Eye Allergies

Eye allergies often are hereditary, and occur due to processes associated with other types of allergic responses.

When an allergic reaction takes place, your eyes may be overreacting to a substance perceived as harmful, even though it may not be. These substances are called allergens.

For example, dust that is harmless to most people can cause excessive production of tears and mucus in eyes of overly sensitive, allergic individuals.

Allergies can trigger other problems, such as conjunctivitis (pink eye) and asthma. Combined nasal and eye allergies create a condition known as rhinoconjunctivitis.

About 30 to 50 percent of U.S. residents have allergy symptoms. And about 75 percent of those symptoms affect the eyes.*

Allergy Symptoms and Signs

Common signs of allergies include:

  • Itchy, red eyes and swollen eyelids
  • Runny nose
  • Sneezing and coughing
  • Itchy nose, mouth or throat
  • Headache from sinus congestion

In addition to these symptoms, you also may feel fatigued and could suffer from lack of sleep.

What Causes Eye Allergies?

Many allergens are in the air, where they come in contact with your eyes and nose. Airborne allergens include pollen, mold, dust and pet dander.

Other causes of allergies, such as certain foods or bee stings, do not typically affect the eyes the way airborne allergens do. Adverse reactions to certain cosmetics or drugs such as antibiotic eye drops also may cause eye allergies.

Some people actually are allergic to the preservatives in eye drops such as those used to lubricate dry eyes. In this case, you may need to use a preservative-free brand.

General Eye Allergy Treatment

Avoidance. The most common “treatment” is to avoid what’s causing your eye allergy. Itchy eyes? Keep your home free of pet dander and dust and keep pets off the furniture. Stay inside with the air conditioner on when a lot of pollen is in the air. Use high quality furnace filters that trap common allergens and replace the filters frequently.

Make sure you wear wraparound sunglasses to help shield your eyes from allergens, and drive with your windows closed during allergy season.

Medications. If you’re not sure what’s causing your eye allergies, or you’re not having any luck avoiding them, your next step probably will be medication to alleviate the symptoms.

Over-the-counter and prescription medications each have their advantages; for example, over-the-counter products often are less expensive, while prescription ones usually are stronger and may be more effective.

Eye drops are available as simple eye washes, or they may have one or more active ingredients such as antihistamines, decongestants or mast cell stabilizers that inhibit inflammation. Antihistamines relieve many symptoms caused by airborne allergens, such as itchy, watery eyes, runny nose and sneezing. Decongestants help shrink swollen nasal passages for easier breathing.

Relief for Watery, Itchy Eyes

Common causes of excessively watery eyes are allergies and dry eye syndrome — two very different problems.

With allergies, your body’s release of histamine causes your eyes to water, just as it may cause your nose to run.

It may seem illogical that dry eye syndrome could cause watery eyes. But sometimes an underlying dry eye condition stimulates your tear glands to overproduce the watery component of your eye’s tears as a protective response, leading to watery eyes.

Decongestants clear up redness. They contain vasoconstrictors, which make the blood vessels in your eyes smaller, lessening the apparent redness. They treat a symptom but not the cause of eye allergies.

In fact, with extended use, the blood vessels can become dependent on the vasoconstrictor to stay small. When you discontinue the eye drops, the vessels actually get bigger than they were in the beginning. This process is called rebound hyperemia, and the result is that your red eyes could worsen over time.

Some products have ingredients that act as mast cell stabilizers, which alleviate redness and swelling. Mast cell stabilizers are similar to antihistamines. But while antihistamines are known for their immediate relief, mast cell stabilizers are known for their long-lasting relief.

Antihistamines, decongestants and mast cell stabilizers are available in pill form, but pills don’t work as quickly as eye drops or gels to bring eye relief.

Nonsteroidal anti-inflammatory drug (NSAID) eye drops may be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis, also called hay fever.

Prescription corticosteroid eye drops also may provide similar, quick relief. However, steroids have been associated with side effects such as increased inner eye pressure (intraocular pressure) leading to glaucoma and damage to optic nerve.

Steroids also have been known to cause the eye’s natural lens to become cloudy, producing cataracts.

Check the product label or insert for a list of side effects of over-the-counter medications. For prescription medication, ask your doctor. In some cases, combinations of medications may be used.

You may benefit from immunotherapy, in which an allergy specialist injects you with small amounts of the allergen to help you gradually build up immunity.

Eye Allergies and Contact Lenses

Even if you are generally a successful contact lens wearer, allergy season can make your contacts uncomfortable. Airborne allergens can get on your lenses, causing discomfort.

Allergens also can stimulate the excessive production of natural substances in your tears, which can bind to your contacts and cause blur and additional discomfort.

Pollen maps can help you determine when allergens are present.

Ask your eye doctor about eye drops that can help relieve your symptoms and keep your contact lenses clean. Certain drops can discolor or damage certain lenses, so it makes sense to ask first before trying out a new brand.

Another alternative is daily disposable contact lenses, which are discarded nightly. Because you replace them so frequently, these types of lenses are unlikely to develop irritating deposits that can build up over time and cause or heighten allergy-related discomfort.

 
By Vance Thompson, MD