Conjunctivitis, Allergic

Description

General Measures

Medicine Treatment

Referral

---

H10.1

DESCRIPTION

An inflammatory condition of the conjunctivae caused by allergy to pollen, grass, animal fur, medication, cosmetics, etc. Often associated with allergic rhinitis or hay fever.

• Common features include:
  • Itching, watery eyes and photophobia
  • Slightly red or normal conjunctiva
  • Conjunctival swelling in severe cases
  • Normal cornea, iris and pupil
  • Normal visual acuity

In cases of vernal keratoconjunctivitis (VKC), there may be brown discolouration of the conjunctivae or cobblestone elevations of the upper tarsal conjunctivae.

GENERAL MEASURES

Relieve symptoms with cold compresses, i.e. a clean moistened cloth over the eyes for 10 minutes

MEDICINE TREATMENT

Adults and children >6 years of age                                                                                                     

• Oxymetazoline 0.025%, eye drops, instil 1 drop 6 hourly for a maximum of 7 days.

If no response within 7 days or history of recurrent (seasonal)/ chronic allergic conjunctivitis, change to:

• Anti-allergic eye drops, e.g.:
• Sodium cromoglycate, 2 % eye drops, instil 1 drop 6 hourly (Doctor initiated).
  • Use may be seasonal (1–3 months) or long-term.

LoE:II²

If symptoms not controlled, add cetirizine/ chlorphenamine:

• Cetirizine, oral, 10 mg once daily.
  • Use may be seasonal (1–3 months) or long term.

Children: 2–6 years of age

• Chlorphenamine, oral, 0.1 mg/kg/dose 6–8 hourly. See: dosing table.

If no response within 7 days or history of recurrent (seasonal)/ chronic allergic conjunctivitis, change to: 

• Anti-allergic eye drops, e.g.:
• Sodium cromoglycate, 2 % eye drops, instil 1 drop 6 hourly (Doctor initiated).
  • Use may be seasonal (1–3 months) or long term.

LoE:II³

If symptoms not controlled, add cetirizine:

• Cetirizine, oral, 5 mg once daily. See: dosing table.
  • Use may be seasonal (1–3 months) or long-term.

REFFERAL

• No response to treatment.
• Persons wearing contact lenses.
• Children <2 years of age.

Click here to access the pdf.

---

Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.0_30 September 2024

Chapter 18: Eye Conditions_18.1 Conjunctivitis_18.1.1 Conjunctivitis, Allergic