Treatment of Allergic Rhinitis and Allergic Conjunctivitis

Initial treatment of allergic rhinitis (AR) depends on the severity of symptoms and whether they are intermittent or persistent. Allergic conjunctivitis occurs in most patients with AR. Ocular symptoms such as itching, redness, tearing, and photophobia are frequently seasonal. Nonpharmacologic management includes allergen identification and avoidance, use of refrigerated artificial tears, eyelid cleansers and cold compresses, and refraining from eye rubbing. Wearing sunglasses as a barrier to allergens can also be helpful. Management of AR with an oral second-generation H1-antihistamine or an INCS can benefit concomitant allergic conjunctivitis as well, but oral antihistamines (even second-generation agents) may reduce tear volume and induce or worsen dry eye syndrome.