What is Spring Catarrh in Children?
Spring catarrh of the eye is also known as spring keratoconjunctivitis. This is a chronic allergic inflammation of the eyes that occurs in spring and summer. The disease is characteristic mainly for boys under 9 years old.
In the puberty, the disease in most cases goes away on its own, without intervention. But before puberty, spring catarrh of the eyes in children causes a lot of trouble.
The disease is classified as delayed-type allergic reaction. It occurs if the child has an increased sensitivity to UV rays.
Forms of spring conjunctivitis in children:
- conjunctival (known as tarsal)
- limbal (second name – spring limbit)
According to Yu.F. Maychuk, there is also spring keratoconjunctivitis, which has various clinical forms: corneal epithelium, micropannus, spot epithelial keratitis, corneal erosion, etc.
Causes of Spring Catarrh in Children
The causes of spring catarrh of the eyes in children lie in the increase in the time of solar radiation, the presence of pollen of flowering plants in the air. Also, the reason is in the hormonal characteristics of boys of primary school and preschool age.
Symptoms of Spring Catarrh in Children
The disease begins at the age of 4-5 years, lasts 2-3 years, exacerbations occur in spring and summer. A complete regression of symptoms occurs during puberty. In girls, the disease rarely occurs. It is also very rare that spring catarrh in children begins after a puberty. In such cases, among the patients equally boys and girls. In hot countries, this disease is more common than in temperate countries.
The conjunctival form of the disease is manifested by the formation of papillary growths in the form of a “cobblestone pavement” on the conjunctiva of the upper eyelid. There is a thickening of the conjunctiva, its dullness, pallor (milky shade). On the surface of the conjunctiva visible threadlike discharge viscous structure. The inflammatory process does not apply to other parts of the conjunctiva.
The limbal form of spring catarrh in a child is manifested by the proliferation of pre-limbal tissue, which forms a gelatinous-looking cushion of a yellow-gray or pink-gray hue. The tissue that has formed can grow on the area of the limbus and even the cornea. Its surface is uneven, shiny, with prominent white dots (known as Trantas spots). White dots are dominated by eosinophils and altered epithelial cells. In the period of the regression of the disease, indentations appear in this zone (in the scientific literature they are called Trance pits).
With a mixed form of the disease, the process affects the tarsal conjunctiva and the limb zone. A change in the cornea is accompanied by severe lesions of the conjunctiva of the upper eyelid, vision decreases.
Diagnosis of Spring Catarrh in Children
Diagnosis of spring catarrh of the eyes in children is quite simple. Doctors take into account age, seasonality (spring, summer), perform ophthalmoscopy. This disease should be distinguished from eye diseases of a different nature. To do this, conduct biomicroscopic studies of the detached eye, take scrapings from the mucous membranes of the eyelids, examine plaque sites, nodules.
Current laboratory allergy diagnostics is relevant. To conduct it, they take scrapings and discharge, in which eosinophils are found in large quantities.
Be sure to conduct a general examination of a sick child, since spring catarrh can occur along with other diseases: rheumatism, tuberculosis, bronchial asthma, neurodermatitis.
Treatment of Spring Catarrh in Children
To minimize the effect of ultraviolet rays on the body, it is recommended to wear sunglasses, in the afternoon you need to be as little as possible in sunlight. In rare cases, the family has to move to a country with a less hot climate.
For the treatment of spring catarrh, glucocorticosteroid solutions (GCS) should be instilled in the conjunctival sac 3-4 times a day, and ointments should be placed at night:
- solution and ointment dexamethasone 0.1%
- hydrocortisone ointment 0.5, 1 and 2.5%.
With long courses of corticosteroids, side effects may develop, therefore it is recommended to use lower concentrations of dexamethasone (0.01-0.05%), which are produced ex temporae.
To reduce the dose of glucocorticosteroids, mast cell membrane stabilizers and antihistamines are used:
- solution of cromolyn sodium 2%;
- lodoxamide solution 0.1%;
- acelastine solution 0.05%.
For 7-10 days, systemic desensitizing therapy is used. Inside, take loratadine. For children from 2 to 12 years, taking 5 mg of the drug once a day. For children from 12 years old, taking 10 mg of the drug is also 1 time per day.
Prevention of Spring Catarrh in Children
To prevent spring catarrh, children should wear sunglasses and minimize the time spent in the sun during the day.