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Allergy. 2017 Oct;72(10):1485-1498. doi: 10.1111/all.13178. Epub 2017 May 10.

Diagnostic tools in ocular allergy.

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Department of Neuroscience, Ophthalmology Unit, University of Padua, Padua, Italy.
Service d'Ophtalmologie, Hôpital Bichat and Fondation A. de Rothschild, Paris, France.
Unité d'Allergologie de l'Enfant CHU Estaing, CHU Estaing, Clermont-Ferrand Cedex1, France.
Faculty of Medicine, Department of Ophthalmology, Selcuk University, Konya, Turkey.
Rapallo Hospital Ophthalmology Department, Allergic Conjunctivitis Unit, Ocular Inflammatory Diseases Referral Center, Genova, Italy.
Pole sanitaire du Vexin, Pontoise, France.
Allergy Unit, Regional University Hospital of Malaga, IBIMA, UMA, Malaga, Spain.
Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland.
University Hospitals Leuven, Leuven, Belgium.
Laboratory of Immunology, Faculty of Medicine, Basic and Clinical Immunology Unit, and Center for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal.
Department of Ocular Biology & Therapeutics, UCL Institute of Ophthalmology, London, UK.


Ocular allergy (OA) includes a group of common and less frequent hypersensitivity disorders frequently misdiagnosed and not properly managed. The diagnosis of OA is usually based on clinical history and signs and symptoms, with the support of in vivo and in vitro tests when identification of the specific allergen is required. To date, no specific test is available for the diagnosis of the whole spectrum of the different forms of OA. The lack of recommendations on diagnosis of OA is considered a medical need not only for allergists but also for ophthalmologists. This position paper aims to provide a comprehensive overview of the currently available tools for diagnosing OA to promote a common nomenclature and procedures to be used by different specialists. Questionnaires, sign and symptom grading scales, tests, and potential biomarkers for OA are reviewed. We also identified several unmet needs in the diagnostic tools to generate interest, increase understanding, and inspire further investigations. Tools, recommendations, and algorithms for the diagnosis of OA are proposed for use by both allergists and ophthalmologists. Several unmet needs in the diagnostic tools should be further improved by specific clinical research in OA.


allergic conjunctivitis; biomarkers; diagnosis; ocular allergy; quality of life

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