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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Conjunctivitis of allergic origin is associated with a diversity of clinical presentations. Common features include pronounced itching, a milky conjunctival appearance, a stringy or ropy discharge and papillary hypertrophy of the tarsal conjunctiva in severe cases, and a family history of allergy. The diagnosis should be based on thorough history-taking and careful ophthalmic examination, and, when necessary, confirmation by laboratory testing. An IgE-mediated immediate hypersensitivity mechanism is associated with most types of allergic conjunctivitis, although contact allergy is mediated by lymphocytes rather than antibody. Treatment is based on the diagnosis and severity of signs and symptoms. An array of medications is available to control symptoms, and the regimen of choice should be based on the response to milder forms of therapy and consideration of drug side effects.
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PMID:Conjunctivitis of allergic origin: clinical presentation and differential diagnosis. 823 3

Forty-five patients with contact-lens-associated papillary conjunctivitis (CLAPC) were included in a 6-week double-masked group comparative study of unpreserved 2% nedocromil sodium eye drops and placebo. Data were collected by diary card recording of symptoms and duration of lens wear, assessment of symptoms at clinic visits, biomicroscopic appraisal of signs on the globe and the upper tarsal conjunctiva, and laboratory analysis of tear and serum IgE levels. All assessments were made by the same clinician throughout the study. Diary card records demonstrated that there was significantly less itching in the nedocromil sodium group compared with the placebo group during weeks 1-3 of the study (p < 0.01), but not during weeks 4-6. Findings for duration of lens wear were inconclusive, due to differences between the groups at admission. Biomicroscopic assessment showed a significant difference in mucus found on the upper tarsal surface in favour of nedocromil sodium by the end of the study (p < 0.02). Twenty-one patients experienced adverse events during the study. The most common were taste and/or stinging on insertion of the drops. No significant difference was seen for tear or serum IgE between the two treatment groups during the study.
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PMID:Nedocromil sodium in contact-lens-associated papillary conjunctivitis. 825 22

The term ocular allergy encompasses a group of diseases in which there is a high frequency of atopy, ocular itching, stringy discharge and a papillary conjunctival reaction. Conditions confined to the lids and conjunctiva (e.g. seasonal allergic conjunctivitis) have a good prognosis but those involving the cornea may result in visual impairment (e.g. atopic keratoconjunctivitis). Mast cell and eosinophil mechanisms are important in al the ocular allergies, but T cell inflammation is prominent only in vernal keratoconjunctivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis. Therapy involves the use of antigen avoidance (where possible), nonspecific medical therapy (e.g. cold compresses, artificial tears), specific medical therapy and, in certain situations, immunotherapy and surgery. Topical antihistamines (often in combination with a vasoconstrictor) and oral antihistamines are widely used in perennial and seasonal conjunctivitis. Levocabastine is a new preparation which is more rapid and potent. Mast cell inhibitors [e.g. sodium cromoglycate (cromolyn sodium)] have a proven track record as safe and effective therapy for all ocular allergic diseases and the newer, more potent nedocromil and lodoxamide are now available. Topical steroids are only indicated in sight-threatening disease due to their serious adverse effects and other therapy should be continued to minimise the dose required. There is a lack of intermediate potency and high potency but safe topical preparations. A number of future possibilities exist, some of which have been partially explored. Cyclo-oxygenase inhibitors have proved of limited use, but inhibitors of lipoxygenase and kinin pathways are awaited. Although results with HEPP have been disappointing, other modulators of mast cell function (e.g. picumast, beta-agonists and phosphodiesterase inhibitors) may prove useful in the future. So far, results with topical cyclosporin in serious disease are very encouraging. Future developments in the manipulation of eosinophilic products, cytokines and adhesion molecules may also be relevant. However, the current situation for those with serious ocular allergy remains a disturbing dependence upon topical steroids, with all the attendant risks.
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PMID:Therapeutic options in ocular allergic disease. 852 55

