Allergy/EyeballFilter: What's the same in Japan, Italy and Austria?
September 21, 2008 3:56 PM   Subscribe

Allergy Brainstorm Time: What could I possibly have an allergic reaction to in my EYE in Italy, Austria and Japan?

I've been battling follicular conjunctivitis (aka a version of pink eye) for 2+ months now and seeing pretty good doctors and what not, and it seems that the only possibility remaining is a case of allergic conjunctivitis.


Now what's weird is that I've never really had difficulties with allergies, and I've had this now for 1 month in Italy, 1 month in Austria, and now, after 2 weeks totally clear in Japan (the first 10 days were spent tapering off of Hydrocortisone drops), I'm suddenly getting symptoms again. Wtf?

So, what could I either be bringing with me to all of these places, or what is the same in all of these places? Are japanese dust mites the same as european dust mites? Is Japanese pollen the same as European? The only toiletries I've brought with me are shaving supplies (every 3 days), toothpaste and preservative free artificial tears (didn't start using those again until the symptoms started coming back yesterday).

Also, if anyone has been diagnosed with allergic/follicular conjunctivitis and it turned out to be something else, please lemme know. The other extremely weird thing with the diagnosis is that my fiancee has had similar, but lesser symptoms on and off during the same period.

Disclaimer: I know you are not my doctor, but hell, I'm in Japan and I have some doubts as to whether I'm going to find a *very good* ophthalmologist to solve a *very weird, non-standard presentation* of an eye problem AND speak English.
posted by sirion to Health & Fitness (13 answers total)
 
(Of note, I picked up 3 phlyctenules in my right eye for a few days, which went away with a short course of steroids. This solidified the allergy diagnosis)
posted by sirion at 4:34 PM on September 21, 2008


You shouldn't play around with your eyes. Go to the US embassy and get a recommendation for an English speaking doctor.
posted by footnote at 4:44 PM on September 21, 2008


Allergies can start at any age, any time, anywhere; doesn't matter if you're allergy-prone or not.

Do you wear contacts? What kind of moisturizer do you use on your face? What soaps and toiletries are you using? More detail could help provide clues or jog the memory of someone else who has suffered similar problems.

And, yeah, what footnote said: get to an English-speaking doctor.
posted by LuckySeven~ at 4:54 PM on September 21, 2008


That your fiance had similar symptoms makes me think it's an infection.

Here's some of what the HANDBOOK of Ocular Disease Management has to say about phlyctenules:

Their formation seems to be the result of a delayed hypersensitivity reaction to tuberculin protein, Staphylococcus aureus, Coccidioides immitis (a soil-based fungus common in the southwestern U.S.), Chlamydia, acne rosacea, some varieties of interstitial parasites and the fungus Candida albicans. Rarely are cases idiopathic. Such a diagnosis could only be made by exclusion. ...

If the suspected etiology is Staph. reaction or acne rosacea, prescribe 250mg of oral tetracycline QID or 250mg erythromycin QID PO, along with topical antibiotic ointments such as bacitracin or erythromycin at bedtime. Topical metronidazole (Metrogel) applied to the skin TID is also effective. Because tetracycline can damage and discolor the teeth of children, it is contraindicated in patients under age 10. In these cases, substitute doxycycline 100mg TID or erythromycin 250mg QID PO. Continue treatment for two to four weeks. In suspicious cases, order a chest X-ray and PPD to rule out tuberculosis.
posted by jamjam at 5:29 PM on September 21, 2008


One thing about eye infections is that if you don't take every last dose of the eye drops they give you, it won't go away. It might seem like it did, but it didn't. So if you're not already, take those drugs as insanely often as they recommend and finish them all.
posted by piper4 at 7:27 PM on September 21, 2008


What's the same in those countries? Lots of plants (and their pollen) - many species have been introduced in non-native locations for food and ornamental use. Dunno if you might get conjunctivitis from pollen, but I sometimes get itchy eyes along with the more typical respiratory symptoms, so maybe pink-eye is within the realm of possibility.

