Seasonal allergic conjunctivitis

Seasonal allergic conjunctivitis is rarely associated with permanent vision impairment; however, it is a relatively common condition that may compromise the quality of life of patients with this diagnosis. In extreme cases daily activities, including work, may be compromised. Numerous treatment options have become available for the relief of acute symptoms. Corticosteroids may be used for severe cases for a limited time. If topical corticosteroids are being considered, an ophthalmologist should be consulted. Decongestants and antihistamines are useful treatment options for the majority of cases. Antihistamines, either topical or oral, should be the first-line therapy. Ketorolac may be helpful in relieving pruritus but offers little advantage over topical antihistamines. Sodium cromoglycate and lodoxamide may be helpful in the prophylaxis of symptoms during the allergy season but require frequent dosing. Immunotherapy is effective and should be offered to those who are intolerant or refractory to medications. Obviously, avoidance should always be the first choice in therapy but in most cases is not practical, especially with pollen allergies. The use of saline eyedrops is simple, nontoxic and is effective in up to 30-35% of cases. It can and should be added to all other remedies to reduce adverse effects and cost by decreasing the need for other therapeutic options.