Background: Allergic conjunctivitis is a common, non-contagious eye condition triggered by environmental allergens such as pollen and dust, particularly during seasonal changes. In regions like Shimla, where climate transitions are sharp and recurrent, the condition’s prevalence is high, yet public awareness remains limited. This study aimed to assess awareness, misconceptions, and self-care behaviors related to allergic conjunctivitis among residents of Shimla. Materials and Methods: A descriptive, cross-sectional online survey was conducted from January to March 2025 among 350 adult residents of Shimla using a structured, bilingual (Hindi and English) questionnaire. The tool captured socio-demographic data, knowledge of symptoms and triggers, attitudes, common misconceptions, and self-care practices. Data were analyzed using descriptive statistics, and awareness levels were categorized into Very Good, Good, Fair, and Poor. Results: Of the 350 participants, 29.7% were aged 26–35 years, 62.3% were graduates or above, and 49.7% reported a history of seasonal eye allergies. Most respondents correctly identified itching as the primary symptom (81.7%), pollen as a key trigger (77.7%), and acknowledged the non-contagious nature of the condition (80.6%). However, misconceptions about the use of antibiotic drops without prescription (75.4% correct) and eye rubbing (81.1% aware of its risk) were prevalent. Knowledge scores showed 14.9% had Very Good awareness, 39.4% Good, 29.1% Fair, and 16.6% Poor. Conclusion: Despite reasonable recognition of allergic conjunctivitis symptoms and triggers, persistent misconceptions and risky practices point to a need for focused public health education. Empowering communities through seasonal awareness campaigns and accessible, evidence-based guidance can play a key role in reducing unnecessary complications and promoting safe, effective management of eye allergies.
Allergic conjunctivitis, commonly referred to as "eye allergy," is a frequently encountered ocular condition that affects people of all age groups, particularly during seasonal transitions. Characterized by symptoms such as redness, itching, tearing, swelling, and a burning sensation, allergic conjunctivitis is often triggered by environmental allergens like pollen, dust, animal dander, or mold spores. In regions like Shimla, which experiences sharp seasonal changes—from dry, dusty pre-summers to heavy monsoons and pollinated springs—the incidence of allergic conjunctivitis tends to spike, yet remains largely underreported and misunderstood by the general public [1-4].
Despite being non-contagious and typically non-vision threatening, allergic conjunctivitis significantly impacts quality of life. It affects concentration, disrupts daily routines, and can mimic more serious ocular infections, leading to inappropriate self-medication or delayed medical consultation. Misconceptions—such as confusing allergic conjunctivitis with "pink eye" (infectious conjunctivitis), overuse of antibiotic eye drops, and reliance on unproven home remedies—can not only worsen symptoms but also contribute to public health issues such as antimicrobial resistance and increased burden on healthcare facilities [5-8].
The general public’s understanding of eye allergies, their seasonal triggers, and appropriate preventive or self-care measures is critical in managing this condition effectively. However, existing studies in India have predominantly focused on clinical patterns and pharmacological treatment, with limited exploration of Public awareness, perception, and behavioral responses to allergic conjunctivitis. Particularly in semi-urban and hill regions like Shimla, where climatic variations are acute and access to ophthalmic care may be limited, understanding community-level awareness is essential to designing effective health education strategies.
This study seeks to assess the level of public awareness, prevalent misconceptions, and common self-care practices related to allergic conjunctivitis among the residents of Shimla. By exploring what people know, how they react to symptoms, and where they seek information or treatment, the study aims to inform public health efforts to reduce preventable complications and improve self-management practices through better education and seasonal preparedness campaigns.
Study Design
A descriptive, cross-sectional online survey was conducted to evaluate public awareness, perceptions, and self-care behaviors related to allergic conjunctivitis, particularly during changing seasons, among residents of Shimla, Himachal Pradesh. The study was designed to collect quantitative and qualitative data regarding knowledge of symptoms, environmental triggers, misconceptions, and treatment preferences.
