Background: Atopy is the hereditary
predisposition to allergy. Eye
complications in atopy can be a source of substantial morbidity.
Objective: To assess allergic
eye manifestations in patients with other chronic severe atopy and to determine
whether IgE-mediated sensitization could be a predisposing factor.
Patients & Methods: Ninety consecutive patients with chronic severe atopy as assessed by Nottingham Eczema Severity Score (NESS), ARS
(allergic rhinitis score) and/or ACT (asthma control test), were included. The
enzyme-linked immunosorbent assay (ELISA) technique was used for total and
specific serum IgE assays in 30 and 45 patients of them consequently.
Results: Sixty-two females (68.89%) versus 28 males
(31.11%) were included, with no specific racial susceptibility (p=0.129). In 67 patients (74.44%), more than one allergic condition
coexisted (atopic march), with asthma was the most common (30 patients),
followed by allergic
rhinitis (AR) and
food allergy (each in 17 patients). In 49 patients (54.44%), eye symptoms were
reported. On examination, all patients had ocular signs, with 22 (24.44%)
patients showed blepharitis, 27 patients (30.0%) showed blepharo-conjunctivitis-dry
eye, while 41 (45.56%) patients showed asymptomatic benign papillofollicular
conjunctivitis. One patient (1.1%) had keratoconus. Allergic Skin and Eye
manifestations were highly statistically significantly related to each other (p<0.001). There was no statistically significant relation between either of allergic skin or eye manifestations and the presence of family history of atopy, high total serum IgE, or specific serum IgE-aeroallergen panel (p<0.05). However, there was statistically significant relation between skin allergic manifestations and specific serum IgE-Food panel (p=0.012). Conclusions: This study demonstrates the potentially significant ocular involvement in chronic severe atopic patients, particularly those with skin allergic manifestations. It also highlights food allergy in a considerable ratio of severe atopic dermatitis (AD) patients. It, thus, identifies scope to enhance current international clinical guidelines for management of atopy, through the inclusion of ocular and food allergy screening, for possible co-morbidities