Allergic eye conditions in toddlers

Are your toddler’s eyes always red, teary, and itchy? This could be a sign of allergic eye disease and only one of many manifestations of allergy.

By Dr Pieter J de Waal, Paediatrician and Allergologist, MediClinic, Bloemfontein

Typically, symptoms include teary, itching and redness of both eyes...

Allergies in childhood are becoming more common worldwide. In South Africa, we are joining the global allergy epidemic, with more children diagnosed with allergies than ever before.

Allergy is a medical term used to describe hypersensitivity to aspects of the environment, called allergens. An allergy susceptible person’s immune system may see these substances as strange (foreign), causing it to launch an abnormal immunological attack. Allergies often manifest in early childhood. Unfortunately, there are some allergies (e.g., allergies of the eyes and nose, peanut allergy, and shellfish allergy) which persist into adulthood and cannot be outgrown.

Causes and symptoms

Eye allergies (also called allergic conjunctivitis) are a common, chronic, and often relapsing condition, affecting people from a young age. Because the surface of the eye is the most obvious environmentally exposed area of the body, allergens (for example pollens from grasses, weeds and trees, certain proteins from pet hair and their skin, and indoor allergens like house dust mites and cockroaches) are common triggers for eye allergy.

Typically, symptoms include teary, itching and redness of both eyes, with swelling of the eyelids almost immediately after contact with an allergen. These allergens are usually airborne (for example pollen) or can be introduced to the eye by direct transmission (stroking a pet and touching the eyes). In some food-allergic patients (milk, egg, and peanut), touching food and soon after this, touching the eyes, may cause acute allergic eye symptoms. Acute onset allergic eye symptoms can also be part of a serious, systemic allergic reaction, called anaphylaxis. Allergic conjunctivitis often occurs in patients with hay fever – these two allergic conditions often co-exist in the same patient. Hay fever (also called allergic rhinitis) symptoms include a runny and itchy nose, sneezing, and nose blockage. Snoring is often reported. Allergic conjunctivitis and hay fever symptoms can occur the whole year around or only during certain months (typically spring and early summer).

More severe signs of conjunctivitis (eye surface inflammation) include a dirty, white eye discharge, sensitivity to sunlight and impairment in vision. Here, the white parts of the eye (called the sclera) may have a brownish appearance and if left untreated, may cause permanent scarring of the eye surfaces, and even blindness.

When to look for help

Speak to your doctor as soon as you suspect your child may have an allergic eye disease. Some types of conjunctivitis may be serious and may not only interfere with your child’s daily life activities but may also be sight-threatening.

Treatment

Your doctor should take a history, perform a thorough clinical examination, determine if any specific triggers for symptoms can be identified and then decide on specific allergen testing.

Early referral to a specialist (paediatrician or ophthalmologist) may be warranted. Allergen testing may include a skin prick test. This can be done for infants as young as four months old. Although a bit uncomfortable, skin prick testing is not painful.

Alternatively, blood can be taken to test for IgE antibodies aimed at specific allergens. A careful selection of allergens during these tests is mandatory, not only to avoid unnecessary costs, but also to avoid testing for allergens which are irrelevant in your child’s specific environment.

Typically, pollen from grasses, trees, and corn, as well as allergens from house dust mites, cockroaches, moulds, and pets (cats and dogs) will be tested. The aim of these tests is to assist in possible practical allergen avoidance and exposure reduction strategies, which forms an important part of allergy management.

Once a trigger is identified, practical allergen avoidance strategies should be implemented. Some of these may be expensive and time consuming, so specific allergen avoidance, based on a good history and complemented by adequate allergy testing are important. For instance, getting rid of your toddler’s favourite pet, without clear proof of an allergic reaction against it, is cruel, unnecessary and should be avoided. Avoiding cigarette smoke exposure cannot be stressed enough – this is mandatory and non-negotiable.

Anti-allergic eye drops, and non-sedating antihistamines (in the form of syrups) are important pharmacological treatments for allergic eye disease. Many allergens, for example outdoor pollen, are difficult to avoid. Medicine should therefore be given daily and pro-actively to prevent rather than rescue.

