 11 subjects also had epinastine hydrochloride (EH) applied alone and combined with CC in random order or instillation of a volume-matched saline control.

MAIN OUTCOME MEASURES:

Bulbar conjunctival hyperemia, ocular surface temperature, and ocular symptoms repeated before and every 10 minutes after treatment for 1 hour.

RESULTS:

Bulbar conjunctival hyperemia and ocular symptoms decreased and temperature recovered to baseline faster with nonpharmaceutical treatments compared with no treatment (P <0.05). Artificial tears combined with CC reduced hyperemia more than other treatments (P <0.05). The treatment effect of EH was enhanced by combining it with a CC (P <0.001). Cold compress combined with ATs or EH lowered the antigen-raised ocular surface temperature to less than the pre-exposure baseline. Artificial tear instillation alone or CC combined with ATs or EH significantly reduced the temperature (P <0.05). Cold compress combined with ATs or EH had a similar cooling effect (P >0.05). At all measurement intervals, symptoms were reduced for both EH and EH combined with CC than CC or ATs alone or in combination (P <0.014).

CONCLUSIONS:

After controlled exposure to grass pollen, CC and AT treatment showed a therapeutic effect on the signs and symptoms of allergic conjunctivitis. A CC enhanced the use of EH alone and was the only treatment to reduce symptoms to baseline within 1 hour of antigenic challenge. Signs of allergic conjunctivitis generally were reduced most by a combination of a CC in combination with ATs or EH.

• Authors: Paramdeep S Bilkhu, James S Wolffsohn, Shehzad A Naroo, Louise Robertson, Roy Kennedy
• Journal: Ophthalmology (Ophthalmology) Vol. 121 Issue 1 Pg. 72-78 (Jan 2014) ISSN: 1549-4713 [Electronic] United States
• PMID: 24070810 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Chemical References

• Allergens
• Dibenzazepines
• Histamine H1 Antagonists
• Imidazoles
• Ophthalmic Solutions
• epinastine

Topics

• Acute Disease
• Adult
• Aged
• Allergens (adverse effects)
• Combined Modality Therapy
• Conjunctiva (blood supply)
• Conjunctivitis, Allergic (diagnosis, etiology, therapy)
• Cryotherapy
• Dibenzazepines (administration & dosage)
• Double-Blind Method
• Female
• Histamine H1 Antagonists (administration & dosage)
• Humans
• Hyperemia (chemically induced, drug therapy)
• Imidazoles (administration & dosage)
• Male
• Middle Aged
• Ophthalmic Solutions (administration & dosage)
• Pollen (adverse effects)
• Seasons
• Skin Tests
• Treatment Outcome
• Young Adult