The allergy and the ocular surface in the elderly

Allergic diseases in children and adults have been studied for many years In contrast, in older subjects. they are not well known, in particular with regard to ocular pathology The particularity of these conditions in older subjects is a result of the interaction of all aging and co-morbidities It can be assumed that an individual over 60 years of age suffers from at least three different diseases and that he takes medications for them (Fabbri et Ferrari. 2006 [1]) The aging process favours. for example. the dry eye syndrome, accommodation disorders. and dysfunctioning of the meibomian gland As a result. the clinical picture of ocular allergy can be atypical, and other diseases, such as meibomitis. blepharitis. acne rosacea. or a toxic drug reaction can resemble an allergy (Baudouin [2]. Ramkissoon et al [3]) The diagnostic work-up should be based on very detailed medical history followed by ophthalmologic and allergic examinations Skin prick tests and specific serum IgE have an uncertain diagnostic value in older patients (Simola et al [4]. Bozek et al [5]. King et al [6]) Management is based on the choice of a small number of agents which have a good therapeutic index. the risk of adverse effects is great in older patients (Hanlon et al [7]) (C) 2010 Elsevier Masson SAS All rights reserved