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CLINICAL PROBLEM OF ALLERGY IN RELATION TO CONJUNCTIVITIS AND IRITIS FREE

ALAN C. WOODS, M.D.
[+] Author Affiliations

Read before the meeting of the American Academy of Otolaryngology and Ophthalmology, New York, Sept. 29, 1936.


Arch Ophthalmol. 1937;17(1):1-17. doi:10.1001/archopht.1937.00850010013001
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The importance of allergy, or an altered state of reactivity to specific agents, has been stressed repeatedly in the recent ophthalmic literature. Much of this literature deals with purely experimental lesions of the eye, and a small amount deals with clinical investigation. Rather broad deductions appear to have been made from these experimental and clinical findings, and at present clinical ophthalmologists are constantly confronted with the questions of therapeutic desensitization and various forms of vaccine treatment for patients with inflammatory lesions of the conjunctiva and anterior part of the uveal tract.

I have no wish to minimize the importance of allergic reactions in these conditions. However, the questions involved are complicated and in many instances not clearly understood, and often lie more in the domain of the immunologist and of the bacteriologist than in the province of the ophthalmologist. It is my purpose in this paper to outline, from

REFERENCES

Koutseff, A.:  Contribution à l'étude des conjonctivites allergiques non infectieuses , Zentralbl. f. d. ges. Ophth. 33:333, 1935;
 Les conjonctivites allergiques non infectieuses envisagées dans le cadre des allergies en général , Bull. Soc. d'opht. de Paris , (April) 1935;, p. 267.
LaGrange, H., and Delthil, S.:  Les réactions allergiques de la conjonctive oculaire , Ann. d'ocul. 170:1009 ( (Dec.) ) 1933;.
Krückmann, E.:  Ueber Allergie in der Augenheilkunde , Klin. Monatsbl. f. Augenh. 92:809, 1934;.
Berneaud, G.:  Allergische Augenerkrankungen , Ztschr. f. Augenh. 78:193, 1932;.
Blake, E. M.:  Allergic Reaction of the Eyelids , Arch. Ophth. 53:272, 1924;.
Dejean, C., and Temple, J.:  Some Special Cases of Follicular Conjunctivitis , Bull, et mém. Soc. franç. d'opht. 46:143, 1933;.
Landsteiner, K.:  Experiments on Anaphylaxis to Azoproteins , J. Exper. Med. 39:631, 1924;.
Burky, E. L.:  Staphylococcus Toxin and Antitoxin , Internat. Clin. 3:258 ( (Sept.) ) 1936;.
Scholtz, H. G.:  Schwerste stomakake Conjunctivitis, Rhinitis und Bronchitis bei allergischer Diathese , München, med. Wchnschr. 79:916 ( (June 3) ) 1932;.
MacKenzie, G. M., and Hanger, F. M., Jr.:  Allergic Reactions to Streptococcus Antigens , J. Immunol. 13:41, 1927;.
Swift, H. F.; Lancefield, R. C., and Goodner, K.:  The Serologic Classification of Hemolytic Streptococci in Relation to Epidemiologic Problems , Am. J. M. Sc. 190:445, 1935;.
Swift, H. F.:  The Pathogenesis of Rheumatic Fever , J. Exper. Med. 39:497, 1924;.
Wainwright, C. W.:  Treatment of Chronic Rheumatoid Arthritis with Streptococcus Vaccine on the Basis of Skin Sensitivity , J. A. M. A. 103:1357 ( (Nov. 3) ) 1934;.
LaGrange, H., and Delthil, S.: Les conjonctivites de nature anaphylactique , Paris, Gaston Doin & Cie, 1932;.
LaGrange, H.:  Le rôle de l'allergie dans certaines conjonctivites , Bull. Soc. d'opht. de Paris , (April) 1935;, p. 230.
