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Everything You Don't Know About Eye Allergies

Everything You Don't Know About Eye Allergies

Everything You Don't Know About Eye Allergies

 Are you familiar with all of the unpleasant signs of allergies? If you are one of the millions of people who are affected by allergies, this list of symptoms should appear only too familiar:

  • Sneezing.
  • Congestion.
  • Runny nose.
  • Sore throat.
  • Itchy burning and watery eyes

Often the most irritating symptom on this list is the last one - the red, weepy, burning eyes that are often a result of exposure to an allergen.

It can be embarrassing when you start to "cry" in front of a new acquaintance because of your allergies - but the truth is that this may not be the worst that eye allergies has in store. The tears that cause make-up or pride to run can cause other concerns. The blurred vision associated with watering or mucous produced by irritated eyes can turn you into a safety hazard on the road. For some of the most severe cases, there is a chance that eye allergies can threaten your eyesight permanently.

The itchy, burning sensation that causes your eyes to water should not be confused with the tears that come from allergy-related sinus pressure. When your head feels "stuffed up" sometimes the pressure affects the almond-sized glands above your eyes that produce tears. This pressure causes your eyes to start flowing. Eye allergies are very different that the tears caused by sinus pressure. People with eye allergies will also experience redness and irritation, which is often described as a burning, itching or tired sensation.

So how can you be sure that you have eye allergies? If you do have this condition, what can you do to curb the burn and tearfulness? The information in article should give you a fighting chance when it comes to overcoming eye allergies.

What are the allergens?

Eye allergy (more formally called ocular allergy) affects the thin tissue (known as the conjunctiva) that covers the white part of the eye as well as the insides of the eye lids. This tissue acts as a barrier to protect your eyes from invading particles, microbes and other debris. Another player in ocular allergies is the tear gland. Tears aren't simply made up of water - they actually contain important immune defense substances, like immunoglobulin (antibodies), lymphocytes (specialized white blood cells) and enzymes. When airborne allergens collide with your eyes, an allergic reaction is kicked off in the conjunctiva which causes itching and burning, red color and swelling.

Once the eye is irritated by contact with pollen or pet dander or some other allergy trigger, your tear glands do their best to flush the offensive allergen from the eyes. This attempt to flush irritants out of the eye is what causes your eyes to flood with tears. The irony of eye allergies is that your body is trying to protect you-- but it accidentally is making you feel miserable in the process!

How are eye allergies different than other allergies?

Eye allergies are actually the same as any other type of allergies. The tissues that make up the allergy-sensitive areas of your eyes are very similar to the tissues in your nose and throat. Eye allergies often co-exist with other allergic conditions like hay fever (nasal allergies) and even eczema (skin allergies). The biggest difference between eye allergies and any other type of allergy is the way that the allergen comes in contact with you.

There are a couple of ways for allergens to find their way into your eyes:

  • Airborne allergens can enter the eyes by simply walking into an area where the source of the allergen is located
  • Another common way for allergens to enter your eyes is by simply rubbing or touching the area around your eyes with your hands. Sometimes rubbing your eyes after they start burning just helps to spread more allergens to the area.

Nasal allergies are almost always triggered by inhaling airborne allergens like pollen or animal dander. People with allergic eyes often have a strong family or personal history of allergies-- and most likely are going to experience eye allergy symptoms before the age of 30.

Two common types of eye allergies:

  • Seasonal Allergic Conjunctivitis (SAC).
  • Perennial Allergic Conjunctivitis (PAC).

The main difference between these two common forms of ocular allergy is their timing.

You have Seasonal Allergic Conjunctivitis (PAC) if you:

  1. Usually have symptoms for a short period of time.
  2. Are bothered by the spring tree pollen, or in the summer by grass pollen, or in the fall by weed pollen.
  3. Generally have period during the year where your symptoms completely disappear - usually this occurs in the winter.

You have Perennial Allergic Conjunctivitis (PAC) if you:

  • Have symptoms that last throughout the year.
  • Are bothered by indoor allergens like dust mites, cockroaches and pet dander
  • Find that seasonal outdoor allergies worsen your eye allergies if you are sensitive to them as well.

Here Are Some Common Allergen Triggers for Eyes:

  • Pollen.
  • Grass.
  • Weeds.
  • Dust.
  • Pet hair or dander.
  • Some medicines or cosmetics.

There are also some elements that irritate eyes but are not actually considered to be allergens:

  • Cigarette smoke.
  • Perfume.
  • Diesel Exhaust.

