BACKGROUND: Nasal provocation tests (NPTs) are indicated in confirming the 
diagnosis of allergic rhinitis if the clinical history, skin tests or sIgE are 
inconclusive. NPTs are time- consuming, technically difficult and expensive to 
perform. Consequently, conjunctival provocation tests (CPTs), which are easier, 
cheaper and safer should be considered as an alternative method. No recent study 
has compared CPTs with NPTs in allergic rhinitis children.
OBJECTIVE: To compare CPTs with NPTs in allergic rhinitis children with house 
dust mite sensitization
METHODS: Fifty-five children with allergic rhinitis were included. Thirty-six 
children had positive skin prick tests (SPTs) to Dermatophagoides pteronyssinus 
(Dp). NPTs were performed by spraying 0.1 ml of Dp extract with concentrations 
of 50, 200 and 500 AU/ml to each nostril at 15 minute interval. The clinical 
symptom scores, anterior rhinomanometry results and nasal peak flow testing were 
performed to assess the responses. For CPTs, 0.1 ml of the same concentration of 
allergen extract was droppedinto one eye and the control solution was dropped 
into the other. The responses were assessed by clinical symptom scores. The 
tests were stopped when the subject reported a positive response, or continued 
to the maximum concentration.
RESULTS: The sensitivity, specificity, positive predictive value, negative 
predictive value and accuracy of CPT compared with NPT are 97.1% (84.7-99.9), 
90.5% (69.6-98.8), 94.3% (80.8-99.3), 95% (75.1-99.9) and 94.5 (84.9-98.9), 
respectively in all patients. Among individual allergic rhinitis subjects the 
sensitivity, specificity, PPV and NPV are 100%.
CONCLUSIONS: CPT can be an alternative test for NPT in allergic rhinitis 
children with house dust mite sensitization, even if they do not have 
conjunctival symptoms.