Woods, Alan C.: Allergy and Immunity in Ophthalmology , Baltimore. Johns Hopkins Press, 1933;.
Swift, H. F., and Derick, C. L.:  Hyperergic Tissue Response to Non-Hemolytic Streptococci , Proc. Soc. Exper. Biol. & Med. 25:222, 1927-1928;.
Schultz, M. P., and Swift, H. F.:  Reaction of Rabbits to Streptococci: Comparative Sensitizing Effect of Intracutaneous and Intravenous Inocula in Minute Doses , J. Exper. Med. 55:591, 1932;.
Julianelle, L. A.:  Reactions of Rabbits to Intracutaneous Injections of Pneumococci and Their Products: V. The Development of Eye Reactivity to Derivatives of Penumococci , J. Exper. Med. 51:633, 1930;
 VI. Hypersensitiveness to Pneumoccoci and Their Products , JulianelleJ. Exper. Med. 51:643, 1930;.
Seegal, D., and Seegal, B. C.:  Local Organ Hypersensitiveness: I. Experimental Production in the Rabbit Eye , Proc. Soc. Exper. Biol. & Med. 27:390, 1930;.
Seegal, B. C.: Seegal, D., and Khorazo, D.:  Local Organ Hypersensitiveness: V. The Fate of Antigen and the Appearance of Antibodies During the Development of Hypersensitiveness in the Rabbit Eye , J. Immunol. 25:207, 1933;.
Seegal, B. C., and Seegal, D.:  Local Organ Hypersensitiveness: VI. An Indirect Method for Its Production in the Rabbit Eye , J. Immunol. 25:221, 1933;.
Julianelle, L. A.; Morris, M. C., and Harrison, R. W.:  Studies on Vascularization of the Cornea: I. Sensitization of Cornea of Rabbits to Bacteria , J. Immunol. 26:267 ( (April) ) 1934;
 II. Sensitization of Cornea of Rabbits to Proteins , JulianelleJ. Immunol. 26:281 ( (April) ) 1934;.
Julianelle, L. A.; Harrison, R. W., and Morris, M. C.:  III. Sensitization of Cornea of Monkeys , J. Immunol. 26:295 ( (April) ) 1934;.
Julianelle, L. A.; Morris, M. C., and Harrison, R. W.:  IV. Question of Passive Corneal Hypersensitiveness , J. Immunol. 26:303 ( (April) ) 1934;.
Brown, A. L.:  Chronic Uveitis: Bacteriologic and Immunologic Considerations , Arch. Ophth. 12:730 ( (Nov.) ) 1934;.
MacLean, A. L.:  Experimental Iritis: The Ocular Reactions in Rabbits Sensitized to Streptococcus Viridans , Tr. Am. Ophth. Soc. , 1936;, to be published.
Brown, A. L.: Tr. Am. Ophth. Soc. 33:435, 1935;.
Julianelle, L. A.:  Reactions of Rabbits to Intracutaneous Injections of Pneumococci and Their Products , J. Exper. Med. 51:441, 1930;.
Seegal, D.; Heidelberger, M., and Jost, E. L.:  The Formation of Precipitin for the Group A Specific Carbohydrate of Streptococcus Hemolyticus in Rabbits Injected Intravenously and Subcutaneously , J. Immunol. 27:211. 1934;.
Tillet, W. S., and Francis, T.:  Cutaneous Reactions to the Polysaccharides and Proteins of Pneumococcus , J. Exper. Med. 50:687, 1929;.
Berens, C.: Connolly, P. T., and Chapman, G. H.:  Focal Infection in Diseases of the Eye: I. Report of Certain Laboratory Examinations , Am. J. Ophth. 17:1094, 1934;.
Benedict, W. L.:  The Relation of Infections of the Pelvic Organs and Diseases of the Eye , Am. J. Ophth. 16:665, 1933;.
Derick, C. L., and Fulton, M. N.:  Skin Reactions of Patients and Normal Individuals to Protein Extracts of Streptococci , J. Clin. Investigation 10:121, 1931;.
Birkhaug, K. E.:  Rheumatic Fever: III. Skin Hypersensitiveness of Patients with Rheumatic Fever and Chronic Arthritides to Filtrates, Autolysates and Bacterial Suspensions of Streptococci , J. Infect. Dis. 44:363 ( (May) ) 1929;.

