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A Breakdown of Ocular Allergies by Dr. Wang

spring allergies

Are your eyes constantly red? Do people always ask you why you always look like you have been crying? Redness and puffiness around the eyes could be a sign of chronic allergic conjunctivitis associated with environmental allergies.

A Chemical Chain Reaction

An allergic reaction is an immune system response to benign or nonthreatening things in our environment called allergens. Common allergens include dust mites, pollen, mold and pet dander. When the body is exposed to these allergens for extended periods or over the course of a long time, the body’s immune system sends antibodies called Immunoglobulin (IgE) to where the offending allergens are. The result is a complex chemical reaction leading to histamine-containing mast cells to degranulate or burst open and release histamine to the surrounding tissues. As the allergic chain reaction continues, more and more mast cells continue degranulating, increasing the histamine concentration, causing swelling and increased mucus secretion.

Unfortunately, Hampton Roads consistently ranks in the top 50 worst places for allergies according to the Asthma and Allergy Foundation of America. At some point during the year, we all notice a yellow dusty film coating our cars, sidewalks, patio furniture, and windowsills. When we see these clouds of yellow pollen blowing around, many people who live in Hampton Roads start to notice increased sinus congestion, throat scratchiness, asthma, or eye allergy symptoms. Common eye allergy symptoms include:

  • Redness
  • Itchiness
  • Burning feeling
  • Watery eyes
  • Swollen eyes or eyelids
  • Feeling like there is dirt or grit in your eyes
  • Intermittent blurriness
  • Increased sensitivity to light
  • white or clear, stringy, mucus discharge

Although eye allergies can be annoying, it is not a serious condition and not contagious. However, symptoms can be similar to infectious conjunctivitis caused by germs such as bacteria, viruses, fungi, or protozoa. Infections can result in more serious consequences if not treated appropriately, including loss of vision or permanent blindness. If you have any of the above symptoms, you should contact your eye care provider and be evaluated to determine the best course of treatment.

Treatment and Management of Eye Allergies

The best option to manage eye allergies is to avoid or minimizing exposure to the offending allergen. Strategies include:

  • washing hands after petting or grooming animals, being outside, or dusting/cleaning
  • showering after coming indoors to wash away the pollen that are stuck to your body
  • keeping windows in the house and in your car closed
  • vacuuming the house regularly with a HEPA (High Efficiency Particulate Air)-filtered vacuum cleaner to reduce allergen accumulating indoors
  • showering before going to bed to reduce the amount of allergens that you bring into your bed
  • washing bed linens and towels regularly to reduce allergen build up
  • using hypoallergenic pillow covers and bed covers.

The next best option for managing allergies is taking allergy medications before allergic symptoms start to become an issue. If you have historically suffered from seasonal or perennial allergies, daily oral antihistamines during allergy season or all year round (if you are a year-long allergy sufferer) can help to reduce the severity of your symptoms. Some oral antihistamines may cause drowsiness. Some good non-drowsy oral antihistamines are now available over-the-counter without a prescription (Claritin, Allegra, Zyrtec, Xyzal). Antihistamines compete with the histamines that are secreted during an allergic reaction and slow down the chain reaction that happens. Using allergy eye drops specifically target the allergic reaction in the eyes. Some tips that help specifically with eye allergies include:

  • avoid using eye drops that advertise that they “get the red out” or “redness reliever” as they contain vasoconstrictors that are not recommended for long-term use
  • wearing sunglasses and brimmed hats while outside to reduce exposure to outdoor allergens
  • reducing contact lens wear or switching to daily replacement contact lenses
  • using artificial tears to wash away pollen or dust particles after being outside
  • combination antihistamine/mast cell stabilizer drops (Pataday, Alaway, Zaditor) used daily during allergy season or all year round prevent the allergic reaction from getting started in the eyes

If your eye allergy symptoms persist, even with the above tips, stronger eye drops such are corticosteroids may be needed. These drops potentially have long-term side effects and must be monitored closely by your eye care provider. Patients with severe allergies that are not well-managed with oral allergy medicines and/or allergy eye drops, immunotherapy (allergy shots) may helpful in providing long-term relief from allergies.

Dr. Abhner Wang