Is your nose causing your ocular symptoms?

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http://www.ncbi.nlm.nih.gov/pmc/arti...6/#!po=5.00000

This is a free full article. Read the whole study. It may change your understanding of ocular allergies.

Mediator profiles in tears during the conjunctival response induced by allergic reaction in the nasal mucosa

Mol Vis. 2013; 19: 1453–1470.
Published online 2013 July 12.
PMCID: PMC3712666
Zdenek Pelikan
Allergy Research Foundation, Breda, Netherlands


Here are two excerpts of interest:

Various hypersensitivity mechanisms, such as immediate type (IgE-mediated type I), late (type III), or delayed (cell-mediated type IV), may be involved in both forms of AC [1-22]. The involvement of various hypersensitivity types results in the development of various types of conjunctival response (CR) to allergen exposure (challenge), an immediate (ICR), a late (LCR), a dual late (DLCR, a combination of an immediate and a late type), a delayed (DYCR), and a dual delayed (DDYCR, a combination of an immediate and a delayed type) [1-12,15-19,22,23]. The primary forms of AC can be demonstrated by conjunctival provocation tests with allergens (CPTs), whereas the secondary AC forms can be confirmed only by nasal provocation tests with allergens (NPTs) in combination with registration of the conjunctival signs and subjective symptoms. The purpose of this study was to investigate the following: (1) the concentration changes of basic mediators in tears during the secondary immediate (SICR), late (SLCR), and delayed (SDYCR) conjunctival responses; (2) the significance of these mediators and their changes in tears for the mechanism(s) underlying the particular types of secondary conjunctival response.

Allergic reactions taking place primarily in the nasal mucosa due to intranasal exposure to an inhalant allergen may affect the conjunctiva and other ocular tissues, such as the cornea, in various ways and upon involvement of various mechanisms [7-10,20,31-34]. These mechanisms may include the following: (1) Various cell types participating in the nasal allergic reaction can migrate into the bloodstream and/or lymphatic system and sometimes into lacrimal ways, and thus attain the conjunctiva. (2) Various factors (classical mediators, eicosanoids, cytokines, chemokines, adhesion molecules, and other factors) released during the allergic reaction in the nasal mucosa can reach the conjunctiva either directly by retrograde penetration through the lacrimal ways or indirectly through the related blood or lymphatic vessel system. (3)The nasal allergic reaction can also activate the local neurogenic system (sensory nerves, sympathetic and parasympathetic fibers) releasing the neuropeptides that reach the conjunctiva through related nerves, such as the nervus trigemini, nervus nasociliaris, and ganglion pterygopalatinum. (4) The nasal allergic reaction can also stimulate the local nasal mucosal lymphatic system called the nose-associated lymphatic tissue (NALT), a part of the mucosa-associated lymphatic system (MALT). The MALT system facilitates multiple mutual communication among the particular lymphatic organ-related sub-systems, such as the NALT and the eye-associated lymphatic tissue (EALT), conjunctiva-associated lymphatic tissue (CALT), tear-associated lymphatic tissue (TALT), and lacrimal drainage-associated lymphatic tissue (LDALT).