Clinical profile of ocular allergy and its impact on quality of life in Brazilian children and adolescents

Marino, Luiza Moulin; Chong Neto, Herberto José; Rosario, Cristine Secco; Rebouças, Layra Layane de Andrade Belo; Melo, Ana Caroline Dela Bianca; Solé, Dirceu; Wandalsen, Gustavo Falbo

doi:10.1590/1984-0462/2025/43/2025116

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ORIGINAL ARTICLE • Rev. paul. pediatr. 43 • 2025 • https://doi.org/10.1590/1984-0462/2025/43/2025116 linkcopy

Clinical profile of ocular allergy and its impact on quality of life in Brazilian children and adolescents

Caracterização clínica da alergia ocular e seu impacto sobre a qualidade de vida em crianças e adolescentes brasileiros

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To describe the symptoms, severity, and impact on quality of life of ocular allergy in children and adolescents followed up in referral centers in Brazil.

Methods: Cross-sectional, observational study carried out in three referral centers for pediatric allergy in children and adolescents (5–17 years) diagnosed with ocular allergy. Clinical data was obtained from the medical records. Patients scored the intensity of their ocular and nasal symptoms using a visual analog scale. The impact of ocular allergy on their quality of life was assessed using a specific questionnaire (Quality of Life in Children with Keratoconjunctivitis — QUICK) and the EQ-5D visual analog scale.

Results: 196 participants were included, 37.8% with vernal or atopic keratoconjunctivitis and 62.2% with seasonal or perennial allergic conjunctivitis. The most common allergic comorbidity was rhinitis. The most intense symptoms in both groups were pruritus and ocular hyperemia. The main trigger for allergic symptoms, according to patients’ perceptions, was house dust. Participants with keratoconjunctivitis had a significantly lower median score on the EQ-5D than those with seasonal/perennial allergic conjunctivitis. There was a higher prevalence of medication use across all the classes investigated among patients with keratoconjunctivitis. Ocular lubricants were underused by patients, especially in the milder forms of the disease.

Conclusions: The clinical presentation of ocular allergy is heterogeneous, with pruritus and hyperemia being the most common symptoms. House dust was reported as the main trigger of symptoms. Children and adolescents with keratoconjunctivitis experience higher impact on quality of life during symptomatic periods than those with seasonal and perennial allergic conjunctivitis.

Keywords:
Allergic conjunctivitis; Keratoconjunctivitis; Vernal keratoconjunctivitis; Atopic conjunctivitis

		VKC/AKC (n=74)	SAC/PAC (n=122)	p-value
Male sex (%)		50 (67.5)	70 (57.3)	0.156
Current age (years)		12 (10–14)	11 (9–14)	0.073
Age at onset of ocular symptoms (years)		4 (2–6)	3,5 (2–6)	0.939
Age at diagnosis of ocular allergy (years)		7 (4–10)	6 (4–9)	0.404
Allergic comorbidities (%)
	Allergic rhinitis	69 (93.2)	110 (90.1)	0.283
	Asthma	40 (54.0)	72 (59.0)	0.496
	Atopic dermatitis	43 (58.1)	65 (53.2)	0.510
	Food allergy	16 (21.6)	20 (16.4)	0.359

Apparent trigger	Total n (%)	VKC/AKC n (%)	SAC/PAC n (%)	p-value
House dust	171 (87)	66 (89)	105 (86)	0.724
Temperature changes	155 (79)	55 (74)	100 (82)	0.099
Pollution	131 (67)	48 (65)	83 (68)	0.622
Mold	106 (54)	41 (55)	65 (53)	0.915
Respiratory infections	98 (50)	30 (41)	68 (56)	0.029*
Cats	87 (44)	35 (47)	52 (43)	0.590
Wind	84 (43)	36 (49)	48 (39)	0.238
Light/brightness	72 (37)	36 (49)	36 (30)	0.009*
Dogs	61 (31)	29 (39)	32 (26)	0.068
Pollens	44 (22)	16 (22)	28 (23)	0.782

During the last 2 weeks, because of conjunctivitis...	VKC/AKC (n=74)	SAC/PAC (n=122)	p-value
Question 1: ... did you feel burning in your eyes?	1 (1–3)	2 (1–3)	0.253
Question 2: ... did you have trouble staying in an air-conditioned room?	1 (1–3)	1 (1–3)	0.938
Question 3: ... did you have to use tissues?	2 (1–3)	2 (1–3)	0.898
Question 4: ... did you have puffy eyes?	2 (1–3)	2 (1–3)	0.915
Question 5: ... did you have problems in the light?	2 (1–3)	1 (1–3)	0.084
Question 6: ... did you have tearing?	2 (1–3)	2 (1–3)	0.946
Question 7: ... did you have itchy eyes?	2 (1–3)	2 (1–3)	0.988
Question 8: ... did you have red eyes?	2 (1–3)	2 (1–3)	0.348
Question 9: ... did you have blurred vision?	2 (1–3)	1 (1–3)	0.097
Question 10: ... did you have eye secretions?	2 (1–3)	1 (1–3)	0.297
Question 11: ... did you have to use eye drops?	3 (1–3)	2 (1–3)	0.003*
Question 12: ... did you have closed and sticky eyes in the morning?	2 (1–3)	1 (1–3)	0.074
Question 13: ... did you have trouble playing outdoors?	1 (1–3)	1 (1–3)	0.363
Question 14: ... did you have trouble practicing sports (e.g., football and gym)?	1 (1–3)	1 (1–3)	0.795
Question 15: ... did you have trouble meeting your friends?	1 (1–3)	1 (1–3)	0.962
Question 16: ... did you have trouble going to the swimming pool?	1 (1–3)	1 (1–3)	0.872
Total score:	26 (16–40)	26 (16–43)	0.180

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[T1FN1] Legend: VKC:vernal keratoconjunctivitis; AKC: atopic keratoconjunctivitis; SAC: seasonal allergic conjunctivitis; PAC: perennial allergic conjunctivitis. Data are expressed as number (%) or median (interquartile range).