Patients with AC may be more likely to need incisional eyelid surgery.
Patients with AC may be more likely to need incisional eyelid surgery. Photo: Charissa Young, OD. Click image to enlarge.

With springtime upon us, you may notice more patients in your practice suffering from allergic conjunctivitis (AC). Eyelid swelling, such as hordeolum and chalazion, has been shown to be much more common in those with AC than in the general population. In fact, a recent study found that patients with AC are 4.27 times more likely to undergo eyelid incisional surgery than patients without the condition. The study also revealed that steroid use increased the risk of needing surgery.

Using a population-based cohort in South Korea, researchers gathered data from 66,657 pediatric and adult patients diagnosed with AC; however, their analysis included only 15,703 patients who did not have a prescription for eye drops or a history of any condition that could affect the development of eyelid inflammation. Pediatric patients without AC were used as controls. The team looked at trends in prevalence, demographics and predictors of surgery among study participants.

As one might expect, incisional surgeries were performed more often during peak allergy seasons (spring and fall). In the AC group, the likelihood of undergoing surgery was higher in every age group compared with controls. When researchers performed a subanalysis in the AC cohort, they discovered that the likelihood of surgery was 2.34 times greater in patients who received treatment with steroids.

“The incision surgery rate was high when steroids that indirectly reflected severe AC were used,” the researchers wrote in their paper. For this reason, along with the observation that AC increases a patient’s chance of needing surgery, they also suggested the development of chalazion and hordeolum, and thus the incision surgery for these eyelid disorders, should be evaluated as a complication following AC.

Bottom line: be aware of the risk of severe eyelid inflammation in patients of any age who are diagnosed with AC, especially those using steroids to manage the condition, they concluded.

Wang LL, Kwon JW, Lee JY. Allergic conjunctivitis increases the likelihood of undergoing eyelid incision surgery in pediatric and adolescent patients. Sci Rep. April 6, 2022. [Epub ahead of print].