Background: A significant number of patients present with conjunctivitis that is not strictly speaking of allergic, infectious, or dry eye origin. Patients affected by this pseudo-allergic form of vasomotor or idiopathic conjunctivitis usually live in urban polluted areas and may be affected by a new clinical entity called the 'urban eye allergy syndrome'.
Scope: To identify the incidence, pathogenesis and therapeutic response of this condition by collecting from the literature experimental evidence on the relationship between air pollution, allergy, and conjunctival disease.
Findings: Allergen susceptibility might be increased in areas with increased air pollutants. Both allergens and pollutants can directly initiate specific and nonspecific mucosal inflammation through several interweaving mechanisms.
Conclusions: The present commentary introduces the concept of 'urban eye allergy syndrome' discussing inter-actions between air pollutants and pollens, the increase of allergic signs and symptoms by pollutants, the prevalence of urban allergy, preliminary data from a single restricted geographical area, and proposed mechanisms of action.