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Eye Allergies

BELIEVE YOUR EYES, AND SEE WHAT THEY MAY BE TELLING YOU.

If your eyes itch, are red, tearing or burning, pay attention to what they may be telling you. You may have eye allergies, or allergic conjunctivitis, a condition that affects millions of Americans. It is a condition that can occur alone, but often accompanies nasal allergy symptoms, such as sneezing, sniffling and a stuffy nose. And, while most people treat nasal allergy symptoms, they often ignore their itchy, red, watery eyes. This document answers questions about eye allergies and suggests effective ways for you to recognize and treat the symptoms.

WHAT CAUSES EYE ALLERGIES?
Just like hay fever and skin rashes, eye allergies develop when the body's immune system becomes sensitized and overreacts to something that is ordinarily harmless. An allergic reaction can occur whenever that "something" - called an allergen - comes into contact with your eyes. The allergen causes certain cells in the eye (called mast cells) to release histamine and other substances or chemicals that cause blood vessels in the eyes to swell, and the eyes to become itchy, red and watery.

WHAT ALLERGENS TRIGGER EYE ALLERGIES?
Allergens that may be present indoors or outdoors can cause eye allergies. The most common outdoor airborne allergens are grass, tree and weed pollens. People who are sensitive to these allergens suffer from seasonal allergic conjunctivitis, the most common type of eye allergy.

Pet hair or dander, dust mites and molds are the most common indoor allergens. These indoor allergens can trigger symptoms for some people throughout the year, resulting in perennial allergic conjunctivitis.

Although cigarette smoke, perfume and diesel exhaust may inflame your eyes, they act as irritants rather than triggering an allergic response. They can, however, make your allergy symptoms worse.

CAN EYE ALLERGIES HARM MY EYESIGHT?
No. Eye allergies can be extremely annoying and uncomfortable, and they may disrupt your day-to-day activities, but they cannot harm your eyes.

HOW ARE EYE ALLERGIES TREATED?
As with any allergy, the first approach for successful management should be prevention or avoidance of the allergens that trigger your symptoms. Here are some avoidance tips to reduce exposure to allergens that affect your eyes.

Stay indoors as much as possible when pollen counts are at their peak, usually during the mid-morning and early evening, and when wind is blowing pollens around.

  • Keep windows closed and use air conditioning in your car and home. Air conditioning units should be kept clean. Avoid using window fans that can draw pollens and molds into the house.
     
  • Wear glasses or sunglasses when outdoors to minimize pollen getting into your eyes.
     
  • Avoid rubbing eyes, which will only irritate them or make your condition worse.
     
  • Reduce dust mite exposure in your home, especially the bedroom. Bedding, particularly pillows, should be encased in "mite-proof" covers. Wash bedding often in hot water (at least 130*F). Keep humidity in your home low (between 30 percent and 50 percent).
     
  • Clean floors with a damp rag or mop rather than dry dusting or sweeping.
     
  • Wash your hands immediately after petting any animals. Remove and wash clothing after visiting friends with pets.
     
  • If you have a pet to which you are allergic, keep it out of your house as much as possible. If the pet must be in the house, keep it out of the bedroom so you are not exposed to animal allergens while you sleep. Close the air ducts to your bedroom if you have forced-air or central heating/cooling. Replace carpeting with hardwood, tile or linoleum which are easier to keep dander free.
     
  • Reduce indoor molds caused by high humidity by cleaning bathrooms, kitchens and basements regularly. A dehumidifier can be used to reduce molds, especially in damp, humid places like basements. Make sure the dehumidifier is cleaned often. To clean moldy areas in the home, use a 1-to-10 parts diluted mixture of chlorine bleach and water.

Because many of the allergens that trigger eye allergies are airborne, avoidance is not always possible. You should discuss your eye allergy symptoms with an allergy specialist or your personal physician to determine which of several treatment options is right for you. On the next two pages is a list of the kinds of over-the-counter (OTC) and prescription eye drops and oral medications that are available for the treatment of eye allergies.

