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The Importance of Preventing and Managing Tear Dysfunction Syndrome in Allergic Conjunctivitis and How to Tackle This Problem

Montero-Iruzubieta J1,2, Sanchez Hernandez MC3, Dávila I4,5,6,7, Leceta A8

1Department of Surgery, University of Seville, Seville, Spain
2CARTUJAVISION Eye Clinic, Seville, Spain
3Department of Allergy, Hospital Universitario Virgen Macarena, Seville, Spain
4Allergy Department, Hospital Universitario de Salamanca, Spain
5Instituto de Investigación Biosanitaria de Salamanca (IBSAL), Salamanca, Spain
6Departamento de Ciencias Biomédicas y del Diagnóstico, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
7Red de Enfermedades Inflamatorias RICORS RD21/0002/000
8Medical Affairs Department, Faes Farma SA, Bizkaia, Spain

J Investig Allergol Clin Immunol 2023; Vol 33(6) : 439-445
doi: 10.18176/jiaci.0960

Tear dysfunction syndrome, also known as dry eye disease (DED), is a multifactorial disease of the ocular surface characterized by the loss of tear film homeostasis. DED shows a significant clinical overlap with ocular allergy (OA), which alters tear film homeostasis, thus predisposing the patient to DED. Both conditions constitute the most common ocular surface disorders and have a potentially severe impact on patients’ quality of life. Clinical practice guidelines recommend topical therapies as first-line treatment for OA. However, eye drop formulations may contain additional substances that can contribute to ocular surface damage and the development of DED. Therefore, physicians treating ocular allergy should be aware of problems affecting the tear film, the role of tear film disruption in OA, and topical treatment to prevent or minimize DED. The aim of this review is to present an updated overview of the topic.

Key words: Allergic conjunctivitis, Tear dysfunction syndrome, Dry eye disease, Eye drops, Preservatives, Antihistamines, Benzalkonium chloride, Hyaluronic acid