Is it allergic rhinitis / conjunctivitis?

If purulent discharge, unilateral consider other causes


Provide hay fever information leaflet

Assess quality of life “Juniper rhinitis Quality of Life score”

Prescribe steroid nasal spray and demonstrate how to use device e.g. Avamys

If not controlled / eye symptoms

Add regular long-acting antihistamine (not Piriton) and/or non-steroid eye drops e.g. olopatadine

If not controlled

Review compliance – many children are not compliant with treatment

Refer to a specialist if

Symptoms not responsive to above treatment despite good compliance

Complex allergy, troublesome asthma