ARE THE OTC AND PRESCRIPTION EYE DROPS AND MEDICATIONS SAFE FOR CHILDREN?
There are eye drops and oral medications available to treat eye allergies in children. Artificial tears are extremely safe and can be used at any age. Some eye drops, such as antihistamines and antihistamines/mast cell stabilizers, can be used in children who are 3 and older. Any treatment should be discussed with your child's physician.

DO ALLERGY SHOTS TREAT EYE ALLERGIES?
If avoidance, oral medication and eye drops do not control your symptoms, allergy shots or immunotherapy is another option for relieving eye allergies. Tiny amounts of the allergen are injected with gradually increasing doses over time. The shots can actually keep your body from reacting to the allergens. The treatment takes several months to achieve maximum results and some continuing medication may still be required.

MEDICATIONS FOR THE TREATMENT OF EYE ALLERGIES
Over-the-counter eye drops and oral medications are commonly used for short-term relief of some eye allergy symptoms. However, they may not relieve all symptoms, and prolonged use of some OTC eye drops may actually cause your condition to become worse.

Prescription eye drops and oral medications also are used to treat eye allergies. Prescription eye drops provide both short- and long-term targeted relief of eye allergy symptoms, and they can be used to manage eye allergy symptoms in conjunction with an oral antihistamine that might be taken to manage nasal allergy symptoms.

OTC EYE DROPS AND MEDICATIONS

  • Tear Substitutes. Artificial tears can temporarily wash allergens from the eye and also moisten the eyes, which often become dry when red and irritated. These drops, which can be refrigerated to provide additional soothing and comfort, are safe and can be used as often as necessary.
     
  • Decongestants-Antihistamines. Decongestants or vasoconstrictors are available as over-the-counter eye drops to reduce the redness associated with eye allergies. (Eye drops containing vasoconstrictors should not be used by anyone with glaucoma.) The decongestant drops are available alone or in conjunction with an antihistamine, which provides additional relief of itching. The drops are weak and must be used frequently (four to six times a day). It is very important not to use these OTC eye drops for more than two to three days. Prolonged use can actually lead to increased swelling and redness that may last even after discontinuing the drops. You may be familiar with this "rebound effect" that occurs when you use decongestant nasal sprays for more than three days, and your nose becomes even more congested than before.

  • Oral Antihistamines. Oral antihistamines can be mildly effective in relieving the itching associated with eye allergies, however these medications may cause dry eyes and potentially worsen eye allergy symptoms. Also, some OTC versions of these medications can cause side effects such as sedation, excitability, dizziness or disturbed coordination.

PRESCRIPTION EYE DROPS AND MEDICATIONS
Antihistamines. Eye drops that contain antihistamines can reduce the itching, redness and swelling associated with eye allergies. Although antihistamine eye drops provide quick relief, the effect may last only a few hours, and some of these drops need to be used four times a day.

Mast Cell Stabilizers. Mast cell stabilizers are eye drops that prevent the release of histamine and other substances that cause allergy symptoms. The drops must be taken before exposure to an allergen to prevent itching.

Antihistamine/Mast Cell Stabilizers. Some of the newest eye drops have both an antihistamine and a mast cell stabilizing action to treat and prevent eye allergies. They are used twice a day and provide quick and long-lasting relief of itching, redness, tearing and burning.

NSAIDS. Nonsteroidal anti-inflammatory eye drops also are available to relieve itching. These drops may cause stinging or burning when applied and may need to be used four times a day.

Corticosteroids. Steroid eye drops can help treat chronic and severe eye allergy symptoms such as itching, redness and swelling, but continued use of the drops can have side effects, such as a risk of secondary infection, glaucoma and cataracts. These drops should only be used short-term and under the supervision of an ophthalmologist.

Nonsedating Oral Antihistamines. Like OTC oral antihistamines, prescription antihistamines can be mildly effective in relieving the itching associated with eye allergies. They do not have the same sedating side effects as OTC antihistamines, but they still can cause dry eyes and worsen symptoms.

Your allergist or personal physician can help determine which treatments are best for you.

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