Understanding eye allergies: How to treat, itchy, red and watery eyes

Published Nov. 03, 2010 @ 11 p.m.

ANDREA PERKINS: When people think about allergies, they may picture sneezing, rashes, coughs, and runny noses.  But what about the eyes?  Eyes can react to allergens by becoming red and irritated, itchy and watery.  These are the signs of allergic conjunctivitis.  Eye inflammation can interfere with your daily activities.  Use the following information to identify your symptoms and get relief.

Allergic Conjunctivitis - What is it?

The conjunctiva of the eye is the clear mucous membrane that lines the eyelids, covers the sclera, and protects the eye from microbes by producing mucus and tears.  Conjunctivitis is the inflammation of the conjunctiva.

The most common causes of conjunctivitis are bacteria, viruses and allergies.  Bacterial conjunctivitis creates red inflammation and increased thick purulent discharge, which often causes matting of the eyelashes after sleep.  Viral conjunctivitis creates a lighter pink inflammation and is often called "pink eye."  Discharge is thin and clear.  Both bacterial and viral conjunctivitis may start in one eye and easily spread to the other eye.  Both types are also contagious.

Allergic conjunctivitis causes redness of the sclera and significant watery discharge.  Intense itching is the key to diagnosing conjunctivitis as allergic.  Patient may also experience blurred vision and swelling of the eyelid.  Patient's history of allergies, asthma, and eczema is also important to diagnosis.  Allergic conjunctivitis may affect one or both eyes.  Allergic conjunctivitis is not contagious.

Allergic Conjunctivitis - What causes it? 

Allergic Conjunctivitis can be caused by a multitude of allergens including pollen, grasses, molds, pet dander, dust mites. There are two types of allergic conjunctivitis.  When it is caused by seasonal allergens like a grass, tree, weed or mold, it is considered seasonal allergic conjunctivitis.  When the person suffers from symptoms year round from indoor allergens including dust mites, pet dander, or feathers, the allergic conjunctivitis is considered perennial.

Allergic Conjunctivitis - How do I prevent it?

Avoidance is important in treating and preventing allergic conjunctivitis.  If an individual has been diagnosed with allergens it is best to avoid exposure to those allergens.  If exposure does cause symptoms, avoid further exposure to allow healing.  Avoidance techniques may include, but are not limited to, using dust mite covers on mattresses and pillows; using HEPA filters when vacuuming; using high quality air filters in the furnace and air conditioner; avoiding the outdoors for long periods when pollen counts are high; washing linens weekly in hot water; and washing Fluffy (cat or dog) weekly to get rid of excess dander.

Allergic Rhinitis- How do I treat it? 

Unfortunately, avoidance is not always successful and symptoms may appear.  First, do not rub or scratch your eyes.  This activity causes increased irritation to the site and may introduce germs from your fingers into your eyes.  Secondly, if you wear contacts, remove them.  Contacts may also increase the inflammation.  Thirdly, see a medical professional to determine if you are suffering from allergic conjunctivitis or another cause of the inflammation.  Diagnosis is critical to receiving appropriate care.

If allergic conjunctivitis is the cause, natural tears may provide relief of symptoms.  Individuals may also try oral antihistamines to provide relief especially if there are associated nasal symptoms. 

Prescription medications may include ocular decongestants, antihistamines, and steroids.  Decongestants reduce the redness but may only be used for a short time since extended use may result in rebound redness.  Antihistamines help to block the allergic response and may contain anti-inflammatory components which provide relief for the patient.  Ocular steroids may also be used but are usually only prescribed for short periods due to side effects associated with long term use

Special care must be provided to individuals with eye disease such as cataracts and glaucoma and for those who wear contacts. 

For long term treatment of conjunctivitis caused by allergies, one may consider allergy immunotherapy.  Once allergens are determined by allergy testing, an individual can receive gradually increasing doses of the allergy via injection until a "maintenance" dose is reached.  Allergy immunotherapy is completed over the process of about five years after which time a patient may have years-long or life long relief of symptoms.

Allergic Conjunctivitis - What are the take home points?

  • Identify your allergens so that you may try to avoid them.
  • If symptoms begin, do not rub eyes, avoid other irritants such as contacts.
  • Seek treatment from a medical professional so that a correct diagnosis may be given and appropriate medication provided.
  • Consider long-term treatment for long-term relief. Allergy immunotherapy may provide you an opportunity to stop the medications, stop the inflammation, and stop the conjunctivitis.

Andrea Perkins is a family nurse practitioner providing assessment and care for patients at Springfield Clinic's Allergy and Immunology Department.


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