Symptoms of acute rhinoconjunctivitis

Allergic rhinitis

Patients are bothered by profuse rhinitis, uncontrollable sneezing attacks, difficulty in nasal breathing up to its complete cessation. At the same time, itching of the hard palate, pharynx, nasal mucosa, and ear canals occurs. These phenomena are accompanied by intoxication, fatigue, loss of appetite, sweating, irritability, tearfulness, and sleep disturbances appear. Symptoms such as rhinorrhea and nasal congestion contribute to the development of sinusitis, eustachitis, otitis, polyps, and bronchial asthma. The morphological expression of acute allergic rhinitis is edema and eosinophilic infiltration of the nasal mucosa. Rhinoscopic picture: the mucous membrane is pale gray, swollen, sometimes Voyachek's spots (areas of ischemia) are visible. Serous-mucous discharge contains a large number of eosinophils. Acute allergic rhinitis may be accompanied by acute sinusitis. In this case, the mucous membrane of the maxillary sinuses is involved in the process. The radiographic picture varies from slight veiling and edematous-parietal swelling of the mucous membrane to an intense homogeneous decrease in the transparency of the sinuses. The dynamics of the process are usually favorable, except in cases of bacterial infection.

Allergic conjunctivitis

Among allergic eye diseases, lesions caused by pollen allergy account for 14.2%. Ocular manifestations of hay fever are typical for 90-95% of children. Isolated lesions of the eye membranes with pollen allergy are rare. Combinations are found: dermatitis and conjunctivitis, conjunctivitis and iridocyclitis, lesions of the anterior parts of the eye and the retina or optic nerve. Allergic eye lesions in children are almost always combined with lesions of the ENT organs.

Patients complain of itching and redness of the eyelids, a feeling of "sand" in the eyes, photophobia, lacrimation, and in severe cases, blepharospasm. A common variant of the lesion is dermatitis of the eyelids. There is a feeling of heaviness in the eyelids, severe itching. An objective examination reveals dryness and hyperemia of the skin of the eyelids, scales and cracks on them. Quincke's edema often occurs.

Conjunctivitis is the most common eye lesion. Allergic conjunctivitis is observed in 95.1% of patients with hay fever. It has sharply expressed subjective symptoms in the form of a sensation of a foreign body in the eyes, "sand behind the eyelids". Complaints of itching, burning in the eye area, a feeling of fatigue and pain in the area of the superciliary arches. The most typical objective sign of conjunctival damage is hyperemia of the mucous membrane. This phenomenon is called the "red eye" symptom. It is typical that hyperemia of the mucous membrane is clearly expressed 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 its combination with conjunctival (mixed injection) indicate a more severe eye lesion (keratitis, uveitis). In conjunctivitis, hyperemic papillae are visible on the mucous membrane of the eyelids, which are hyperplastic elements of lymphoid tissue. They are especially noticeable against the background of swelling of the mucous membrane, called chemosis. The swelling can be so pronounced that the mucous membrane falls out in the form of a ridge between the eyelids, and the cornea is immersed in the depth of the swelling. Chemosis can lead to a violation of the trophism of the cornea. The mucous discharge from the eye slit is colorless or light yellow, transparent, has the form of lumps or long threads.

Damage to 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. During an objective examination, in addition to ciliary injection, a change in the color of the iris is revealed. The pupil of the affected eye narrows, the shape of the pupil becomes scalloped.

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