Ocular Allergy: A New Ethiopathogenic Approach

. Objectives : Our study reports the relationship of allergic ocular disease, and extra ocular parasitic or bacterial infection in order to establish a cause and effect relationship.

Eye allergy is a common pathology affecting 30% of the population disrupting the quality of life. It is a hypersensitivity reaction to a foreign antigen. Damage to the ocular surface is frequent and can sometimes put the functional prognosis into play. The frequent negativity of corneal-conjunctial samples encourages us to actively seek an infectious site in chronic and recurrent damage to inflammation of the ocular surface.

This is a prospective case-control study spread over a period of 06 years in the ophthalmology department of the Moulay Ismail military hospital in Meknes, looking for infectious sites in the intestines, urogenital tract and ENT sites in patients with chronic inflammation or recurrent ocular surface in 53 patients divided according to ocular lesions as follows: 3 cases of nummular keratitis,  keratoconjunctivitis, 5 cases of blepharo-conjunctivitis, 4 cases of episcleritis and 5 cases of keratitis.

The medium age of the cases was 14.29 years with a group sex ratio M / F of 1,304. The different assessments requested: Stool culture, ECBU, ASLO and throat swab, cornea-conjunctival swab and vaginal swab (only one case) objectify an intestinal parasitosis in 41 cases or 77.3% and presence of bacteria in 27 cases or 50.9% of which 23 cases present a post-streptococcal ocular syndrome or 43.3% of the cases studied against 3 non-groupable streptococcus cases and 1 single parasitic case in the controls, which is significant (p<0.05).The administration of a treatment adapted to the germ :antibiotic ,antiparasitic and in some cases a tosillectomy allowed a complete resolution of the damage over 5 year follow-up

We suggest that repeated parasitological examination of the stool along with ASLO title and bacteriological throat swab should be included in the workup for any ocular surface injury.