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Koutseff, A.:  Contribution à l'étude des conjonctivites allergiques non infectieuses , Zentralbl. f. d. ges. Ophth. 33:333, 1935;
 Les conjonctivites allergiques non infectieuses envisagées dans le cadre des allergies en général , Bull. Soc. d'opht. de Paris , (April) 1935;, p. 267.
LaGrange, H., and Delthil, S.:  Les réactions allergiques de la conjonctive oculaire , Ann. d'ocul. 170:1009 ( (Dec.) ) 1933;.
Krückmann, E.:  Ueber Allergie in der Augenheilkunde , Klin. Monatsbl. f. Augenh. 92:809, 1934;.
Berneaud, G.:  Allergische Augenerkrankungen , Ztschr. f. Augenh. 78:193, 1932;.
Blake, E. M.:  Allergic Reaction of the Eyelids , Arch. Ophth. 53:272, 1924;.
Dejean, C., and Temple, J.:  Some Special Cases of Follicular Conjunctivitis , Bull, et mém. Soc. franç. d'opht. 46:143, 1933;.
Landsteiner, K.:  Experiments on Anaphylaxis to Azoproteins , J. Exper. Med. 39:631, 1924;.
Burky, E. L.:  Staphylococcus Toxin and Antitoxin , Internat. Clin. 3:258 ( (Sept.) ) 1936;.
Scholtz, H. G.:  Schwerste stomakake Conjunctivitis, Rhinitis und Bronchitis bei allergischer Diathese , München, med. Wchnschr. 79:916 ( (June 3) ) 1932;.
MacKenzie, G. M., and Hanger, F. M., Jr.:  Allergic Reactions to Streptococcus Antigens , J. Immunol. 13:41, 1927;.
Swift, H. F.; Lancefield, R. C., and Goodner, K.:  The Serologic Classification of Hemolytic Streptococci in Relation to Epidemiologic Problems , Am. J. M. Sc. 190:445, 1935;.
Swift, H. F.:  The Pathogenesis of Rheumatic Fever , J. Exper. Med. 39:497, 1924;.
Wainwright, C. W.:  Treatment of Chronic Rheumatoid Arthritis with Streptococcus Vaccine on the Basis of Skin Sensitivity , J. A. M. A. 103:1357 ( (Nov. 3) ) 1934;.
LaGrange, H., and Delthil, S.: Les conjonctivites de nature anaphylactique , Paris, Gaston Doin & Cie, 1932;.
LaGrange, H.:  Le rôle de l'allergie dans certaines conjonctivites , Bull. Soc. d'opht. de Paris , (April) 1935;, p. 230.
Woods, Alan C.: Allergy and Immunity in Ophthalmology , Baltimore. Johns Hopkins Press, 1933;.
Swift, H. F., and Derick, C. L.:  Hyperergic Tissue Response to Non-Hemolytic Streptococci , Proc. Soc. Exper. Biol. & Med. 25:222, 1927-1928;.
Schultz, M. P., and Swift, H. F.:  Reaction of Rabbits to Streptococci: Comparative Sensitizing Effect of Intracutaneous and Intravenous Inocula in Minute Doses , J. Exper. Med. 55:591, 1932;.
Julianelle, L. A.:  Reactions of Rabbits to Intracutaneous Injections of Pneumococci and Their Products: V. The Development of Eye Reactivity to Derivatives of Penumococci , J. Exper. Med. 51:633, 1930;
 VI. Hypersensitiveness to Pneumoccoci and Their Products , JulianelleJ. Exper. Med. 51:643, 1930;.
Seegal, D., and Seegal, B. C.:  Local Organ Hypersensitiveness: I. Experimental Production in the Rabbit Eye , Proc. Soc. Exper. Biol. & Med. 27:390, 1930;.
Seegal, B. C.: Seegal, D., and Khorazo, D.:  Local Organ Hypersensitiveness: V. The Fate of Antigen and the Appearance of Antibodies During the Development of Hypersensitiveness in the Rabbit Eye , J. Immunol. 25:207, 1933;.
Seegal, B. C., and Seegal, D.:  Local Organ Hypersensitiveness: VI. An Indirect Method for Its Production in the Rabbit Eye , J. Immunol. 25:221, 1933;.
Julianelle, L. A.; Morris, M. C., and Harrison, R. W.:  Studies on Vascularization of the Cornea: I. Sensitization of Cornea of Rabbits to Bacteria , J. Immunol. 26:267 ( (April) ) 1934;
 II. Sensitization of Cornea of Rabbits to Proteins , JulianelleJ. Immunol. 26:281 ( (April) ) 1934;.
Julianelle, L. A.; Harrison, R. W., and Morris, M. C.:  III. Sensitization of Cornea of Monkeys , J. Immunol. 26:295 ( (April) ) 1934;.
Julianelle, L. A.; Morris, M. C., and Harrison, R. W.:  IV. Question of Passive Corneal Hypersensitiveness , J. Immunol. 26:303 ( (April) ) 1934;.
Brown, A. L.:  Chronic Uveitis: Bacteriologic and Immunologic Considerations , Arch. Ophth. 12:730 ( (Nov.) ) 1934;.
MacLean, A. L.:  Experimental Iritis: The Ocular Reactions in Rabbits Sensitized to Streptococcus Viridans , Tr. Am. Ophth. Soc. , 1936;, to be published.
Brown, A. L.: Tr. Am. Ophth. Soc. 33:435, 1935;.
Julianelle, L. A.:  Reactions of Rabbits to Intracutaneous Injections of Pneumococci and Their Products , J. Exper. Med. 51:441, 1930;.
Seegal, D.; Heidelberger, M., and Jost, E. L.:  The Formation of Precipitin for the Group A Specific Carbohydrate of Streptococcus Hemolyticus in Rabbits Injected Intravenously and Subcutaneously , J. Immunol. 27:211. 1934;.
Tillet, W. S., and Francis, T.:  Cutaneous Reactions to the Polysaccharides and Proteins of Pneumococcus , J. Exper. Med. 50:687, 1929;.
Berens, C.: Connolly, P. T., and Chapman, G. H.:  Focal Infection in Diseases of the Eye: I. Report of Certain Laboratory Examinations , Am. J. Ophth. 17:1094, 1934;.
Benedict, W. L.:  The Relation of Infections of the Pelvic Organs and Diseases of the Eye , Am. J. Ophth. 16:665, 1933;.
Derick, C. L., and Fulton, M. N.:  Skin Reactions of Patients and Normal Individuals to Protein Extracts of Streptococci , J. Clin. Investigation 10:121, 1931;.
Birkhaug, K. E.:  Rheumatic Fever: III. Skin Hypersensitiveness of Patients with Rheumatic Fever and Chronic Arthritides to Filtrates, Autolysates and Bacterial Suspensions of Streptococci , J. Infect. Dis. 44:363 ( (May) ) 1929;.

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