The therapeutic utility of cyclooxygenase (CO) inhibitors, such as ketorolac, in reducing the inflammatory events associated with allergic conjunctivitis is not unexpected since prostanoids (PG) elicit conjunctival redness (PGD2, PGE2, PGF2 alpha), edema (PGD2, TxA2), eosinophil infiltration (PGD2, PGJ2) and mucous cell discharge (PGD2, PGJ2, TxA2). Recently, topically administered ketorolac has also been reported to alleviate the itching associated with allergic conjunctivitis. This was viewed as intriguing since CO inhibitors are not regarded as useful for treating itching dermatoses and PGs do not elicit itching when applied to the skin. In order to investigate the antipruritic activity of ketorolac, we developed a model for reproducibly measuring ocular surface itch responses. The model involves itch-scratch responses to pruritogens applied locally to the ocular surface. Painful and foreign body stimuli do not produce an itch-scratch response. Unlike reported skin studies, PGE2 was a potent itch-producing substances in the conjunctiva. PGD2 was weakly pruritogenic but PGF2 alpha and the TxA2-mimetic U-46619 were inactive. The PG precursor arachidonic acid was also a potent pruritogen and its effects were inhibited by ketorolac pretreatment. Ketorolac also dose-dependently inhibited the itching associated with experimental allergic conjunctivitis. It appears that PGs are potent itch-producing substances in the conjunctiva and the anti-itch efficacy of ketorolac in allergic conjunctivitis appears to involve inhibition of conjunctival PG biosynthesis from arachidonic acid.
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PMID:The pruritogenic and inflammatory effects of prostanoids in the conjunctiva. 859 Feb 66

We report a 29-year-old man with a recurrent history of conjunctival redness, itching, and tearing, who was first seen with transient, multiple Trantas' dots bilaterally on the bulbar, forniceal, and palpebral conjunctiva. Conjunctival scrapings and biopsy revealed histopathologic features consistent with Trantas' dots. To our knowledge, this is the first case report that clearly documents the occurrence of extralimbal Trantas' dots on the bulbar, forniceal, and palpebral conjunctiva.
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PMID:Extralimbal Trantas' dots: a clinicopathologic report. 889 78

A second epidemiological ocular allergy survey was carried out by ophthalmologists during the winter of 94/95 in order to define the main characteristics of patients suffering from chronic, perennial allergic conjunctivitis or keratoconjunctivitis. From the data collected from a wide sample of 791 patients, we were able to describe the main symptoms and lesions related to chronic ocular allergy, its evolution and the allergens involved. Allergic symptoms (conjunctival redness, foreign body sensation, itching) are reported in 98.5% of patients. Non specific symptoms (burning, photophobia, blurred vision, ocular dryness) are reported in 3 patients out of 4. 40% of patients have perennial manifestations without any seasonal exacerbation while 1 patient in 2 suffers from a seasonal worsening. In 80% of the cases, the responsible allergens are domestic (house dust, miles), 60% of patients are affected by at least 2 allergens. Ophthalmic examination shows lesions of the tarsal conjunctiva (papillas, follicles) in 94% of the cases and corneal lesions in practically 50% of the patients. This epidemiological survey shows the necessity of having a rigourous clinical approach which includes a complete ophthalmological examination which is the only thorough means of assessing the allergic lesions and proposing the most suitable treatment for day to day ophthalmic practice.
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PMID:[Observatoire des Allergies Oculaires. National epidemiological survey of chronic (perennial) allergic conjunctivitis and/or keratoconjunctivitis seen in ophthalmology]. 898 39

We report on a 32-year-old atopic female office employee with a moderate tree pollinosis who also suffered from indoor-related perennial rhinoconjunctivitis. Once when she repotted her two ornamental nonflowering green plants of the genus Tradescantia (synonym; Albifloxia; family Commelinaceae), she immediately experienced itching of the face, throat, and conjunctiva; swelling of the lips; and dyspnea and wheezing. Skin prick tests with the leaves of Tradescantia (T. albifloxia and T. fluminensis) (Ta and Tf) were strongly positive as was the specific IgE to Ta leaves extract. On RAST inhibition studies, no cross-reactivity was found between Ta and Ficus benjamina (weeping fig), a nonflowering green plant, which produces, in its milky sap, an important respiratory allergen. Green plants should be considered potential indoor allergens and tested in plant-keepers referred for allergologic investigation.
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PMID:Allergy to the ornamental indoor green plant Tradescantia (Albifloxia). 920 67