Your doctor should explain the correct technique of administering eye drops. With careful monitoring from your family doctor, paediatrician or ophthalmologist, side effects of these medicine can be avoided.

Unfortunately, many allergic diseases, like eye and nose allergies, cannot be cured, but their symptoms can be effectively managed with safe, daily anti-allergic medications and allergen avoidance.

Early life allergies may also progress into other allergic conditions, for instance asthma, later in life, so a careful “wait and see” approach should be followed, with regular follow-up visits to a healthcare practitioner.  Dr Pieter de Waal qualified as a Paediatrician in 2009 at the University of the Free State. In 2017, he obtained the South African Certificate in Asthma Care (NAEP) and in 2018, he obtained his Diploma in Allergology from the College of Family Physicians of South Africa. He qualified as a Certified Allergologist at the University of Cape Town in 2018 and obtained his M.Phil. degree in Allergology in 2019. He currently works as a full-time subspecialist in Allergology at MediClinic, Bloemfontein and holds a part-time post as a senior consultant at the University of the Free State, where he teaches the subjects of allergology, asthma and pulmonology. He is also part of the South African National Asthma Education Programme (NAEP) and Allergy Society of South Africa (ALLSA) executive committees.

Retail price: R163,95

Mentat 200ml Syrup

A herbal supplement scientifically formulated to help improve memory, mental functioning and attention. Mentat comes in tablet and syrup format. Availabe at Dischem, Clicks, leading independent pharmacies and e-commerce stores.

SAVE R24 Retail price:

R100

Kure-All Healing Cream

Kure-All Healing Cream effective treatment for: • Diabetic related sores • Cuts, burns and fever blisters • Sunburn • Nappy rash • Acne • Insect bites Available online at www.watkinsonline.co.za

Use discount code:

BB10 – for 10% off your entire order.

health

health

Septilin 100s Tablets

A herbal supplement formulated to help boost your immune system and fight infections. Septilin comes in tablet and syrup format. Available at Dischem, Clicks, leading independent pharmacies and e-commerce stores.

Retail price: R194,95

HPA® Lanolin Nipple Cream

Lansinoh® HPA® Lanolin is proven to help soothe and protect sore cracked nipples. • 100% natural & hypoallergenic • No need to remove before breastfeeding • Safe for mum & baby • No taste, colour or smell • Free from preservatives and parabens – just lanolin and nothing else • Anhydrous, does not contain any medium in which bacteria can grow

Available online at

www.azatimix.com or select pharmacies and baby department stores.

Retail price: R199,45

SAVE R24

Retail price: R105

Kure-All Psoriasis Cream

Kure-All Psoriasis Cream stimulates microcirculation, increasing water supply to the epidermis, reduces inflammation and inhibits infective bacteria in several skin conditions. Available online at www.watkinsonline.co.za

Use discount code:

BB10 – for 10% off your entire order.

Chesteeze Syrup 100ml

Can assist with the alleviation of symptoms associated with cold and flu such as: sore chest, coughs and respiratory congestion. Acts as a bronchodilator, expectorant, and has antiinflammatory properties. Available at all leading pharmacies.

Retail price: R83,95

Retail price: R525

Lady Prelox

Lady Prelox is an all-natural estrogen-free supplement clinically proven to boost sexual function and satisfaction in women between 37 and 45 by 88% within one month, and by up to 126% in two months. It’s even proven to boost sexual satisfaction in menopausal (45–55) and even postmenopausal (50+) women by 60% and more. Available at all leading pharmacies or online at www.lamellepharmaceuticals.co.za

• Anti-allergic properties for acute allergies • Natural antibiotic • Broad spectrum herbal complex • Antibacterial, antiviral, anti-inflammatory, and antioxidant Available at all leading pharmacies.

Retail price: R164,95

Septogard Syrup 100ml

Provides support by the following mechanisms: • Targeted immune response against infection (first line defence) • Chronic immune support against opportunistic/ recurring infections for people with a compromised immune system