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Nuzzi R., Franceschini C., Russo V. M.
Section of Ophthalmology Department of Clinical Pathophysiology University of Turin, Turin, Italy
Allergic conjunctivitis is one of the most common misdiagnosis of ophthalmology. Allergies are progressively increasing in industrial countries and this fact is correlated with infections reduction, with more immunity system’s stimulation and with increasing pollution. The conjunctiva is like a lymph node where the outer antigen stimulates the immunocompetent cells. At conjunctival level we can identify 2 main types of immunological reaction, occurring with different clinical pictures. Allergic conjunctivites prevalently have an immunological type I and IV reaction pathogenesis. In particular, in aero-allergens or animal allergens allergies we exclusively recognize an immediate type I reaction, whereas in the other forms of atopic conjunctivitis there is a delayed type IV reaction or both causes variably present, as in the spring conjunctivitis. The first reaction type is the immediate allergy or type I allergic reaction: this one needs a first contact with the antigen or the sensitising inoculation, which causes the IgE production. In consequence of the antigen-antibody link there is the mastocyte oxidative burst and the release of pharmacologically active substances. The second allergic reaction type is the delayed allergy or type IV allergic reaction: it’s started and managed by a T lymphocyte specific antigen. Dia-gnosis can be made on the basis of anamnesis, relevance of symptomatology, itching, physical examination and specific diagnosis proofs. The authors examine atopic keratoconjunctivitis, spring keratoconjunctivitis, allergic conjunctivitis. The topic therapy can be causal or symptomatic carried out by decongestives, vasoconstictors, mastocytes membrane stabilizators, NSAD, steroids.