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Patients & Consumers Conditions En Español Find an Allergist / Immunologist Just for Kids New Research Parent Resources Pollen Levels Publications Request a Speaker School Tools Seniors The Virtual Allergist™ Treatments Search by Condition (A-Z) Search by Topic Allergy & Asthma Issues Educational Brochures Elements of Allergy and Asthma Order Public Education Materials Allergy Shots Drug Guide Sublingual Immunotherapy (SLIT)		Allergy & Asthma Advocate Ocular Allergies By Clifford W. Bassett, MD, FAAAAI Allergies of the eye and related structures affect about one in five individuals in the United States and its prevalence is increasing. About 50% of people with ocular allergy have a positive family history of allergy and also one-half of seasonal and indoor allergy sufferers also have some form of ocular allergy. Allergic conjunctivitis The most common type of ocular allergy is a hypersensitivity to seasonal allergens such as pollens and mold spores, and makes up about 80-90% of all cases. Other related problems including hay fever, sinusitis, asthma and eczema may accompany ocular allergy. Persons with year round or indoor allergies may have milder symptoms that are often less sudden and dramatic in appearance. Indoor al- lergens 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 have worsening during the allergy season due to outdoor and indoor triggers. What are the symptoms of ocular allergies? The conjunctiva is a delicate, thin 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,” 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 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 well as other triggers like fresh cut grass, raking the leaves, grooming a pet as well as after 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 and are reproducible and valid. The allergens identified are then useful in developing a comprehensive avoidance regimen to reduce exposure for relief . 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 reduce redness by constricting blood vessels in the eye and are not recommended for long term usage but may be associated with a “rebound” redness of with prolonged use. These may also be combined with OTC antihistamine eye drops, to provide relief of itchiness and redness. Corticosteroid eye drops although highly effective to suppress ocular symptoms, can be associated with 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. Allergy survival strategies Survival Tip #1 - Take your prescribed allergy medications before your seasonal allergy symptoms begin. Survival 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. Survival Tip #3 - Avoid excessive rubbing of your eyes. Survival Tip #4 - Big sunglasses may serve to block much of the pollens blown around from entering your eyes and eyelids. Survival Tip #5 - 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 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. For more information check out the AAAAI Web site at www.aaaai.org. <back>
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