Asia Pac Allergy.  2011 Oct;1(3):108-114. 10.5415/apallergy.2011.1.3.108.

Ocular allergy in the Asia Pacific region

• Katelaris

• KMID: 2397428
• DOI: http://doi.org/10.5415/apallergy.2011.1.3.108

Abstract

Allergic conjunctivitis (AC) represents a spectrum of disorders, comprising seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC) and giant papillary conjunctivitis. Of these ocular allergy types, SAC and PAC are the most common. The most striking difference within this group of ocular diseases is that SAC and PAC remain self-limited without ocular surface damage, while AKC and VKC can compromise the cornea, causing ulcers and scarring and can ultimately lead to vision loss. Data on AC in the Asia Pacific is scarce however some understanding of prevalence of the condition has been obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) studies and more recently from the Allergies in Asia Pacific study as well as some information from individual country surveys. Unfortunately none of this data has been collected using validated survey instruments specifically designed for AC. Surveys such as ISAAC have been predominantly concerned with respiratory allergic symptoms with questions added that incorporate some ocular symptoms. These questionnaires do not detect individuals who may have AC in the absence of allergic rhinitis. Using hospital ophthalmology outpatient populations for prevalence studies of ocular allergy immediately introduces a bias towards the more severe, complex forms of the condition as patients with the milder forms of SAR and PAR will rarely present to a hospital outpatient clinic. There is a real need for the development of validated questionnaires specifically addressing ocular allergy. There are no widely accessible studies examining prevalence of the complex forms of ocular allergy (AKC, VKC) in Asia Pacific region. This review will provide an overview of ocular allergy, its classification, clinical presentation and differential diagnosis, and will also discuss what is known about the epidemiology of ocular allergy in the Asian Pacific region.

Keyword

Allergic conjunctivitis; Ocular allergy; Epidemiology; Asia Pacific; AKC; VKC; ISAAC studies

MeSH Terms

Asia*
Asian Continental Ancestry Group
Asthma
Bias (Epidemiology)
Cicatrix
Classification
Conjunctivitis, Allergic
Cornea
Cross-Sectional Studies
Diagnosis, Differential
Epidemiology
Humans
Hypersensitivity*
Keratoconjunctivitis
Ophthalmology
Outpatient Clinics, Hospital
Outpatients
Prevalence
Rhinitis, Allergic
Seasons
Strikes, Employee
Ulcer

Figure

• 

  Fig. 1 Allergies in Asia Pacific (AIAP) survey prevalence data for "doctor diagnosis of ARC". Adapted from Ref 12.

• 

  Fig. 2 Doctor most likely to diagnose allergic rhinoconjunctivitis in Asia Pacific region. Adapted from Ref 12.

Reference

1. Nathan RA, Meltzer EO, Selner JC, Storms W. Prevalence of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997. 99:S808–S814.

2. Hesselmar B, Aberg B, Eriksson B, Aberg N. Allergic rhinoconjunctivitis, eczema, and sensitization in two areas with differing climates. Pediatr Allergy Immunol. 2001. 12:208–215.

3. Riedi CA, Rosario NA. Prevalence of allergic conjunctivitis: a missed opportunity? Allergy. 2010. 65:131–132.

4. Granet D. Allergic rhinoconjunctivitis and differential diagnosis of the red eye. Allergy Asthma Proc. 2008. 29:565–574.

5. Blaiss MS. Allergic rhinoconjunctivitis: burden of disease. Allergy Asthma Proc. 2007. 28:393–397.

6. Katelaris CH. Ocular allergy: implications for the clinical immunologist. Ann Allergy Asthma Immunol. 2003. 90:23–27.

7. Jun J, Bielory L, Raizman MB. Vernal conjunctivitis. Immunol Allergy Clin North Am. 2008. 28:59–82.

8. Kumar S. Vernal keratoconjunctivitis: a major review. Acta Ophthalmol. 2009. 87:133–147.

9. Bielory B, Bielory L. Atopic dermatitis and keratoconjunctivitis. Immunol Allergy Clin North Am. 2010. 30:323–336.

10. Aït-Khaled N, Pearce N, Anderson HR, Ellwood P, Montefort S, Shah J. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: The International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Allergy. 2009. 64:123–148.

11. Fok AO, Wong GW. What have we learnt from ISAAC phase III in the Asia-Pacific rim? Curr Opin Allergy Clin Immunol. 2009. 9:116–122.

12. Katelaris CH, Lai CK, Rhee CS, Lee SH, Yun WD, Lim-Varona L, Quang VT, Hwang J, Singh H, Kim J, Boyle JM, Dhong HJ, Narayanan P, Vicente G, Blaiss M, Sacks R. Nasal allergies in the Asian-Pacific population: Results from the Allergies in Asia-Pacific Survey. Am J Rhinol Allergy. 2011. 25:S3–S15.

13. Kilpeläinen M, Terho EO, Helenius H, Koskenvuo M. Validation of a new questionnaire on asthma, allergic rhinitis, and conjunctivitis in young adults. Allergy. 2001. 56:377–384.

14. Yadav SP, Goel HC, Chanda R, Ranga R, Gupta KB. A clinical profile of allergic rhinitis in Haryana. Indian J Allergy Asthma Immunol. 2001. 15:13–15.

15. Uthaisangsook S. Prevalence of asthma, rhinitis, and eczema in the university population of Phitsanulok, Thailand. Asian Pac J Allergy Immunol. 2007. 25:127–132.

16. Lee SI, Shin MH, Lee HB, Lee JS, Son BK, Koh YY, Kim KE, Ahn YO. Prevalences of symptoms of asthma and other allergic diseases in Korean children: a nationwide questionnaire survey. J Korean Med Sci. 2001. 16:155–164.

17. Min YG. The pathophysiology, diagnosis and treatment of allergic rhinitis. Allergy Asthma Immunol Res. 2010. 2:65–76.

18. Baig R, Ali AW, Ali T, Ali A, Shah MN, Sarfaraz A, Ahmad K. Prevalence of allergic conjunctivitis in school children of Karachi. J Pak Med Assoc. 2010. 60:371–373.

19. Choi H, Lee SB. Nonseasonal allergic conjunctivitis in the tropics: experience in a tertiary care institution. Ocul Immunol Inflamm. 2008. 16:141–145.

20. Gaur SN, Gupta K, Rajpal S, Singh AB, Rohatgi A. Prevalence of bronchial asthma and allergic rhinitis among urban and rural adult population of Delhi. Indian J Allergy Asthma Immunol. 2006. 20:90–97.

21. Mimura T, Mimura Y, Arimoto A, Amano S, Yamagami S, Funatsu H, Usui T, Noma H, Honda N, Okamoto S. Relationship between refraction and allergic conjunctivitis. Eye (Lond). 2009. 23:63–66.