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Itchy Eyes and Ocular Allergies

What are Eye Allergies?

Eye Allergies are a very common type of conjunctivitis. They are not contagious and vary greatly in their severity.

Signs and Symptoms of Eye Allergies

The most common symptoms of eye allergies are itching, swelling, and redness of the eyes. There may also be associated nasal and sinus congestion. The eyes usually take on a glossy appearance as the ocular surface swells which can cause a foreign body sensation as the eyelids blink over the swollen tissue. Eye allergies cause superficial blood vessels to dilate and fill with blood resulting in redness. The eyelids themselves often become red and swollen also.

What Causes Eye Allergies?

Eye allergies are the immune system’s inappropriate response to a benign foreign substance called an allergen. The immune system is your body’s defense mechanism against dangerous organisms such as bacteria and viruses. However, the immune system often gets confused and “sends in the troops” to attack a foreign substance that is not dangerous. This causes inflammation and leads to allergy symptoms. Eye allergies can also be associated with dry eyes.

How are Eye Allergies Diagnosed?

Proper diagnosis of eye allergies requires your eye doctor to perform an examination with a lighted microscope called a slit lamp. Small bumps under the lower lid called follicles are a definitive sign of eye allergies.

How are Eye Allergies Treated?

Eye allergies are the most commonly misdiagnosed conjunctivitis. Family practice and urgent care physicians are not well-equipped to differentiate between the different types of conjunctivitis and often prescribe an antibiotic for eye allergies which will be ineffective.

The key to effective allergy treatment is proper diagnosis and consistency of treatment during times of exposure. If taking allergy drops or oral treatments, it is best to take them as directed every day. If treatment is delayed until symptoms are extreme, improvement can be delayed for days or longer as histamine and other chemical mediators have already been released in quantity.

Here is a list of recommended allergy treatments:

  • Simplest: Avoid the allergen. Example, patients with cat dander sensitivities should not own a cat. Unfortunately it is impossible to avoid all allergens but limiting exposure is very helpful.
  • Wear sunglasses to block allergens from getting in the eyes. -Remove allergens after exposure with a shower and change of clothes.
  • Avoid opening windows on windy days or sleeping with windows open during pollen season.
  • Apply cold compresses to reduce swelling and other symptoms.
  • Rinse eyes with ocular lubrication drops to remove allergens from the ocular surface.
  • Anti-Allergy Eye Drops: Several eye drops are available over the counter (OTC) or by prescription.   For some patients, OTC drops such as Zatidor, Naphcon, or Vasocon can be effective but need to be used TWICE daily. Prescription drops such as Pataday or Lasticaf are very effective and need to be used only ONCE daily but are significantly more expensive. Please check with your insurance carrier for coverage.
  • All forms of Visine are minimally effective for ocular allergy or any other eye condition (my opinion). Visine may temporarily “take the red out” as it advertises but its blood vessel constricting (make the eyes look white ) ingredients often irritate the ocular surface and actually make the eyes more red after the medication wears off.
  • Oral Anti-Allergy Medication: these can be somewhat effective for mild ocular allergies but are best used in addition to anti-allergy eye drops especially for those with more severe allergies. Most are available OTC and are fairly inexpensive. Zyrtec, Benadryl, and Clariton are useful examples but must also be used consistently.
  • Steroids: In severe cases of ocular allergy not responding to above treatments, steroidal eye drops can be very effective for short term treatment. Ocular steroids are prescription only. Their use requires monitoring by an eye care professional as rare but serious side effects can occur.
  • Allergy testing: Performed by an allergist, these tests can be useful in determining the exact allergen. However, specific allergy tests can be expensive and often the resulting advice is “avoid allergens and treat consistently during times of exposure with eye drops and orals.”

What Steps Should I Take If I Think I Have Eye Allergies?

We recommend making an appointment to see Dr. Reinders as quickly as possible before the eye allergies worsen and require more aggressive therapy. He has 22 of years of experience treating patients with eye allergies and other related conditions. The sooner he can check your eyes, the better. All doctors agree that waiting and hoping it will get better is not a prescription for success.