Relationship between nasal and conjunctival tests in patients with allergic rhinitis

Simultaneous conjunctival and nasal provcation tests, a total of 174 test pairs, were carried out in fifty patients with allergic rhinitis, using serially diluted antigen solutions of birch, Timothy grass and mugwort pollen, as well as cat and dog dander. The nasal mucosa was found to be more sensitive than the conjunctival mucosa in ninety-six test pairs (55%). This differs from earlier reports. Nasal reaction only was observed in twenty-nine instances (17%). Posterior rhinomanometry was also used to evaluate test reactions, but was found to yield little additional information. In 43% of nasal provocation tests, which according to other criteria were positive, the rhinomanometric results were negative. Despite a fairly good correlation between the results obtained by nasal and conjunctival challenge, the results point to organ specificity in type I reactions. Provocation tests, if indicated in a thorough allergy evaluation, should be performed in the shock organ. The provocation methods and interpretation of reactions of this study differ from those of earlier reports. Comparison of results is difficult and standardization of methods is needed.