The possible involvement of nasal allergy in allergic keratoconjunctivitis

Allergic keratoconjunctivitis coexists regularly with allergic rhinitis. However, little is known about the relationship between these conditions. The purpose of this study was to investigate the possible involvement of nasal allergy in keratoconjunctivitis by means of nasal challenge with allergen (NPT), in combination with recording of the ocular symptoms.

In 26 patients suffering from atopic (n=15) or vernal (n=11) keratoconjunctivitis showing positive history and skin tests, but responding insufficiently to the local ophthalmologic therapy, 71 NPTs with inhalant allergens were performed and combined with the recording of the ocular response. In 11 control subjects with allergic rhinitis, but without ocular disease history, 11 positive NPTs were repeated and supplemented with the registration of the ocular features.

Of the 26 patients, 24 developed 51 positive nasal responses (NRs; P<0.01), 43 of which were accompanied by significant ocular response (P<0.01). No ocular responses were measured during the 26 PBS control challenges (P>0.05) or during 11 repeated NPTs in control subjects (P>0.2).

These results give evidence for possible involvement of nasal allergy in some cases of keratoconjunctivitis. They also show diagnostic value of nasal challenges with allergen in combination with registration of the ocular symptoms in such patients, allowing then consideration of additional therapeutic measures concerning the nasal allergy.