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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.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Bilkhu PS,Wolffsohn JS,Naroo SA,Robertson L,Kennedy R

doi

10.1016/j.ophtha.2013.08.007

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

72-78

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(13)00723-9

journal_volume

121

pub_type

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Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis.