1. Sublingual immunotherapy in allergic conjuctivitis with house dust and dust mite allergies
DR VIPUL SHAH

2. SLIT IN CONJUCTIVITIS WORK DONE AND COMPILED BY DR VIPUL SHAHJ’
OTHER WORKERS
DR ASHOK GUPTA SR EYE CONSULTANT
MRS POONAM KUMAR ALLERGY AND IMMUNOTHERAPY COUSELAR
DR SUMAN KUMAR
ENT AND ALLERGHY SPECIALIST

3. BACKGROUND
Allergic conjunctivitis is many times an ophthalmologist’s nightmare.
Anti allergic eye drops, which often contain corticosteroids, may temporarily bring relief of symptoms but may bring an early cataract, among other side effects

4. BACKGROUND
Allergic ocular symptoms, are common and represent an important feature associted with allergic rhinitis
Sublingual Immunotherapy (SLIT) is an effective and well-tolerated treatment for allergic rhinitis, but its effects on symptoms of ocular allergy have not been well established.

5. Immunotherapy
Immunotherapy (commonly referred to as "allergy shots") is a safe and effective treatment for patients with allergies
It is based on the premise that people who receive injections of a specific allergen will lose sensitivity to that allergen. The most common allergens for which shots are given are house dust, cat dander, grass pollen

6. Candidates
Candidates for Immunotherapy. Immunotherapy may be given to anyone over age 7 with allergies that do not get better with medication. Immunotherapy is safe for pregnant women who are already receiving it, although half-strength doses are generally recommended, and it should not be started during pregnancy

7. Oral Forms
Trials are underway to test forms of immunotherapy taken by mouth as an alternative to allergy shots. These methods include using a pill taken by mouth or a sublingual (under-the-tongue) tablet. Although oral and sublingual immunotherapy is prescribed in many countries in Europe and South America, it is not approved in the United States and is not considered accepted therapy at this time.

8. Objectives
To evaluate the efficacy of SLIT compared with placebo for reductions in ocular symptoms,

9. Selection criteria
Randomised controlled trials placebo controlled, which evaluated the efficacy of SLIT in patients with symptoms of allergic rhino conjunctivitis (ARC) or allergic conjunctivitis (AC).

10. Data collection and analysis
The primary outcome was the total ocular symptom scores. Secondary endpoints included individual ocular symptom scores (such as itchy eyes, red eyes, watery eyes, swollen eyes), ocular medication scores (eye drops) and conjunctival immediate allergen sensitivity

11. trials
Forty-two trials (Sublingual immunotherapy induced a significant reduction in both total ocular symptom scores) and individual ocular symptom scores for red eyes itchy and watery eyes compared to placebo. Those participants having active treatment showed an increase in the threshold dose for the conjunctival allergen provocation test 

12. DATA
Those participants having active treatment showed an increase in the threshold dose for the conjunctival allergen provocation test 

13. SLIT
Overall, SLIT is moderately effective in reducing total and individual ocular symptom scores in participants with ARC and AC..

14. NEED TO EVALUATE SLIT
There is a need for further large rigorously designed studies that study long-term effectiveness after discontinuation of treatment and establish the cost-effectiveness of SLIT.

15. ALLERGIC CONJUCTIVITIS

16. ALLERGIC CONJUCTIVITIS

17. STUDY DONE AT ENT AND ALLERGHY CENTRE (india)panchkula
Years , and follow up period for 3 years(and 1-years after finishing the slit) a total of 88 patients with rhinoconjunctivitis were randomly allocated to placebo and medium-dose extract of house dust or dust mite induced allergic conjuctivitis

18. Results
active treatment groups achieved a 72% reduction in total rhinoconjunctivitis symptom scores compared with placebo

19. Conclusion
Standardized glycerinated was safe and can induce favorable clinical and immunologic changes in ragweed-sensitive subjects. However, additional trials are needed to establish efficacy.

20. Immunotherapy works best
   Immunotherapy works best when environmental controls are first implemented to minimize exposure to allergens, especially at home
If patients sensitive to animal dander are unwilling to banish pets, immunotherapy may be a waste of time and money.

21. WE NEED MORE DATAS
TO MAKE THE SLIT AS ALTERNATIVE TO PHARMACOTHRAPY WE NEED MORE DATAS AND MORE PEOPLE AND RESEARCHERS TO DO WORK ON IT ANMT ITS OUTCOME IN VARIOUS ALLERGIC DISEASESES EFFECTING EVERY ORGAN

22. THANKS