Allergic Conjunctivitis Linked to Worsened Pediatric Quality of Life

Recent developments from the Zhongshan Ophthalmic Center at Sin Yat-sen University in China found that allergic conjunctivitis (AC) had a negative impact on the quality of life (QoL) of young children.

Headed by Shi-yao Zhang, MD, it is believed to be the first known study to focus exclusively on children. The team focused on a particular age group considered to be the “patient population most affected by AC.”

Allergic conjunctivitis is considered to be one of the most common allergic diseases worldwide. Two common types exist: perennial allergic conjunctivitis (PAC) and seasonal allergic conjunctivitis (SAC).

There also exists a prevalence of vernal keratoconjunctivitis (VKC) and atopic keratoconjunctivitis (AKC). While they are rarer diseases, they are also more severe.

The study was conducted at Zhongshan Ophthalmic Center from November 16, 2019 to January 20, 2020.

A population of 92 children aged 5-18 years old with allergic conjunctivitis were enrolled for the study, while 96 children without an eye disease also participated as control. Children were divided into 4 separate groups based on the severity of the disease: 23 children in the VKC group, 7 in AKC, 26 in SAC and 36 in PAC.

The children received slit lamp and refraction examinations as well as evaluations on conjunctival hyperemia, papillary, and follicle formation. Corneal fluorescein staining and corneal pathologic characteristics were also evaluated and graded.

Additionally, the Pediatric Quality of Life Inventory, version 4.0 (PedsQL) was used to measure the QoL of participants.

The study found a significant decrease in the QoL of children with allergic conjunctivitis, especially with VKC and AKC groups. Patients experienced continuous discomfort and other complications.

Additionally disconcerting, and unexpected, was that the decrease in QoL among participants was worse than any previous studies of blinding diseases such as glaucoma and congenital cataract. The study also found that unlike other blinding diseases, there are no signs of improvement over time.

Impairment among the parents of children with allergic conjunctivitis was also found during the study, prompting investigators to suggest a broader conversation be had with parents and doctors regarding treatment and prognosis.

In the study, the team urged parents to be more attentive in regards to children’s struggle with allergic conjunctivitis.

“In addition to visual function, the eye plays a role in one’s psychological, emotional, and subconscious status,” they wrote. They also stressed that “anxiety, depression, or other psychological stress for patients and their family members” can occur when these diseases are not properly acknowledged.

The study, “Association of Allergic Conjunctivitis With Health-Related Quality of Life in Children and Their Parents,” was published online in JAMA Ophthalmology.