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Allergies and your Eyes

What causes Eye Allergies?

Eye allergies develop as a result of an environmental agent or allergen, stimulating the release of histamine from the mast cells that line mucous membranes like inside the eyelids, nasal cavities and the sinuses. Histamine triggers these tissues to swell, itch and produce mucous. Eye allergies cannot be spread from person to person.

Potential allergens include pet dander, dust, pollen, smoke, perfumes or foods. The best way to treat allergies is to avoid the allergen. It is sometimes helpful to see an allergist who can perform skin tests to reveal which items are triggers to you.

Types of Eye Allergies:

Seasonal or Perennial Allergic Conjunctivitis

The most common type of eye allergy. Symptoms are either seasonal (ie. spring or fall) or can be year-round (perennial). People can have chronic dark circles under their eyes, puffy eyelids and sensitivity to bright lights along with the more common itching, redness, burning, and clear watery discharge. Sometimes people will get nasal symptoms associated as well such as runny nose, sneezing, and congestion.

Vernal keratoconjunctivitis

Typically, a more severe version of allergic conjunctivitis. It can be year-round, but symptoms will often worsen seasonally. This is most common in boys and young men, and many patients with this form will be prone to eczema or asthma.

Atopic keratoconjunctivitis

Primarily affects older patients, and more commonly men. These patients also can have more involvement of the lids and the skin surrounding the orbit (dermatitis). If left untreated, can result in scarring of the cornea.

Giant Papillary Conjunctivitis

Usually associated with wearing contact lenses. Thought to possibly be due to an allergy to the contact lens material or contact lens solution. Aggravated by other forms of eye allergy as well. Large fluid filled sacs, or papules, form in the upper lining of the inner eyelid. Symptoms include: itching, puffiness, watering, mucous, blurred vision, intolerance to contact lens, foreign body sensation.

Management and Treatment:

Avoidance of allergens

Avoid triggers by making changes to your home and your routine.

  • Stay indoors as much as possible when pollen counts are high. Or shower after spending time outside to remove pollens from hair and clothes.

  • Keep windows closed during high pollen periods, using air conditioning at home and in your car. Make sure air conditioning units are kept clean.

  • Wear glasses or sunglasses when outdoors to minimize allergen exposure.

  • Use allergen-reducing covers for our bedding, especially pillows. Wash bedding frequently with hot water.

  • When cleaning floors, use a damp mop or rag instead of a dry dust mop or broom to trap the allergens.

  • If mold is a trigger, try to keep humidity levels in home between 30-50 percent. Consider a de-humidifier in humid or moist places, such as a basement.

  • If pets are a trigger, do not allow pets in your bedroom so that you can sleep in an allergen-free room. Consider hardwood or tile flooring over carpet. Wash your hands after touching a pet, and wash clothing that was worn around pets.

  • Keep house clean, dust often. Use a vacuum with a HEPA filter to avoid releasing allergens into the air.

  • Limit contact lens wear during periods of high exposure. Daily disposable contact lenses are ideal for allergy sufferers as each day begins with a clean, allergen-free lens.

  • Avoid rubbing your eyes which causes increased irritation.

Over the Counter and Prescription Treatments

Artificial Tears – May provide temporary relief by washing allergens from the surface of the eye. You can use a preservative free version as much as necessary to help relieve symptoms.

Topical, Nasal or Oral Antihistamines -- These can reduce the itching, redness and swelling associated with eye allergies. These may provide quick relief, but are usually short acting and may need to be used multiple times a day. Oral antihistamines can also dry the surface of the eye and may worsen symptoms.

Mast Cell Stabilizer eyedrops – Prevent the release of histamine that causes allergy symptoms. To prevent symptoms these drops need to be used prior to exposure to an allergen.

Combination Antihistamine & Mast Cell Stabilizer eyedrops -- Newest and most commonly used treatment. One component treats symptoms quickly, while the other helps to prevent further release of histamine and provides long lasting relief.

Corticosteroid eyedrops – These can help reduce the inflammation caused by histamine. Often used to treat chronic, severe eye allergy symptoms, unresponsive to other alternatives. Long-term treatment with steroids (more than 2 weeks) should only be done under the supervision of an eye doctor. There is a possibility of serious side effects with continued use of steroids such as infection, formation of cataract, and increased eye pressure.

Allergy shots (immunotherapy) – With immunotherapy you get shots containing very small amounts of the allergen that triggers the response. This dose is gradually increased with time to help your body become immune to the allergen.


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