When non-native plants were introduced they often brought "hitch-hikers", soil microbes and insects, especially in the old days before anyone worried about this stuff. I'd be surprised if by now there isn't a whole lot of overlap in microbe and insect populations all around the Northern Hemisphere. Again, maybe not common villains for conjunctivitis, but ...
posted by Quietgal at 7:48 PM on September 21, 2008


I have seasonal allergies, and have always had. They usually manifest as the usual -- runny nose, fuzzy head, etc. But during certain times of the year in Austin, I got allergic conjuctivitis.


Freaked the hell out of me at first, because I ended up with blisters. ON MY EYEBALLS. Went to the ophthalmologist and he diagnosed it. Said it wasn't a big deal. Theory was it was a new, different allergen. You develop allergies over time, you know.

The eye doc gave me OTC eyedrops called Opcon-A; they worked really well for me. (That's the Bausch and Lomb brand name. Active ingredients are Naphazoline and Pheniramine maleate. Look for a generic.)

Be warned -- putting the drops in burns like hell. They work really well, though.
posted by mudpuppie at 9:02 PM on September 21, 2008


Same happened to me. Was traveling in Spain and Italy for a few months and could not get rid of it. Seemed to begin when I was near the Mediterranean beaches, then it continued as I traveled further north through Switzerland and to Scandinavia.

The only thing we could associate it with was that the pollen and plant life here in Europe is much different than what I had grown up with. I ended up finding an EU variation of Claritin (same active ingredients) that held it at bay. Went back to NY for 3 weeks and then returned to Europe and have now been allergen free for over a month.

Oh yeah, and no prior history to allergies before this all happened. 32yrs of age male.
posted by wile e at 10:38 PM on September 21, 2008


Nthing Opcon-A, it worked great when I moved to Norway and my eye decided it hated me. It worked particularly well when combined with OTC claritin. I also had read some anecdotes about eating local products as an inoculation against allergens and I bought some local honey and milk. Whatever it was, it's now gone.
posted by melissam at 11:37 PM on September 21, 2008


My Not In Any Way A Doctor opinion is that it sounds like you've been flying an awful lot lately. Combining the dryness of long airplane trips with jet lag probably made your eyes susceptible to whatever nasty critters are available to feast on the vulnerable goodness. That doesn't help you heal, but my eyes always feel like they've been wound with steel wool for a few days after a trans-Pacific flight.
As footnote said, your country's embassy will have a list of English speaking doctors. Give them a call, or possibly check their web site.

Allergies do change and evolve. However it's pretty low allergy season in Japan at the moment, and with the typhoons running through pretty regularly to scrub the air, it might be something else. I'm assuming you're doing some kind of grand trip. Is there something you've bought abroad that you've used or packed with your clothes for the whole trip, or new a hygiene product/perfume you're using?

A side note: Actafed, Sudafed, Claritin D and a few other really good allergy medicines are contraband in Japan and will get confiscated and destroyed if you try to import them. (Customs is amazingly alert.) Which stinks since these have always worked the best for me.

posted by Ookseer at 1:15 AM on September 22, 2008


The other extremely weird thing with the diagnosis is that my fiancee has had similar, but lesser symptoms on and off during the same period.

To me this points away from an allergic reaction (the chances of you both developing allergies to the same thing at the same time is slim - unless there's something you both know yourselves to be allergic to), and this:

(Of note, I picked up 3 phlyctenules in my right eye for a few days, which went away with a short course of steroids. This solidified the allergy diagnosis)

does not necessarily indicate an an allergic reaction (steroids will suppress a variety of immune responses, regardless of whether they began as an allergic response, or after exposure to something else).

So my guess right now is it's something more related to bacterial exposure than pollen or some other allergen.

Not a great deal of help, sorry.
posted by kisch mokusch at 3:25 AM on September 22, 2008


or what jamjam said.
posted by kisch mokusch at 3:38 AM on September 22, 2008


Thanks for the brainstorming so far. Comforting to know some people have gone through similar things and that it *did* end up being allergies and not some horrible disease. Staph and Chlamydia have been ruled out already (Interesting fact of the day: when doctors want to culture something from your eye, it involves horrible painful scraping with rough Q-Tips. Yay!)

Called my doc and am going back onto hydrocortisone until I can get home for better testing. Will of course find a doctor out here if the hydrocortisone doesn't do the trick.
posted by sirion at 8:51 AM on September 22, 2008


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