Combined treatment of noninfectious allergic conjunctivitis with Eyecrol and nozeylin

Treatment of allergic conjunctivitis is one of the main trends of modern ophthalmology. During treatment of allergic diseases particular importance is given to the following:

1. Detection of the allergen
2. Specific immune therapy
3. Pharmacotherapy

Despite detection and eradication of the allergen is effective it is particularly impossible. Specific immune therapy is applicable only in case when specific allergen has been revealed, this of course restricts use of such treatment mode. This is why for any allergic disease of the eye most attention is played to such therapy that can effectively eliminate complaints of patients suffering from allergic conjunctivitis eyelid edema, uncomfortable itching, hyperemia of conjunctiva, lacrimation, photophobia.

Combined treatment with Eyecrol and Nozeylin was conducted in 71 patients with allergic conjunctivitis. Patients age varied from 6 to 52 years. For detection of the causative agent much attention was paid to patients’ anamnesis. Every patient was examined with standard ophthalmology methods: visometry, biomicroscopy, bacterial study of conjunctiva, Schirmer’s test, microscopy study of eyelashes for Demodex, consultation of allergology specialist.

According to objective and subjective data patients were divided into 5 groups:

• group – 22 patients with pollen allergy
• group – 11 patients with spring catarrhal disease
• group – 12 patients with dry eye syndrome (keratoconjunctivitis sicca) IV group-20 patients with Demodex blepharitis

V group – 6 patients with non infective allergic conjunctivitis of unknown etiology

Group I, II, V patients were treated with Eyecrol 4% eye drops 3 instillation/day for 1 month and then 2 instillations/day for 1 month, followed by once daily instillation for one week. After recovery from eyelid edema, hyperemia of conjunctiva and itching Nozeylin was being prescribed only in case of exacerbations with the following symptoms. Within two weeks after starting the therapy, patients mentioned that their complaints were episodic and momentarily relievable by single Nozeylin instillation.

In the group III patients, Eyecrol 4% eye drops (3 instillations/day) with lubricating agents was used. Nozeylin was used as a back up medication in case of severe itching, eyelid hyperemia and mucosal edema.

It is significant that group III patients mentioned in their medical histories: long term nonprescription use of various eye medications (antibiotics, steroids). In case of undetected dry eye syndrome it may be most reason of allergic conjunctivitis.

Group IV patients after being examined microscopically were detected to have Demodex induced blepharitis with marked allergic symptoms. The treatment was 45 days duration and included anti Demodex therapy too. Eyecrol 4% eye drops 3inst./day for 45 days , then -2inst./day for 1 month.

Nozeylin 2inst./day for one week, 1 inst/day for one week followed by episodic short term use in case of necessity.

According to the results of our clinical trial we can conclude the following:

1. Eyecrol 4% eye drops use is effective for long term treatment of allergic conjunctivitis.
2. Nozeylin co-administration with Eyecrol quickly eliminates the symptoms of acute allergic conjunctivitis: edema, hyperemia, itching, and improves subjective sense of the patients’ general well
3. Combined treatment with Eyecrol and Nozeylin is recommended for treatment of Demodex induced
4. For those patients with pollen allergy, Nozeylin and Eyecrol can be used for eye allergy
5. Combined use   of    Eyecrol   and   Nozeylin    can   effectively   relieve   allergic manifestations of dry eye syndrome (keratoconjunctivitis sicca).

NINO KARANADZE, MD, PhD, Assistant Professor Tbilisi State Medical University

Department of Eye Diseases