Not every patient who consults his physician because of reddening, pain, burning or itching sensation in an eye suffers from a bacterial or viral infection of the anterior eye segments. The sicca-syndrome mainly occurring in the elderly leads often to chronic reddening and a disturbing sensation of a foreign body in the eye. Allergic manifestations are often a cause for swelling and reddening of the conjunctiva. If next to reddening a rapidly progressing deterioration of vision develops, eventually accompanied by nausea and vomiting acute glaucoma has to be considered. In uveitis the patient mainly complains about sensations of dazzling, reduced visual acuity and pain, reddening of the conjunctiva may be variable. If in addition to acute hyperemia also a yellow-whitish infiltrate of the cornea is observed a bacterial ulcer of the cornea may be suspected. In this case an ophthalmologist has to be consulted without delay. Viral inflammations are often a diagnostic and therapeutic challenge. If reduced sensibility of the cornea is observed, herpetic infection should be considered.
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PMID:[Reddened eyes, what should be done?]. 938 Oct 49

In general, irritation is a physiological response to a chemical or physical stimulus involving objective changes (e.g., local redness and edema) and subjective sensations (e.g., pruritus and pain). The perception of an irritating stimulus in the eyes and the upper airways is called sensory irritation. Sensory irritation is a prevalent symptom in relation to complaints about indoor air quality. The intensity of perceived sensory irritation in humans has mainly been evaluated using psychophysical methods. However, perceived sensory irritation is dependent on the subject expressing the symptoms; that is, it is a subjective measure. This is a problem in assessment of irritation effects from air pollution or other factors, since the expression of the irritation symptoms may be biased by, for example, interaction with other people and odors. The subjectivity of the measures is an important complication in several studies dealing with problems regarding indoor air quality. The bias problems make it important to complement the psychophysical measurements of sensory irritation with objective assessments of irritation. In addition, only little is known about the association between sensory irritation and possible physiological/ pathological changes in the mucosal membranes in relation to studies of indoor air. Two studies (study 1 and study 2) were conducted to investigate changes in conjunctival hyperemia and conjunctival fluid cytology for subjects exposed to volatile organic compounds (VOCs) in their eyes only. Eight subjects participated in study 1. Each subject was exposed to three different mixtures of VOCs. A total of 16 subjects participated in study 2. Half of the subjects were exposed to 1-octene and the other half, to n-butanol. In both studies, photographs of bulbar conjunctiva were taken and conjunctival fluid was sampled before and after exposure. Moreover, the perceived irritation intensities were registered continuously during exposure. Overall, perceived irritation intensity and conjunctival hyperemia increased with increasing exposure concentrations, whereas cytological changes in the conjunctival fluid samples did not seen to be related to exposure concentration, perceived irritation, or changes in conjunctival hyperemia.
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PMID:Cytological changes and conjunctival hyperemia in relation to sensory eye irritation. 963 78

When a patient presents to a medical practitioner with a painful eye, the initial history is extremely valuable in determining the cause of the complaint. The patient should be questioned specifically about the onset and duration of symptoms; description of the pain; exacerbating and mitigating factors; associated pruritus, discharge, or photophobia; and any previous occurrences. It is important to inquire about the patient's past medical history, past ocular history (including surgeries, trauma, contact lens wear, and family history of glaucoma), systemic and ocular medications, and allergies. A careful examination of the patient's skin, face, eyelids, conjunctiva, sclera, cornea, and anterior chamber should be performed. In this article, the authors describe a variety of external diseases and anterior segment causes of a painful eye, many of which can be diagnosed from the initial history. The article works systematically, beginning externally with the eyelids and conjunctiva and progressing internally toward the cornea and anterior chamber.
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PMID:The painful eye: external and anterior segment causes. 985 61


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