Prevalence and Burden of Allergic Conjunctivitis in India Among Adults and Children
Allergic conjunctivitis affects approximately 10.1% of children and adolescents seeking eye care in India, with prevalence rates varying significantly by age group and showing the highest burden in early childhood (18.3%) and middle childhood (15.8%). 1
Prevalence by Age Groups in India
The prevalence of allergic eye disease (AED) in India shows distinct patterns across different age groups:
- Infancy (<1 year): 0.3%
- Toddlerhood (1-2 years): 6.6%
- Early childhood (3-5 years): 18.3% (highest prevalence)
- Middle childhood (6-11 years): 15.8%
- Early adolescence (12-18 years): 8.1%
- Late adolescence (18-21 years): 4.9% 1
This data demonstrates that allergic conjunctivitis peaks during early and middle childhood and shows a self-limiting trend by late adolescence.
Risk Factors and Demographics
Several key risk factors have been identified for allergic conjunctivitis in the Indian population:
- Gender: Males have significantly higher risk (OR 2.05)
- Age: Early and middle childhood carry the highest risk (OR 66.6 and 59.1 respectively)
- Socioeconomic status: Higher socioeconomic class shows increased risk (OR 1.46)
- Systemic allergies: History of systemic allergies substantially increases risk (OR 3.74) 1
Clinical Presentation and Burden
The burden of allergic conjunctivitis in India manifests in several ways:
Clinical Forms
- Palpebral vernal keratoconjunctivitis: Most common form, affecting 42.8% of eyes 1
- Seasonal allergic conjunctivitis: Most frequent form globally, though chronic forms are more commonly seen in ophthalmology referral centers 2
Complications
- Corneal scarring: 2.4% of eyes
- Keratoconus: 1.4% of eyes
- Limbal stem cell deficiency: 0.4% of eyes
- Shield ulcers: 0.3% of eyes 1
Seasonal Patterns
- Most patients with allergic eye disease in India present during spring and summer months 1
Quality of Life Impact
Allergic conjunctivitis significantly impacts quality of life:
- Causes substantial deterioration in quality of life for both children and adults 3
- Can lead to irreversible visual damage in some cases 3
- Ocular symptoms often rank as severe as nasal symptoms in patients with rhinoconjunctivitis 4
- Reduced quality of life justifies increased attention to this condition 4
Association with Other Allergic Conditions
Allergic conjunctivitis frequently coexists with other allergic conditions:
- Most children with allergic conjunctivitis also have allergic rhinitis 4
- Allergic rhinitis and allergic conjunctivitis are so frequently associated that the term "allergic rhinoconjunctivitis" is often used 5
- Ocular symptoms are present in 30-71% of patients with allergic rhinitis 2
Global Context
While the study focused on India provides specific prevalence data (10.1% among children and adolescents seeking eye care), global estimates suggest:
- Allergic conjunctivitis affects 6-30% of the general population globally 2
- Up to 30% of children worldwide may have allergic conjunctivitis alone or associated with allergic rhinitis 2
- Recent studies suggest prevalence rates as high as 40% in some populations 4
Treatment Challenges
A significant challenge in managing allergic conjunctivitis is that treatment is frequently not appropriate 2. While most patients suffer from mild, intermittent episodes, approximately 30% of patients are affected by frequent episodes with intense and persistent symptoms that require more aggressive management 2.