Study Area and Population
The target population comprised residents of Shimla, including both urban and semi-urban dwellers aged 18 years and above, irrespective of gender or educational background. Inclusion criteria were:
Residency in Shimla (for at least the past 12 months),
Ability to understand and respond in either Hindi or English
Access to an internet-enabled device (smartphone, tablet, or computer)
Willingness to provide informed electronic consent
Study Duration
The study was conducted over a two-month period, from January to March 2025, aligning with the pre-summer and spring allergy seasons in the region.
Sampling Technique and Sample Size
A convenience sampling method was used due to the online nature of the study. The survey link was distributed through:
Local social media platforms (WhatsApp, Facebook, Instagram)
Community health forums
Online bulletin boards of educational institutions and resident associations
A minimum target sample size of 350 participants was estimated to provide meaningful statistical insights, accounting for possible dropouts or incomplete responses.
Data Collection Tool
Data were collected using a structured, pre-tested online questionnaire developed in Google Forms. The questionnaire was bilingual (Hindi and English) and reviewed by experts in ophthalmology and public health. It was divided into four main sections:
Demographic Profile: Age, gender, education level, residence type (urban/semi-urban), and known history of seasonal eye allergies
Knowledge and Awareness: Identification of symptoms, understanding of triggers (e.g., pollen, dust, cosmetics), differentiation between allergy and infection, and beliefs about causes
Attitudes and Misconceptions: Use of antibiotics or steroid drops without prescription, reliance on home remedies, perception of seriousness, and delay in seeking care
Self-Care Practices and Health-Seeking Behavior: Use of protective eyewear, hygiene practices, source of health information, and history of medical consultations for eye allergies
The questionnaire underwent pilot testing with 30 participants (data excluded from analysis) to ensure clarity, user-friendliness, and cultural relevance. Necessary adjustments were made based on feedback.
Data Collection Procedure
An explanatory cover page outlined the study's purpose, voluntary nature, anonymity, and confidentiality assurance. Participants were required to provide informed e-consent before accessing the survey. The online form allowed single submission per user to prevent duplication.
Data Analysis
Responses were exported into Microsoft Excel and analyzed using IBM SPSS Version 26.0. Descriptive statistics (frequencies, percentages, and means) were used to summarize the data.
Ethical Considerations
Participation was completely voluntary, and data were collected anonymously, ensuring adherence to ethical standards for online surveys.
Socio-Demographic Characteristics of Participants
A total of 350 individuals residing in Shimla participated in the online survey. The majority were aged 26–35 years (29.7%), followed by 36–45 years (25.1%). Females slightly outnumbered males. Educational attainment was generally high, with 62.3% of participants having completed graduation or higher. Urban residents made up the larger share (56.6%) compared to semi-urban populations. Notably, nearly half (49.7%) of respondents reported a history of seasonal eye allergies, reflecting the widespread nature of the condition in the region.
Table 1: socio-demographic characteristics of participants (n = 350)
| Variable | Category | Frequency (n) | Percentage (%) |
| Age (Years) | 18–25 | 56 | 16.0 |
| 26–35 | 104 | 29.7 | |
| 36–45 | 88 | 25.1 | |
| 46–60 | 62 | 17.7 | |
| >60 | 20 | 5.7 | |
| Gender | Male | 172 | 49.1 |
| Female | 178 | 50.9 | |
| Education Level | Up to Higher Secondary | 132 | 37.7 |
| Graduate & Above | 218 | 62.3 | |
| Residence | Urban | 198 | 56.6 |
| Semi-Urban | 152 | 43.4 | |
| History of Eye Allergies | Yes | 174 | 49.7 |
| No | 176 | 50.3 |
Awareness and Misconceptions About Allergic Conjunctivitis
Participants responded to 20 multiple-choice questions designed to assess their knowledge about allergic conjunctivitis. While awareness of key symptoms such as itching and triggers like pollen was high, many misconceptions persisted. A substantial number believed it was contagious, and a notable portion used antibiotic drops without prescriptions. Although participants showed a fair understanding of protective measures (e.g., eyewear and saline rinses), unsafe practices like eye rubbing and use of steroids without medical advice were still common.
