|Year : 1953 | Volume
| Issue : 3 | Page : 94-96
Synopen in allergic conjunctivitis
King George's Medical College, and Gandhi Memorial and Associated Hospitals, Lucknow, India
S P Gupta
King George's Medical College, and Gandhi Memorial and Associated Hospitals, Lucknow
|How to cite this article:|
Gupta S P. Synopen in allergic conjunctivitis. Indian J Ophthalmol 1953;1:94-6
The increase in stress and strain in the body by the prevalent political, social and hygienic conditions characterising various epochs, countries and occupational groups are accompanied by certain distinctive types of diseases. One such is an altered reaction capacity of the tissue to an allergen and is called allergy.
The allergic manifestations of the eye are many but allergic conjunctivitis are of two main forms
(1) allergic simple conjunctivitis which could be (a) acute oedematous (hay fever type), (b) eczematous (drug type) and (c) chronic recurrent forms (bacterial type) and
(2) interstitial allergic conjunctivitis which include phlyctenular and vernal conjunctivitis.
The line of treatment of allergic conditions depends largely upon the discovery of the etiologic factor. The principles of treatment are:
1. Elimination or avoidance of the specific or contributory factor (isolation).
2. Desensitization by specific or non-specific methods.
3. When an excitory agent is not discovered, removal or lessening of sensitization in acute phases is done by an adjuvant. Adjuvant therapy includes treatment with antihistamines.
| Antihistamines|| |
It is believed that the antigen antibody reaction in some way brings about the liberation of histamine or a histamine like substance by the affected tissues and that the action of this amine is responsible for allergic manifestations. Hence methods to neutralize these amines is tried by means of many chemical compounds, the basic radical being either phenyl rings or a benzule, anpyridyl, a thiodiphenyl or a thiophenyl group. Many such synthetic compounds called antihistamines are available e.g. Benadryl, Neo-antergen, Antistine, Histadyl, Pyribenzamine, Anthisan, Synopen and others. These antihistamines show promise in relieving the symptoms of ocular allergy.
Effect of antihistamine drugs on anaphylactic and pollen types of hypersensitivity has been fairly established. Little or nothing is as yet known of any deterrent action these drugs may exert in allergic reaction resulting from bacterial type of hypersensitivity.
In the first two types of allergic conjunctivitis, i.e. sudden oedematous type associated with hay fever and oedematous type of blepharo-conjunctivitis associated with drug allergy, use of antihistamine drugs is clearly indicated. In eczematous blephero-conjunctivitis associated with drug reactions where itching is intolerable, oral antihistamine drugs and local use of these compounds is suggested.
It was with a view to try the effects of antihistamins in bacterial type of hypersensitivity that we started to use antihistamins and below we give an account of our observations on all hypes of conjunctival conditions that may be grouped under allergic conjunctival manifestations. It may be stated from the beginning that allergic conditions have a tendency to recur and by no means antihistamins can be used as a cure for the allergic condition. The study was undertaken with a view to find out how soon does the acute allergic manifestation come under control and whether antihistamins are useful in relieving the acute symptoms. For our observations we have picked on only one antihistamin viz. Synopen to maintain the uniformity of our trials.
SYNOPEN : It is a white, odourless powder which dissolves easily. It has got a pronounced antihistaminic action. The side effects are very few.
The dosage of synopen required is to be adapted to the needs of the individual patient. An initial dose of one tablet of 0.25 gm.. 3 to 4 times a day is usually recommended. The tablets should be swallowed whole, preferably during meals. In acute cases where a rapid action is desired, the course of treatment can be commenced with an initial intravenous injection of 2 - 4 cc. of 1% of synopen, i.e. 0.2 to 0.4 gms intravenously.
| Clinical Material|| |
60 cases of phlycten, 15 cases of vernal catarrh, and 32 of allergic conjunctivitis were observed. Twenty-seven of these were kept as controls and others were treated with the antihistamine.
A detailed history of the patient was taken, particularly that suggestive of any allergic tendency and the following investigations were done
(1) Conjunctival smear examination for eosinophils and organisms (2) total and differential W.B.C. Count, (3) tuberculin test, (4) general examination of the body for septic foci and (5) conjunctival tests for pollen sensitivity.
RESULTS: Twenty cases of phlyctenular conjunctivitis were treated as controls by fomentations and calomel insufflation locally and calcium lactate gr. X.B.D. with Cod Liver Oil oz. 1 B.D. orally. By this treatment the eyes cleared in 5 - 10 days time, average being 8.1 days. Two cases did not show much improvement by this treatment, one of which was later treated by synopen while one did not turn up.
Forty cases were treated by Synopen tablets orally, one tablet three times a day in adults and twice a day in children and zinc and acid boric drops locally. 32 cases improved satisfactorily, within 2 - 6 days time average being 3.75 days, and 8 showed only moderate improvement.
Fifteen cases of spring cattarh were treated by Synopen. All the cases showed considerable improvement within 2 - 4 days, average being 2.62 days. Only one case took longer time (10 days). This case was a tedious case with large cauliflower type of follicles. He also improved by synopen therapy only after scraping had been done. Hence it is difficult to gauge how far synopen helped in the relief of this case.
Twenty-five cases of allergic conjunctivitis were treated by synopen and seven by conservative line of treatment.
The synopen treated cases improved within 2 - 5 days, average being 3.5 days. Three of the above cases were kept in the hospital under observation and were given 4 injections of synop-.n. It was interesting to note that in some cases where there were associated allergic conditions other than those of eye, they also got relieved by synopen.
Seven cases treated as control improved within a period of 6 to 8 days average being 7 days.
The other laboratory tests like conjunctival smears, tuberculin test, pollen sensitivity tests, and blood count have not yielded any interesting result from which one can draw any useful conclusion and so are not reported. One can only comment here, that whether the one or the other test was positive or not, or whatever the blood picture and whether a focus of infection could be detected or not, antihistamins are helpful in relieving the distress of the initial acute phase of an ocular allergic manifestation.
| Summary|| |
1. A study of 100 cases: 60 of phlycten. 15 of spring catarrh and 25 of allergic conjunctivitis are presented here.
2. Synopen, an antihistaminic drug was tried in 72 cases, which showed a more rapid improvement as against the 28 cases treated as controls by routine treatment.
3. Synopen has no side effects.
4. Other associated allergic conditions also got relieved during treatment.