Today we are going to address allergies, specifically how having allergies can affect your eyes.
Eye allergies affect over 20% of the population and is an inflammatory reaction of the conjunctiva, or the outer lining of the eye to particles, in the environment, otherwise known as allergens. Some common allergens are dust, animal dander, medications, and pollen, especially during the spring and fall.
Allergy symptoms are a result of the body’s immune response to certain allergens due to a release of inflammatory chemicals such as histamine. Histamine works with nerves to produce itching, can cause vomiting and diarrhea, constricts muscles in the lungs, or can even result in anaphylaxis, which is a severe reaction that can be potentially fatal.
If you have allergy symptoms, it is important to know what allergens you are sensitive to so you can avoid these. Seasonal allergies, an allergy to pollen, will usually present with a runny nose, sneezing, cough, and sinus headaches. The eyes can get swollen with shiners, specifically around and below the eyes, and the eyes themselves can get red, teary, and itchy.
If your symptoms seem to last all year and are associated with eczema, asthma, and food allergies, you might have atopy, a genetic tendency to develop allergies. It would be best to address your issues with your doctor, who may refer you to a dermatologist, ophthalmologist, or other specialists depending on your symptoms.
Another common cause of eye allergies is a reaction to ingredients in certain eye makeup or skincare products. Many makeup products contain preservatives to maintain shelf-life, fragrances, solvents, or ingredients that should not be applied around the sensitive eye area. If you start getting eye irritation with a new makeup product, fragrance, or detergent, stop immediately.
A sneaky cause of eye allergies is an allergy to preservatives found in eye drops. Most eye drops in bottles have preservatives and especially with chronic long-term use of drops, your eyes can develop an allergy to preservatives. I always recommend preservative-free medications as much as possible to eliminate this risk of ocular toxicity and allergy.
In the eye clinic, we can distinguish an allergy reaction from other forms of pink or red eye based on the eyelid reaction. With any kind of allergic reaction, we see papillae, which are dilated peripheral blood vessels found mostly on the upper eyelid.
If you have itchy eyes, what can you do about it?
The first treatment you can try are over-the-counter preservative-free artificial tears. These tears will help wash out allergens, and if you put these tears in the fridge and then you put them in your eye, they will feel amazing.
Another important step is avoiding allergens. Use an air filter and if you still do not know what you are allergic to, you might need to get an allergy test. This test, which is otherwise known as a skin prick test, will check for immediate allergic reactions to the most common allergens and will help you find out which substances you need to avoid.
An over-the-counter treatment you can try are antihistamine eye drops. My favorite drop is called Pataday, which is now available over-the-counter, and is an antihistamine as well as a mast cell stabilizer that not only helps with itching but works to prevent further release of histamine. If you are sensitive or allergic to preservatives, Alaway has a preservative-free formulation that I like to recommend as well.
If you have other allergy symptoms, a systemic medication like an oral antihistamine will also help with your eye symptoms. Some medications can cause drowsiness so take these with caution, and a common side effect of antihistamines are dry eyes. Make sure you lubricate your eyes with preservative-free tears if you are taking a regular antihistamine.
Finally, if your allergy symptoms do not go away, you might need to go to your eye doctor to confirm the diagnosis and consider prescription treatment. We can use a variety of low to medium dose steroid eye drops to help control your symptoms and address the eye inflammation.
Steroids work at every phase of the inflammatory cascade and are the most effective treatment for allergic reactions, but your eyes need to be monitored as long-term use of steroids will accelerate cataracts and may cause higher eye pressures that must be addressed to avoid long-term complications.