Issue link: http://optometricmanagement.epubxp.com/i/781116
F E B R U A R Y 2 0 1 7 • O P T O M E T R I C M A N A G E M E N T . C O M OptoChek ™ Plus Auto Refractor + Keratometer LensChek ™ Plus & Pro Digital Lensometers Reichert® combines technology, simplicity, and value at the core of your exam. © 2017 AMETEK, Inc. & Reichert, Inc. (1-2017) · www.reichert.com All-new! · SECO #1137 · reichert.com/exam Elements of pre-test. mune system so he or she becomes less symptom- atic. Previously, only allergy shots, or subcutane- ous immunotherapy, which required weekly visits to the allergist, were available. is process can be outside our scope in some states; consult state guidelines for clarity. GET TO THE ROOT CAUSE Managing ocular allergies can be both challeng- ing and rewarding, as can following your favorite baseball team. Getting at the root cause is key. My Minnesota Twins have not had stellar years lately, but look at what the Cubs did last year. e Twins will need to figure out why their hitting percent- ages are low and how to perform better on defense, or sort out the root cause issues. Remember, when you keep working at getting to the root cause of any adverse situation, you will likely find a satis- factory solution. OM DR. SCHMIT is in private practice specializing in oculoplas- tics, aesthetics, cataract and refractive clinical care at Vance Thompson Vision in Sioux Falls, S.D. He is the president of ConceptualEyes, an ophthal- mic consulting company. Email him at Jason.schmit@ vancethompsonvision.com or visit tinyurl.com/OMCom ment to comment on this article. Triggering the Cascade The two main factors that determine whether a per- son will become allergic to an antigen is genetic predisposition and exposure. Ocular allergies typi- cally occur when one's eye comes in contact with an allergen, and it irritates the conjunctiva. Mast cells, which are the gatekeepers to immune system response, are a type of white blood cell that contain histamine and heparin, and are found in the ocular tissues. When the initial exposure to an antigen oc- curs, the body produces Immunoglobulin E-mediated antibodies that are attached to the mast cells. When re-exposure of the antigen occurs again, the mast cells become activated and release inflammatory mediators, such as histamine and cytokines (leukot- rienes and prostaglandins), which cause the ocular symptoms. Symptoms can generally include burning, itching, tearing, redness and edema and are typical- ly worse with outdoor allergies vs. indoor allergies.