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Mikhail E, Mohebbi M, Gokhale M, Azizoglu S, Suphioglu C. Development and validation of a health practitioner survey on ocular allergy. Sci Rep 2024; 14:9932. [PMID: 38689009 PMCID: PMC11061311 DOI: 10.1038/s41598-024-60837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 04/28/2024] [Indexed: 05/02/2024] Open
Abstract
Survey studies have played a significant role in understanding the gaps in the knowledge and practices of health practitioners. However, there have been no such survey studies on Ocular Allergy (OA). Thus, the purpose of this study was to develop and validate a survey on OA to better understand the gaps in the diagnostic, treatment, and collaborative care approaches of health practitioners in OA. The survey is titled "Survey on Ocular Allergy for Health Practitioners (SOAHP)". SOAHP was developed in a five-stage process. First, item extraction via the use of a literature review, second, face and content validity, third, a pilot study, fourth, test-retest reliability, and fifth, finalisation of the survey. 65 items under 6 domains were initially generated in the item extraction phase. Content validity was conducted on 15 experts in the field. This was conducted twice to reach consensus whereby items and domains were added, edited, kept, or removed, resulting in 50 items under 7 domains. The pilot study was conducted on 15 participants from the five relevant health practitioner fields (Allergists/Immunologists, General Practitioners (GPs), Ophthalmologists, Optometrists and Pharmacists). This altered the survey further to 40 items under 7 domains. Test-retest reliability was conducted on 25 participants from the five health practitioner fields. Reliability was moderate to almost perfect for most (97%) investigated items. The finalised survey was 40 items under 7 domains. SOAHP is the first survey created to assess diagnostic, treatment and collaborative care approaches of Allergists/Immunologists, GPs, Ophthalmologists, Optometrists and Pharmacists on OA. SOAHP will be a useful tool in clinical research on OA.
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Affiliation(s)
- Ereeny Mikhail
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia.
| | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, 3216, Australia
| | - Moneisha Gokhale
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
| | - Serap Azizoglu
- Deakin Optometry, School of Medicine, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
| | - Cenk Suphioglu
- NeuroAllergy Research Laboratory (NARL), School of Life and Environmental Sciences, Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Waurn Ponds, Geelong, VIC, 3216, Australia
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Azari AA, Arabi A. Conjunctivitis: A Systematic Review. J Ophthalmic Vis Res 2020; 15:372-395. [PMID: 32864068 PMCID: PMC7431717 DOI: 10.18502/jovr.v15i3.7456] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/25/2020] [Indexed: 01/10/2023] Open
Abstract
Conjunctivitis is a commonly encountered condition in ophthalmology clinics throughout the world. In the management of suspected cases of conjunctivitis, alarming signs for more serious intraocular conditions, such as severe pain, decreased vision, and painful pupillary reaction, must be considered. Additionally, a thorough medical and ophthalmic history should be obtained and a thorough physical examination should be done in patients with atypical findings and chronic course. Concurrent physical exam findings with relevant history may reveal the presence of a systemic condition with involvement of the conjunctiva. Viral conjunctivitis remains to be the most common overall cause of conjunctivitis. Bacterial conjunctivitis is encountered less frequently and it is the second most common cause of infectious conjunctivitis. Allergic conjunctivitis is encountered in nearly half of the population and the findings include itching, mucoid discharge, chemosis, and eyelid edema. Long-term usage of eye drops with preservatives in a patient with conjunctival irritation and discharge points to the toxic conjunctivitis as the underlying etiology. Effective management of conjunctivitis includes timely diagnosis, appropriate differentiation of the various etiologies, and appropriate treatment.
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Affiliation(s)
- Amir A Azari
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Arabi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Ophthalmology, Torfeh Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Hossain IT, Sanghi P, Manzouri B. Pharmacotherapeutic management of atopic keratoconjunctivitis. Expert Opin Pharmacother 2020; 21:1761-1769. [PMID: 32602382 DOI: 10.1080/14656566.2020.1786534] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Atopic keratoconjunctivitis (AKC) is a form of allergic eye disease that can have sight threating implications. Prevalence is underestimated due to scarce published data and treatment is expanding as a result of limitations of current strategies. This article aims to provide an up-to-date overview of AKC and summarize current and upcoming management. AREAS COVERED The authors provide history, immunopathogenesis, and summary of the clinical manifestations of AKC as well as presenting a review of the evidence in relation to treatment options including mast cell stabilizers, antihistamines, corticosteroids, and immunomodulatory drugs based on clinical trials. Future trends, drug targets, and novel delivery drug systems are also highlighted in this review. EXPERT OPINION Previously established treatment strategies of AKC had relied on corticosteroids, but the side effects of long-term therapy resulted in the expansion into the use of immunomodulatory drugs such as tacrolimus and ciclosporin. However, these too provide limited success due to the suboptimal structural properties of the current molecules. The ideal molecule should generate maximum permeability across the multi-layered structure of the cornea, be able to be formulated into eye drops for ease of application with minimal dosing and for maximal clinical effect.
