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M. F. Afshar, L. Clifford, A. Tappin, T. Evans; Supratarsal Steroid Injection for Allergic Conjunctivitis in Children. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1930.
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Allergic conjunctivitis (AC) is the most common form of ocular and nasal allergy affecting about 20% of the population. It is a severe cause of morbidity and is potentially sight threatening. Its management in children poses a considerable challenge as treatment often involves intensive drops with corresponding low levels of compliance and subsequent persistence of disease. We present the clinical outcomes in our unit of children who underwent supratarsal steroid (STS) injections for their allergic conjunctivitis.
A retrospective case note review of all children with AC who underwent supratarsal injections from 2007 to 2009. Patients received a 0.6 millilitre supratarsal steroid injection consisting of 1ml triamcinolone (40mg/ml) + 1ml betnesol (4mg/ml) under general anaesthetic. Mean age of patients was 9.2 years. All Patients were reviewed at 2 and 8 weeks with visual acuity, clinical examination and measurement of intraocular pressure.
Ten eyes of five patients had injections. All had an improvement in clinical symptoms with resolution of conjunctival injection. An improvement in visual acuity was recorded in all patients (mean 2 lines Log MAR) and none of the patients experienced an intraocular pressure rise above 21mmHg. This resulted in reduced frequency of steroid drops required post injection with one patient free from topical medication for 9 months. No adverse events were reported.
Our data shows an improvement in clinical symptoms, including visual acuity in children receiving STS injections for AC, with a reduced dependence on topical medication. There was no associated intraocular pressure rise observed. In our small cohort STS was a safe and effective treatment for AC. Further larger studies are required to fully establish the risk profile.
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