Focusing on how to avoid itchy eyes [ 1st Eye Clinic Dr. Yoon Sam Young ]
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    As the number of outings increases due to the easing of restrictions on wearing masks, more and more people are complaining of discomfort due to pollen or seasonal allergies. In fact, 20-30% of the people in Korea suffer from various allergic diseases, and according to the Health Insurance Review and Assessment Service, the number of patients treated for allergic diseases in 2021 increased by 57.6% from 1,543,135 in January to 2,432,365 in April. Allergy is caused by various substances contained in the surrounding environment, and more special attention is required because it is highly likely to occur at the time of reduced immunity or in infancy when the immune system is immature.

    Typical symptoms of allergic conjunctivitis include itching and congestion of the eyes (congestion of the cornea). Symptoms appear in both eyes at the same time, and sticky mucous secretion, foreign body sensation, tears, blurred vision, and glare symptoms may also appear. In the case of an acute allergic attack, conjunctival congestion may be prominent, followed by severely swollen conjunctival edema with a whitish color.

    Among them, vernal corner conjunctivitis, which has severe symptoms, causes severe itching of the eyes, production of thread-like secretions, and severe inflammatory reactions that may cause drooping or spasms of the eyelids. Repetitive wounds, especially if mismanaged. Corneal opacity accompanied by neovascularization and, in severe cases, corneal ulcers may occur, but care is needed as vision may remain permanently impaired. Atopic keratoconjunctivitis is also similar to vernal keratoconjunctivitis, and is characterized by red rashes appearing on the skin around the eyes and becoming rough.

    Allergy refers to a series of immunological reactions showing hypersensitivity to a specific causative agent. Allergies do not occur with only one cause, but are caused by several factors, such as genetic influences, the degree of exposure to ‘allergens’ that cause allergic reactions, lifestyle, and environment. After initial exposure to an antigen, when a person sensitized to that antigen encounters the antigen again, basophils and mast cells with IgE (immunoglobulin E that responds to a specific antigen) react to substances (such as histamine, prostaglandins, and leukotrienes). , which causes swelling or inflammation of the surrounding tissues. This chain reaction continues to irritate and damage tissues, and these reactions can range from mild to severe.

    As a genetic factor, it is known that if one of the parents has an allergic disease, the probability of their child suffering from an allergic disease is about 50%, and if both parents have an allergic disease, about 75% will suffer from an allergic disease. As environmental factors, dry air and changing seasons have a great effect. Especially in spring, the immune system overreacts to pollen or dust, which are usually harmless to the human body, and causes inflammation in the nasal passages and bronchi. Common allergy symptoms include sneezing, watery eyes, itchy eyes, runny nose, itchy skin, and rashes.

    When an allergic disease is suspected, it is important to identify the causative antigen through a prompt diagnostic test and to prevent exposure to the causative substance. A representative allergen test is the MAST (Multiple Allergen Simultaneous Test) test. After blood sampling, it is a principle to determine whether IgE is present in the serum for 108 allergens such as animal hair, food, pollen, house dust mite, mold, and insect.

    Since there is no risk of shock that can appear in skin test and various allergens can be identified at the same time, infants and children and patients with a wide range of skin diseases can be tested safely.

    Drug therapies such as antihistamines and intranasal steroids can be applied first, but it is known that avoidance therapy to keep away from allergens is the best option for allergic diseases. This is also a strong recommendation specified in the guidelines of the Korean Academy of Asthma, Allergy and Clinical immunology.

    For example, in response to fine dust and pollen, it is necessary to refrain from going out in spring when the air quality is bad, and to reduce irritation by using glasses instead of contact lenses on days when eye irritation is severe. In the case of allergic conjunctivitis that reacts to house dust or dust mites, it is better to pay more attention to ventilation and cleanliness in the house, and to wash bedding frequently. It is also helpful to frequently put eye drops in the eyes to wash away contaminants. Also, if itchiness appears, do not rub your eyes, and it is helpful to relieve itching with cold compresses.
    Allergic conjunctivitis itself rarely causes visual impairment, but if the symptoms last for a long time and are severe, it is recommended to receive appropriate treatment after an ophthalmologic examination.