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document
Effectiveness of nonpharmacologic treatments for acute seasonal allergic conjunctivitis . OBJECTIVE To investigate whether artificial tears and cold compress alone or in combination provide a treatment benefit and whether they were as effective as or could enhance topical antiallergic medication . DESIGN Randomized , masked clinical trial . PARTICIPANTS Eighteen subjects ( mean age , 29.5±11.0 years ) allergic to grass pollen . INTERVENTION Controlled exposure to grass pollen using an environmental chamber to stimulate an ocular allergic reaction followed by application of artificial tears ( ATs ) , 5 minutes of cold compress ( CC ) , ATs combined with CC , or no treatment applied at each separate visit in random order . A subset of 11 subjects also had epinastine hydrochloride ( EH ) applied alone and combined with CC in random order or instillation of a volume-matched saline control . MAIN OUTCOME MEASURES Bulbar conjunctival hyperemia , ocular surface temperature , and ocular symptoms repeated before and every 10 minutes after treatment for 1 hour . RESULTS Bulbar conjunctival hyperemia and ocular symptoms decreased and temperature recovered to baseline faster with nonpharmaceutical treatments compared with no treatment ( P < 0.05 ) . Artificial tears combined with CC reduced hyperemia more than other treatments ( P < 0.05 ) . The treatment effect of EH was enhanced by combining it with a CC ( P < 0.001 ) . Cold compress combined with ATs or EH lowered the antigen-raised ocular surface temperature to less than the pre-exposure baseline . Artificial tear instillation alone or CC combined with ATs or EH significantly reduced the temperature ( P < 0.05 ) . Cold compress combined with ATs or EH had a similar cooling effect ( P > 0.05 ) . At all measurement intervals , symptoms were reduced for both EH and EH combined with CC than CC or ATs alone or in combination ( P < 0.014 ) . CONCLUSIONS After controlled exposure to grass pollen , CC and AT treatment showed a therapeutic effect on the signs and symptoms of allergic conjunctivitis . A CC enhanced the use of EH alone and was the only treatment to reduce symptoms to baseline within 1 hour of antigenic challenge . Signs of allergic conjunctivitis generally were reduced most by a combination of a CC in combination with ATs or EH .
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Intervention_Control
nonpharmacologic treatments
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Intervention_Control
topical antiallergic medication
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Intervention_Pharmacological
epinastine hydrochloride
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Outcome_Physical
Bulbar conjunctival hyperemia
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Outcome_Physical
ocular surface temperature
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Outcome_Physical
ocular symptoms
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Outcome_Physical
Bulbar conjunctival hyperemia
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Outcome_Physical
ocular symptoms
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Outcome_Physical
hyperemia
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Outcome_Physical
ocular surface temperature