Table 2: awareness and misconceptions about allergic conjunctivitis (n = 350)
No. | Question | Options | Correct (n) | % |
1 | Which symptom is most commonly associated with allergic conjunctivitis? | a) Eye discharge, b) Itching, c) Blurred vision, d) Eye pain | 286 | 81.7% |
2 | Typical seasonal trigger in Shimla? | a) Snowfall, b) Pollen, c) Humidity, d) Saltwater | 272 | 77.7% |
3 | Can it cause permanent vision loss? | a) Yes, b) Only in children, c) Occasionally, d) No | 258 | 73.7% |
4 | Which is NOT a symptom of eye allergy? | a) Tearing, b) Loss of smell, c) Redness, d) Swelling | 230 | 65.7% |
5 | Distinction from infectious conjunctivitis? | a) By eye color, b) Through fever, c) Lack of discharge, d) Based on age | 248 | 70.9% |
6 | What to avoid during flare-up? | a) Sunglasses, b) Staying indoors, c) Rubbing eyes, d) Cold compress | 278 | 79.4% |
7 | Are OTC antibiotic drops safe without prescription? | a) Yes, b) No, c) Only if redness is severe, d) Yes with clean hands | 264 | 75.4% |
8 | Is allergic conjunctivitis contagious? | a) Yes, b) No, c) Sometimes, d) Only with pets | 282 | 80.6% |
9 | Who is more susceptible? | a) Adults, b) Children/young adults, c) Elderly, d) Males only | 270 | 77.1% |
10 | Role of pollen in allergic conjunctivitis? | a) Prevents infection, b) Clears vision, c) Triggers allergies, d) Cures dry eyes | 266 | 76.0% |
11 | Who to consult for eye allergies? | a) Physician, b) Pharmacist, c) Ophthalmologist, d) Nurse | 292 | 83.4% |
12 | Does screen time cause allergies? | a) Yes, b) No, c) Only in summer, d) Only in children | 254 | 72.6% |
13 | Reducing allergen exposure outdoors? | a) Sunglasses, b) Protective goggles, c) Eye makeup, d) Scarves | 276 | 78.9% |
14 | Safest eye cleaning method? | a) Hot compress, b) Tap water, c) Saline rinse, d) Eye rubbing | 244 | 69.7% |
15 | Use of steroid drops without Rx? | a) Yes, b) No, c) Only mild ones, d) With cold compress | 250 | 71.4% |
16 | Which practice may worsen symptoms? | a) Cold compress, b) Dusting, c) Using drops, d) Washing hands | 238 | 68.0% |
17 | If symptoms persist >1 week? | a) Ignore, b) See specialist, c) Any drop, d) Wait until summer ends | 278 | 79.4% |
18 | Most appropriate OTC item for relief? | a) Whitening drops, b) Artificial tears, c) Herbs, d) Antibiotics | 269 | 76.9% |
19 | Can rubbing eyes worsen allergies? | a) No, b) Yes, c) Only in kids, d) If dirty hands | 284 | 81.1% |
20 | A common misconception? | a) Highly contagious, b) Can be cured with antibiotics, c) Affects one eye, d) Only in winter | 240 | 68.6% |
Knowledge Score Classification
Based on their total correct responses across 20 questions, participants were classified into four knowledge levels. A significant portion of respondents (39.4%) fell into the Good category, followed by Fair (29.1%). Only 14.9% demonstrated Very Good knowledge, while 16.6% had Poor awareness—indicating that nearly one in six residents may hold potentially harmful misconceptions about managing eye allergies.
Table 3: knowledge score classification (n = 350)
| Knowledge Category | Score Range (%) | Frequency (n) | Percentage (%) |
| Very Good | ≥ 80 | 52 | 14.9 |
| Good | 60 – 79 | 138 | 39.4 |
| Fair | 40 – 59 | 102 | 29.1 |
| Poor | < 40 | 58 | 16.6 |
This study provides crucial insights into the current state of public awareness, attitudes, and misconceptions regarding allergic conjunctivitis among residents of Shimla—a region uniquely affected by seasonal transitions and environmental variability. The findings reveal a moderate level of knowledge among the general population, with notable gaps that have direct implications for personal health practices and public health education strategies.
