Ocular Allergy Affects 49% of Secondary School Students in Trinidad and Tobago

Nearly half of students (49.3%) aged 11-18 years in Trinidad and Tobago have an ocular allergy, a prevalence greater than reported in similar studies from the US, Sweden, Brazil, and Uganda, a new study found.1

“The findings indicate that OA is a significant condition within this population, with the highest prevalence observed among students aged 14 years or younger,” wrote investigators, led by Ngozika E. Ezinne, from the Optometry Unit at the department of clinical surgical sciences at University of the West Indies, Saint Augustine Campus, Trinidad and Tobago.

Previous studies have reported a 15%-20% global prevalence of ocular allergies, corresponding to approximately 1.58 billion individuals.2,3,4,5 The ocular allergy prevalence in Trinidad and Tobago was greater than the prevalence of comparable climatic conditions in Ghana (39.9%), Nigeria (32%), and Pakistan (17.5%).6,4,7

“It might be expected that the prevalence would align more closely with countries with similar weather conditions, such as Ghana or Nigeria,” Ezinne and colleagues wrote.1 “However, genetic differences and variations in the assessment methodologies for ocular symptoms could explain the discrepancies.”

Several factors may trigger ocular allergies, including exposure to pollen, mold, dust, pets, wood or coal smoke, indoor tobacco smoking, household heating, preservatives, fragrances, and dyes in cosmetic products. Metals, such as nickel, cobalt, chromium, and lead, can be found in certain eye shadows, eyeliners, and toy makeup kits, may trigger ocular allergies. Recently, a study identified that platinum salt, used in jewelry, electrical, and automotive products, can be a trigger.

Ocular allergies may not be life-threatening, but they significantly impact productivity and can bring behavioral, emotional, and mental challenges. This type of allergy can also be serious if left undiagnosed, leading to diseases such as severe dry eye syndrome, meibomian gland dysfunction, and sometimes even keratoconus.

Living in Trinidad and Tobago, situated in the southern Caribbean, north of Venezuela and south of Grenada in the Lesser Antilles, may increase the risk of ocular allergy due to the trace of Saharan dust from Africa. With no research on ocular allergy prevalence in the Caribbean, particularly Trinidad and Tobago, investigators sought to assess the ocular allergy prevalence among secondary school students in this region.

The team conducted a descriptive cross-sectional study from October 2022 to May 2023, where they included 420 students aged 11 – 18 years (mean age: 14.36 years), about half female (52.9%). The schools included, selected at random through an online spinner wheel tool, included Couva East Secondary, Arranguez North Secondary, and Barrackpore West Secondary School.

The team assessed the ocular allergy prevalence through a self-reported modified version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, capturing data on demographics, ocular allergy symptoms, associated risk factors, and the ocular allergy impact.

The study found a 49.3% ocular allergy prevalence among secondary school students in Trinidad and Tobago. Seasonal allergic conjunctivitis was the most common subtype, describing 90.3% of the children with an ocular allergy. Additionally, 100% of students with ocular allergy experienced the symptom of redness.

Females (58.8%) and 14-year-olds (23.4%) had the greatest prevalence of ocular allergies. The most prevalent allergic comorbidities were difficulty breathing or wheezing (27.2%), asthma (9.5%), and food allergies (8.3%). The analysis showed that factors significantly linked to ocular allergies included difficulty breathing, wheezing, asthma, food, rhinitis, atopic dermatitis, and mite exposure (P < .05).

The study also found most participants experienced ocular allergy symptoms in January (26.3%), and a statistically significant association was found between the month and the occurrence of symptoms (P < .001).

Ocular allergies had little impact on daily activities, with only 12.6% seeking medical consultation and 6.2% requiring absence from school (6.3%). However, these students did have trouble breathing (P < .001), food consumption (P < .05), dealing with pollen allergy (P < .01), and the sensitivity to mites (P < .04).

“The prevalence of ocular allergy among high school students in [Trinidad and Tobago] is notably high, representing a significant public health concern,” investigators concluded. “Consequently, it is imperative to implement targeted strategies aimed at raising awareness, enhancing early detection, and improving the management and prevention of [ocular allergy] in this cohort.”

References

1. Ezinne NE, Gartiesingh N, Poonan R, Mashige KP. Prevalence of Ocular Allergy Among High School Children in Trinidad and Tobago: A Cross-Sectional Study. Health Sci Rep. 2025;8(5):e70709. Published 2025 May 4. doi:10.1002/hsr2.70709

2. La Rosa M, Lionetti E, Reibaldi M, et al. Allergic conjunctivitis: a comprehensive review of the literature. Ital J Pediatr. 2013;39:18. Published 2013 Mar 14. doi:10.1186/1824-7288-39-18

3. H. J. Chong Neto, A. Cepeda, A. S. Moreira, et al., “Latin American Guideline on the Diagnosis and Treatment of Ocular Allergy—On Behalf of the Latin American Society of Allergy, Asthma and Immunology (SLAAI),” Arquivos de Asmas Alergia e Imunologia 6 (2022): 5–7, https://doi.org/10.5935/2526-5393.20220002.

4. Malu KN. Allergic conjunctivitis in Jos-Nigeria. Niger Med J. 2014;55(2):166-170. doi:10.4103/0300-1652.129664

5. Feng Y, Wang X, Wang F, et al. The Prevalence of Ocular Allergy and Comorbidities in Chinese School Children in Shanghai. Biomed Res Int. 2017;2017:7190987. doi:10.1155/2017/7190987

6. Kumah DB, Lartey SY, Yemanyi F, Boateng EG, Awuah E. Prevalence of allergic conjunctivitis among basic school children in the Kumasi Metropolis (Ghana): a community-based cross-sectional study. BMC Ophthalmol. 2015;15:69. Published 2015 Jul 3. doi:10.1186/s12886-015-0053-8

7. Baig R, Ali AW, Ali T, et al. Prevalence of allergic conjunctivitis in school children of Karachi. J Pak Med Assoc. 2010;60(5):371-373.