Relationship between nasal and conjunctival tests in patients with allergic rhinitis

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Abstract
Simultaneous conjunctival and nasal provocation tests, a total of 174 test pairs, were carried out in 50 patients with allergic rhinitis, using serially diluted antigen solutions of birch, Timothy grass, mugwort pollen, and cat and dog dander. The nasal mucosa was more sensitive than the conjunctival mucosa in 96 test pairs (55%). This differs from earlier reports. Nasal reaction only was observed in 29 instances (17%). Posterior rhinomanometry was also used to evaluate test reactions, but yielded little additional information. In 43% of nasal provocation tests, which according to other criteria were positive, the rhinomanometric results were negative. Despite a fairly good correlation between the results obtained by nasal and conjunctival challenge, the results point to organ specificity in type I reactions. Provocation tests, if indicated in a thorough allergy evaluation, should be performed in the shock organ. The provocation methods and interpretation of reactions of this study differ from those of earlier reports. Standardization of methods is needed for comparison of results.