Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis


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.

Additional Information: Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Publication ISSN: 0161-6420
Last Modified: 23 Oct 2019 13:24
Date Deposited: 10 Dec 2013 10:18
Published Date: 2013
Authors: Bilkhu, Paramdeep S.
Wolffsohn, James S.
Naroo, Shehzad A.
Robertson, Louise
Kennedy, Roy


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