Pollinosis conjunctivitis: causes, symptoms, diagnosis, treatment

Among allergens of biological origin, pollen of plants occupies a prominent place. In humans, it causes an allergic disease called hay fever. The first mention of hay fever was found in the works of Galen, which date back to the 2nd century. The discoverer of pollinosis is considered to be the English doctor Vostok, who in 1819 made the first official report in the London Medical-Chirurgical Society about hay fever, considering hay to be the cause of the disease. However, only at the beginning of the 20th century, it was proven that hay fever is the result of sensitization to the protein of plant pollen.

Hay fever is widespread.

The problem of hay fever is studied in depth throughout the world, as it is widespread in many countries.

Plant pollen that causes allergies has certain properties. It is very small (grain diameter from 2-3 to 40 microns), therefore it is extremely volatile and spreads over long distances. The greatest allergenic activity is possessed by the pollen of common ragweed from the family Asteraceae. Less active is tree pollen, especially pine, despite its abundance and volatility. Intermediate place in allergenic activity is occupied by pollen of cereal grasses, of which the most active is pollen of timothy, fescue, and cocksfoot.

Allergic reactions to plant pollen in humans are characterized by a clear, year-on-year seasonality. The period of the disease coincides with the flowering period of certain plant species. There is a direct connection between the amount of pollen in the air and the severity of attacks of the disease.

There are four pollen waves in Ukraine:

1. the first (mid-late April) is associated with sawing alder, hazel, birch, elm, and willow;
2. the second (early to mid-May) is caused by the pollination of birch, poplar, pine and spruce;
3. the third (beginning of June) coincides with the beginning of the pollination of cereal grasses and the peak of pollination of pine and spruce;
4. the fourth (August-September) is associated with the pollination of wormwood, quinoa and other representatives of the Asteraceae and Rubiaceae families.

It has been established that pollen contains proteins, sugars, fats, carbohydrates, vitamins (especially E), pigments, various enzymes, etc.

Podlinosis is based on an allergic reaction of increased sensitivity of the first type. Pollinosis is included in the group of exoallergic diseases that proceed according to the immediate type. They are related to atopic diseases.

Symptoms of hay fever

Symptoms of pollinosis are caused by allergic inflammation of the mucous membranes of the eyes, nose, nasopharynx, trachea, bronchi, digestive tract, as well as the skin and various parts of the nervous system. The most common clinical manifestations of pollinosis are combinations of allergic pollen rhinosinus, conjunctivitis and pollen asthma.

The organ of vision is often affected by hay fever. Pollypous conjunctivitis can begin acutely, with complete health, suddenly and for no apparent reason severe itching and burning in the eyes occur. Starting in the inner corner of the eye slit, the itching spreads to the upper and lower eyelids, accompanied by swelling of the skin and hyperemia of the edges of the eyelids. Transparent mucous discharge, stretching out in long threads, pain in the area of the superciliary arches, lacrimation, photophobia appear. Edema and hyperemia of the conjunctiva of the eyelids and the eyeball gradually increase. Edema of the conjunctiva can be so pronounced that the cornea "guesses" in the surrounding chemotic conjunctiva. In such cases, marginal infiltrates appear in the cornea, more often in the area of the eye slit. Translucent focal superficial infiltrates, located along the limbus, may merge and ulcerate, forming superficial corneal erosions. In the area of the upper cartilage, diffuse papillary hypertrophy is noted. Pronounced changes only in the conjunctiva or in combination with marginal keratitis are observed, as a rule, in patients without other symptoms of pollinosis. With concomitant rhinitis, the conjunctiva is less hyperemic and edematous, and keratitis has the character of diffuse epitheliopathy or epithelial punctate keratitis, non-ricorneal injection is usually absent.

More often, pollinosis conjunctivitis occurs chronically with moderate burning under the eyelids, minor discharge, periodically occurring itching of the eyelids, mild hyperemia of the conjunctiva, and small follicles or papillae may be found on the mucous membrane.

Treatment of hay fever

During an exacerbation of pollinosis conjunctivitis, antihistamines are prescribed orally, which must be taken regularly. As a local antihistamine, antazaline (antistin) is used in the form of 0.5% eye drops - alone or in combination with 0.05% naphazoline (antistin-privin eye drops), instilled 3-4 times, 2% promolin. In the chronic course, al omide or lekroln is used 2 times a day for 2-3 weeks, in the acute course - allergoftal or persalerg 2-3 times a day. In case of blepharitis, hydrocortisone-POS ointment is applied to the eyelids. In case of persistent recurrent course, specific immunotherapy is carried out under the supervision of an allergist.