A key strength observed was the high recognition of common symptoms such as itching (81.7%) and pollen as a trigger (77.7%), indicating that residents are reasonably familiar with the visible and seasonal nature of allergic conjunctivitis. Additionally, over 80% correctly identified the non-contagious nature of the condition and the importance of consulting a qualified ophthalmologist. These findings suggest that awareness of basic features and appropriate health-seeking behavior exists within a substantial portion of the population.
However, several critical misconceptions persist. Nearly one in four participants still believed that allergic conjunctivitis could spread person-to-person or were unsure, a misunderstanding that may lead to unnecessary social stigma and self-isolation. Furthermore, over 25% of respondents admitted to using over-the-counter antibiotic eye drops without medical supervision, a practice that not only fails to address allergic inflammation but also risks contributing to antimicrobial resistance. Alarmingly, a significant number of individuals endorsed or practiced eye rubbing during allergy episodes, a behavior that can exacerbate symptoms and increase the risk of secondary infections.
The data also point to a knowledge gap regarding safe eye hygiene practices and appropriate use of steroid medications, both of which are essential components of allergic conjunctivitis management. Only 69.7% correctly identified sterile saline rinse as the safest cleaning method, and fewer than three-quarters understood the risks of unprescribed steroid use. These findings highlight the need for more focused health literacy efforts targeting self-care behaviors.
Importantly, while nearly 40% of participants demonstrated Good awareness, only 14.9% achieved a Very Good score, and 16.6% fell into the Poor category. This distribution emphasizes the necessity of public health interventions that move beyond superficial awareness and address the deeper behavioral misconceptions that lead to inappropriate management.
Shimla's unique climate and topography make its population especially vulnerable to seasonal allergens. Yet, public education campaigns tailored for this region remain sparse. This study underscores the urgency of integrating eye health education into local health outreach programs, especially in collaboration with community clinics, schools, and digital media platforms. Additionally, training pharmacists and general practitioners to better guide patients on eye allergy management could greatly enhance safe practices in the community.
Sharma, R., et al. "Pink Eye Perceptions: Understanding Public Awareness and Misconceptions About Conjunctivitis." Himalayan Journal of Applied Medical Sciences and Research, vol. 6, no. 1, 2025, pp. 1–6.
Mohanasundaram, A.S., et al. "Madras Eye Outbreak in India: Why Should We Foster a Better Understanding of Acute Conjunctivitis?" Indian Journal of Ophthalmology, vol. 71, no. 5, May 2023, pp. 2298–2299.
Times of India. "From Raindrops to Redness: Conjunctivitis Awareness During the Rainy Season" [Internet]. [Cited 2025 Mar. 12]. Available from: https://timesofindia. indiatimes.com/life-style/health-fitness/health-news/from-raindrops-to-redness-conjunctivitis-awareness-during-the-rainy-season/articleshow/111548252.cms.
Rathi, V.M., and S.I. Murthy. "Allergic Conjunctivitis." Community Eye Health, vol. 30, no. 99, 2017, pp. S7–S10.
Krishna, M.T., et al. "An Appraisal of Allergic Disorders in India and an Urgent Call for Action." World Allergy Organization Journal, vol. 13, no. 7, July 2020, Article ID 100446.
Care Insurance. "Stay Vigilant of the Signs and Symptoms of Pink Eye This Monsoon" [Internet]. [Cited 2025 Mar. 2]. Available from: https://www.careinsurance.com/blog/health-insurance-articles/stay-vigilant-of-the-signs-and-symptoms-of-pink-eye-this-monsoon.
Healthians. "Conjunctivitis: Causes, Prevention Tips and Treatment Options" [Internet]. [Cited 2025 Mar. 5]. Available from: https://www.healthians.com/blog/ conjunctivitis-causes-prevention-tips-and-treatment-options/.
Ismail, G.M., et al. "Knowledge and Awareness of Allergic Conjunctivitis Among Population: A Systematic Review." General Medicine, vol. 26, no. 1, Jan. 2024, pp. 1138–1142.
Download PDF
Download PDF
Download PDF
Download PDF
Download XML
