EYE (OCULAR) ALLERGY

What is an eye allergy?

Allergies of the eye (also called ocular allergies) and related structures affect about one in five (20%) individuals in the United States and are on the rise. About 50% of people with ocular allergy have a family history of allergy. One-half of seasonal and indoor allergy sufferers also have some form of ocular allergy.

The most common type of ocular allergy is a hypersensitivity/allergy to seasonal allergens such as pollens and mold spores, and makes up about 80-90% of all cases. Other related problems including allergic rhinitis (hay fever), sinusitis, asthma and eczema may accompany ocular allergy. Persons with year round (perennial) or indoor allergies may have milder symptoms that are often less sudden and dramatic in appearance. Indoor allergens are present in the environment all year and include house dust mites, pet dander, cockroach, feather and mold spores. An individual with year round ocular allergies may also experience worsening symptoms during the allergy season due to outdoor and indoor triggers.

What are the symptoms of ocular allergies?

The conjunctiva is a delicate, thin, usually clear membrane that covers the eye and inside of the eyelids. When an allergen comes in contact with the conjunctiva as a result of exposure to seasonal pollens and/or indoor allergens, symptoms that occur may include excess tearing, light sensitivity, redness, “grittiness” (foreign body feeling), eyelid swelling and itchiness. Generally if ocular allergy is present, the symptoms usually affect both eyes. Symptoms may be somewhat reduced if you are already taking allergy medications, such as an antihistamine or eye drop, that suppress itchiness as well as other complaints.

How is ocular allergy diagnosed?

The history (what you describe to your doctor) is a fundamental part of properly diagnosing whether allergic type ocular allergies are present. If you have immediate symptoms after exposure to outdoor allergens, for example on a high pollen day, as well as other triggers like fresh cut grass, raking the leaves, grooming a pet, dusting or vacuuming your home, you most likely have allergic conjunctivitis.

Diagnostic skin tests can be performed by an allergist that will identify the relevant allergic triggers that are likely responsible for your bothersome itchy and irritated eyes. The results are generally seen within 15-20 minutes. The allergens identified are then useful in developing a comprehensive avoidance regimen to reduce exposure for relief and consideration of immunotherapy (allergy shots).

What are the best medical treatment options?

Oral antihistamines are commonly taken especially when there are other symptoms in addition to ocular complaints such as sneezing and runny nose associated with seasonal and indoor allergies. Once or twice daily non-sedating pills and/or syrup are available for adults and children.

Prescription-strength antihistamine eye drops are among the most effective and safest therapy for relief of allergic conjunctivitis for adults and children. Some contain “anti-inflammatory” compounds that further enhance their effectiveness. Topical decongestants, like Visine, reduce redness by constricting blood vessels in the eye and are not recommended for long term usage since they may be associated with a “rebound” redness with prolonged use. These may also be combined with over-the-counter (non-prescription) antihistamine eye drops to provide relief of itchiness and redness.

Corticosteroid eye drops, although highly effective to suppress ocular symptoms, can be associated with unwanted side effects even for a short term course. It is strongly recommended that its use be managed by an ophthalmologist due to a higher incidence of near and long term side effects, such as glaucoma (increased ocular pressure), cataracts and infection.

Allergy immunotherapy (allergy injections) can be very effective for treating and preventing many of the familiar complaints of ocular allergy.

Can eye allergies be prevented?

Controlling the source of the allergen is the most effective way to minimize or even eliminate eye allergies. You will want to reduce or eliminate contact with the items that irritate your eyes. For example:

• Wash your hands, face, and hair thoroughly and frequently, and keep them away from your eyes.

• Use air filters in your home and car; clean them regularly.

• Clean and vacuum your home regularly.

• Stay indoors when the pollen counts are high.

• Keep doors and windows closed.

• Keep your house dry and free of mold.

• Stay away from pets.

Eye Allergy Tips:

Tip #1 - Take your prescribed allergy medications before your seasonal allergy symptoms begin.

Tip #2 - An eyelid wash such as a “baby shampoo” can be used daily to remove unwanted allergens and pollutants. Eye drops may actually work better after using an eyelid rinse.

Tip #3 - Big sunglasses may serve to block much of the pollens blown around from entering your eyes and eyelids.

Tip #4 - Keeping your allergy eye drops or artificial tears in the refrigerator may provide a soothing and cooling sensation when applied. [Always check the package label or your provider for any restrictions on placing medications in the refrigerator]. See your allergist and/or ophthalmologist or optometrist if you have symptoms that persist, to have a more in depth examination for optimal and safe treatment. Remember, your best defense is a solid and good offense, including allergy tests to identify what may be triggering your symptoms.

Tip #5 - When your eyes are itchy or your eyelids are swollen and puffy, avoid touching or rubbing them. This may worsen your symptoms instead of bringing relief.

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