Objective: Allergic rhinitis (AR) is a prevalent chronic pediatric disease that frequently presents with allergic conjunctivitis (AC) as a comorbidity. Despite its impact, the specific prevalence and risk factors associated with ocular involvement in children sensitized to grass pollen have not been sufficiently characterized in the current clinical literature. To determine the prevalence of AC and evaluate the demographic, clinical, and laboratory factors associated with its development in children with grass pollen-sensitized seasonal AR.
Materials and Methods: This retrospective study evaluated children (aged 6–18 years) diagnosed with seasonal AR according to the Allergic Rhinitis and its Impact on Asthma guidelines criteria and confirmed grass pollen sensitization between January 2023 and December 2025. AC diagnosis was established based on clinical findings, patient-reported symptoms, and documented anti-allergic eye drop use. Assessment tools included the Total Nasal Symptom Score (TNSS), Total Ocular Symptom Score (TOSS), Visual Analog Scale (VAS), and medication scores. Multivariate logistic regression was performed to identify independent risk factors for AC development.
Results: A total of 143 children were evaluated, and AC was present in 78 patients (54.5%). The rhinoconjunctivitis group exhibited significantly higher TNSS and VAS scores compared to the isolated AR group (p<0.05). Passive smoking exposure was significantly more frequent in patients with ocular involvement (p=0.041). In multivariate analysis, AR severity emerged as the sole independent predictor (OR=7.518; 95% CI: 3.574–15.815; p<0.001). No significant differences were observed regarding other demographic or laboratory parameters.
Conclusion: Allergic conjunctivitis is a frequent comorbidity in children with grass pollen-sensitized seasonal AR. Increased AR severity markedly elevates the risk of ocular involvement. These findings suggest that systematic screening for ocular symptoms and reduction of passive smoking exposure are essential components of effective disease management in this population.