Symptoms of acute rhinoconjunctivitis
Last reviewed: 23.04.2024
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Allergic rhinitis
Patients are troubled by profuse rhinitis, indomitable sneezing attacks, obstruction of nasal breathing until its complete cessation. At the same time there is an itch of a hard palate, pharynx, mucous membrane of the nose, ear passages. These phenomena are accompanied by intoxication, fatigue, decreased appetite, sweating, irritability, tearfulness, sleep disturbance. Symptoms such as rhinorrhea and nasal congestion contribute to the development of sinusitis, eustachiitis, otitis, polyps, bronchial asthma. Morphological expression of acute allergic rhinitis is edema and eosinophilic infiltration of the nasal mucosa. Rinoskopicheskaya picture: the mucous membrane is pale gray, edema, sometimes visible spots Voyachek (areas of ischemia). Serous-mucosal discharge contains a large number of eosinophils. Acute allergic rhinitis may be accompanied by acute sinusitis. In this process, the mucous membrane of the maxillary sinuses is involved. The radiographic pattern varies from slight veiling and swelling and parietal swelling of the mucous membrane to an intense homogeneous lowering of the sinus transparency. The dynamics of the process is usually favorable, except for cases of attachment of a bacterial infection.
Allergic conjunctivitis
Among allergic eye diseases, allergies due to pollen allergy are 14.2%. Eye manifestations of pollinosis are characteristic for 90-95% of children. Isolated lesions of the eye membranes in pollen allergies are rare. There are combinations: dermatitis and conjunctivitis, conjunctivitis and iridocyclitis, lesions of the anterior parts of the eye and retina or optic nerve. Allergic lesions of the eyes in children are almost always combined with the defeat of ENT organs.
Patients complain of itching and redness of the eyelids, a feeling of "sand" in the eyes, photophobia, lacrimation, in severe cases blepharospasm. A frequent variant of the lesion is the dermatitis of the eyelids. There is a feeling of heaviness of the eyelids, a strong itch. At an objective inspection dryness and a hyperemia of a skin of blepharons are defined, on them there are scales and cracks. Quite often there is edema of Quincke.
Conjunctivitis is the most common lesion of the eyes. Allergic conjunctivitis is noted in 95.1% of patients with pollinosis. With him, the subjective symptoms are sharply expressed in the form of sensation of a foreign body in the eyes, "sand after centuries." Complaints about itching, burning in the eye area, a feeling of fatigue and pain in the area of the superciliary arches. The most characteristic objective sign of a conjunctival lesion is hyperemia of the mucous membrane. This phenomenon is called a "red eye" symptom. It is characteristic that the hyperemia of the mucous membrane is strongly pronounced on the eyelids and gradually weakens towards the cornea (conjunctival injection). With pericorneal injection, hyperemia increases in the opposite direction - from the eyelids to the cornea. Pericorneal injection or a combination of it with conjunctival (mixed injection) indicate a more severe eye damage (keratitis, uveitis). On the mucous membrane of the eyelids with conjunctivitis, hyperemic papillae, which are hyperplastic elements of the lymphoid tissue, are seen. They are particularly noticeable against the background of edema of the mucous membrane, called chemosis. Edema can be so pronounced that the mucous membrane falls out in the form of a roller between the eyelids, and the cornea is immersed in the depth of edema. Chemosis can lead to disruption of the trophism of the cornea. Detachable from the eye slit slimy, colorless or light yellow, transparent, has the form of lumps or long filaments.
The defeat of the choroid (uveitis) and retina (retinitis) is a rare but dangerous manifestation of allergy. With inflammation of the iris and ciliary body (iridocyclitis), the patient experiences sharp pain in the eye. In an objective examination, in addition to ciliary injection, a change in the color of the iris is detected. The pupil of the affected eye narrows, the shape of the pupil becomes scalloped.
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