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Affiliation(s)
- Ibtesham T Hossain
- Department of Ophthalmology, Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust , Romford, UK
| | - Priyanka Sanghi
- Department of Ophthalmology, Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust , Romford, UK
| | - Bita Manzouri
- Department of Ophthalmology, Queens Hospital, Barking Havering and Redbridge University Hospitals NHS Trust , Romford, UK
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Bilkhu PS, Wolffsohn JS, Naroo SA, Robertson L, Kennedy R. Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis. Ophthalmology 2013; 121:72-78. [PMID: 24070810 DOI: 10.1016/j.ophtha.2013.08.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 07/31/2013] [Accepted: 08/07/2013] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate whether artificial tears and cold compress alone or in combination provide a treatment benefit and whether they were as effective as or could enhance topical antiallergic medication. DESIGN Randomized, masked clinical trial. PARTICIPANTS Eighteen subjects (mean age, 29.5±11.0 years) allergic to grass pollen. INTERVENTION Controlled exposure to grass pollen using an environmental chamber to stimulate an ocular allergic reaction followed by application of artificial tears (ATs), 5 minutes of cold compress (CC), ATs combined with CC, or no treatment applied at each separate visit in random order. A subset of 11 subjects also had epinastine hydrochloride (EH) applied alone and combined with CC in random order or instillation of a volume-matched saline control. MAIN OUTCOME MEASURES Bulbar conjunctival hyperemia, ocular surface temperature, and ocular symptoms repeated before and every 10 minutes after treatment for 1 hour. RESULTS Bulbar conjunctival hyperemia and ocular symptoms decreased and temperature recovered to baseline faster with nonpharmaceutical treatments compared with no treatment (P <0.05). Artificial tears combined with CC reduced hyperemia more than other treatments (P <0.05). The treatment effect of EH was enhanced by combining it with a CC (P <0.001). Cold compress combined with ATs or EH lowered the antigen-raised ocular surface temperature to less than the pre-exposure baseline. Artificial tear instillation alone or CC combined with ATs or EH significantly reduced the temperature (P <0.05). Cold compress combined with ATs or EH had a similar cooling effect (P >0.05). At all measurement intervals, symptoms were reduced for both EH and EH combined with CC than CC or ATs alone or in combination (P <0.014). CONCLUSIONS After controlled exposure to grass pollen, CC and AT treatment showed a therapeutic effect on the signs and symptoms of allergic conjunctivitis. A CC enhanced the use of EH alone and was the only treatment to reduce symptoms to baseline within 1 hour of antigenic challenge. Signs of allergic conjunctivitis generally were reduced most by a combination of a CC in combination with ATs or EH.
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Affiliation(s)
- Paramdeep S Bilkhu
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, United Kingdom.
| | - Shehzad A Naroo
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Louise Robertson
- National Pollen and Aerobiological Research Unit, University of Worcester, Worcester, United Kingdom
| | - Roy Kennedy
- National Pollen and Aerobiological Research Unit, University of Worcester, Worcester, United Kingdom
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Mishra GP, Tamboli V, Jwala J, Mitra AK. Recent patents and emerging therapeutics in the treatment of allergic conjunctivitis. ACTA ACUST UNITED AC 2011; 5:26-36. [PMID: 21171952 DOI: 10.2174/187221311794474883] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2010] [Accepted: 12/01/2010] [Indexed: 12/13/2022]
Abstract
Ocular allergy is an inflammatory response of the conjunctival mucosa that also affects the cornea and eyelids. Allergic conjunctivitis includes seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), atopic keratoconjunctivitis (AKC) and giant papillary conjunctivitis (GPC). In general, allergic conditions involve mast cell degranulation that leads to release of inflammatory mediators and activation of enzymatic cascades generating pro-inflammatory mediators. In chronic ocular inflammatory disorders associated with mast cell activation such as VKC and AKC constant inflammatory response is observed due to predominance of inflammatory mediators such as eosinophils and Th2-generated cytokines. Antihistamines, mast-cell stabilizers, nonsteroidal anti-inflammatory agents, corticosteroids and immunomodulatory agents are commonly indicated for the treatment of acute and chronic allergic conjunctivitis. In recent years newer drug molecules have been introduced in the treatment of allergic conjunctivitis. This article reviews recent patents and emerging therapeutics in the treatment of allergic conjunctivitis.
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Affiliation(s)
- Gyan P Mishra
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO 64108-2718, USA
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Chigbu DI. The management of allergic eye diseases in primary eye care. Cont Lens Anterior Eye 2009; 32:260-72. [DOI: 10.1016/j.clae.2009.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 07/17/2009] [Accepted: 08/05/2009] [Indexed: 11/29/2022]
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The pathophysiology of ocular allergy: A review. Cont Lens Anterior Eye 2009; 32:3-15; quiz 43-4. [DOI: 10.1016/j.clae.2008.07.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Revised: 07/14/2008] [Accepted: 07/14/2008] [Indexed: 11/24/2022]
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Nessim M, Pandey SK, Werner L, Mohammed M, Kumar V. Histochemical analysis of bandage contact lens precipitates. Cont Lens Anterior Eye 2008; 31:47-9. [PMID: 17766171 DOI: 10.1016/j.clae.2007.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2006] [Revised: 03/29/2007] [Accepted: 06/20/2007] [Indexed: 10/22/2022]
Abstract
Contact lens deposits have been reported previously with extended wear of soft contact lenses, with proteins, lipids, mucous, and various salts such as chloride, potassium and calcium being deposited on the lens surface [1]. We report an unusual case of precipitates on the surface of a bandage contact lens (BCL) following intensive treatment with topical preservative free artificial tears. Evaluation included microscopic and histochemical analysis of the BCL. We have also reviewed the literature for previous reports of contact lens precipitates.
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Affiliation(s)
- Maged Nessim
- Birmingham and Midland Eye Centre, Dudley Road, Birmingham B18 7QH, UK.
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Swann PG. Giant papillary conjunctivitis associated with an ocular prosthesis. Clin Exp Optom 2001; 84:293-295. [PMID: 12366372 DOI: 10.1111/j.1444-0938.2001.tb05041.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2001] [Indexed: 11/28/2022] Open
Abstract
A case of giant papillary conjunctivitis associated with the wearing of an ocular prosthesis is described. Potential causes and treatment regimens are briefly reviewed.
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Affiliation(s)
- Peter G Swann
- School of Optometry, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, QLD, 4059, Australia
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