title: Ocular symptoms in nonspecific conjunctival hyperreactivity.
abstract: BACKGROUND
  Ocular symptoms can be triggered by nonspecific environmental factors, characterizing conjunctival hyperreactivity (CHR).
  
  
  OBJECTIVE
  To examine CHR in subjects with ocular symptoms by means of a hyperosmolar conjunctival provocation test (HCPT).
  
  
  METHODS
  Sixty-three subjects with ocular complaints (itching, redness, or tearing) were tested for allergy to a common panel of inhalant allergens (Alk Abelló-FDA Allergenic, Brazil). They were considered allergic if tests were positive to at least 1 allergen. HCPT with serial diluted glucose concentrations was positive if it produced conjunctival hyperemia up to a 50% solution. Digital images were analyzed by 2 observers who marked redness in the challenged eyes in red (GIMP 2.6.5 software). The number of red dots of the affected eye was compared with the number of blue dots of the control eye.
  
  
  RESULTS
  HCPT was positive in 6 of 7 grass pollen-sensitive subjects, in 17 of 20 dust mite-sensitive subjects, and in 10 of 11 subjects who were sensitive to both allergens. HCPT was positive in 33 of 38 allergic subjects (87%) and in 4 of 25 (16%) non-allergic subjects; sensitivity was 87%, and specificity was 84%. Significant correlation (r = 0.96 Pearson; P < .0001) was seen between the number of red dots in 23 digitalized images marked by observers.
  
  
  CONCLUSIONS
  HCPT indentified CHR in allergic as well as in non-allergic subjects. Allergic subjects exhibited more CHR than did non-allergic subjects. Conjunctival hyperreactivity was present in allergic subjects even when they were asymptomatic. Digital images may be useful for objective evaluation of ocular hyperemia in HCPT.
authors.affiliation: Postgraduate, Department of Internal Medicine, Federal University of Paraná, Curitiba, Brazil. emourao@terra.com.br
authors.forename: Elizabeth Maria Mercer
authors.initials: EM
authors.lastname: Mourão
authors.forename: Nelson Augusto
authors.initials: NA
authors.lastname: Rosário
authors.forename: Luciano
authors.initials: L
authors.lastname: Silva
authors.forename: Silvia Emiko
authors.initials: SE
authors.lastname: Shimakura
mesh_terms: D000293:Adolescent; D000328:Adult; D000485:Allergens; D002648:Child; D002908:Chronic Disease; D003233:Conjunctivitis, Allergic / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000485:Allergens