Symptoms of Eye Allergies:

  • Redness.
  • Tearing.
  • Burning sensation.
  • Blurred vision.
  • Mattering and/or mucous production.
  • Swelling of the eye.

When Should You Seek Medical Care?

Some people find that it is easy to pinpoint the exact cause of their allergies and avoid the triggers completely (i.e. if allergic to pets, refraining from petting them or keeping no pets yourself). But, if you are unable to indentify the source of your reactions - or simply cannot avoid contact, you should see an ophthalmologist (a doctor who specializes in conditions and care of the eyes).

If you have SAC, you may want to make an appointment with your ophthalmologist before the season when your eye allergies flare up. This way, you can start some sort of treatment or prevention program before you begin feeling symptoms.

If you have PAC, you may want to routinely have appointments with your ophthalmologist to make sure that your eye allergies are being monitored. Occasional flare-ups will make it necessary to keep your eye doctor up to date with your condition. You may also want to consult an allergist (a doctor who specializes in allergic diseases, like nasal allergies and allergic asthma).

Important Questions for You to Ask Your Doctor:

  1. Is there a specific cause of my eye allergies? Can it be identified?
  2. How can I reduce my symptoms or control occasional flare-ups?

These are two important questions that will help to determine whether you can better avoid contact with your trigger allergen or find some sort of treatment to alleviate the irritation.

Conditions Often Confused with Eye Allergies

Here are a few conditions that can commonly be confused with ocular allergies:

  • Dry Eye: Reduced tear production (or "dry eyes") is a condition that is frequently confused with allergies. The main symptoms of reduced tear production are burning, grittiness or the sensation of "something in the eye". Most people with dry eyes are over the age of 65. This condition will definitely be worsened by the use of oral antihistamines (regardless of age of patient), sedatives and b-blocker medications.
  • obstruction - or blockage - forms in the tear duct passage that travels from the eyes to the nasal cavity. Most people with tear duct obstruction are elderly. The primary symptom is watery eyes with none of the itching or burning that is associated with allergy eyes.
  • Conjunctivitis Due to Infection: Infections in the eye are caused by bacteria or viruses. In bacterial infections, the eyes are often bright red and after periods of being closed, the eye lids stick together (especially in the morning). Discolored mucous is often seen (so-called "dirty eyes"). Viral infections cause only slight redness and a glassy appearance in the eyes. Some eye viruses are spread very easily, by either direct contact (from eye to hand to hand to eye) or in contaminated swimming pools. For all of these conditions, it is recommended that you see your primary care doctor immediately.

Testing and Treatment

The best was to determine whether you have eye allergies or not is by visiting your ophthalmologist. A doctor can check for the signs usually associated with the condition. In most cases, this involves using a specialized microscope called a stilt lamp. When examining your eyes with the stilt lamp, the ophthalmologist is looking for dilated blood vessels, conjunctival swelling and eyelid swelling. These are all the usual signs of an allergic reaction in the eye and surround tissue.

On rare occasions, the ophthalmologist with carefully scrape the surface of the conjunctiva. The goal is to check tiny cells removed for traces of eosinophils. Eosinophils are cells commonly tied to severe cases of allergies.

For those with mild to moderate eye allergies, there is a list of over the counter as well as prescription drugs available. Most medicines come in the form of eye drops, which are usually an effective treatment that have little or no systemic side effects. Most drops are used only twice a day. Some of the most common brands prescribed are:

  • Nedocromil (Alocril).
  • Ketotifen (Zaditor).
  • Olopatadine (Patanol).
  • Azelastine (Optivar).
  • Pemirolast (Alamast).
  • Epinastine (Elestat).

For more severe cases, your ophthalmologist may recommend using a topical ophthalmic corticosteroid. Older forms of corticosteroids can cause side effects when used over a long period of time. The newer forms of corticosteroids have much less risk associated with them. Some of the most common brands of topical ophthalmic corticosteroids are:

  • Loteprednol 0.02% (Alrex).
  • Loteprednol 0.05% (Lotemax).
  • Prednisolone (AK-Pred).
  • Rimexolone (Vexol).
  • Medrysone (HMS).
  • Fluorometholone (FML, FML Forte, FML Liquifilm).

Home Care

Whether you make an appointment with your eye doctor or decide that you can suffer through the brief seasonal flare-ups, here are some tips to help you help yourself.

Avoidance of Allergen Triggers:

  1. Reduce the number of places where allergens can lurk in your home by limiting the number of knick-knacks, pillows, dust ruffles, curtains and canopies in your home. All of these are the favorite collecting places of dust and other allergens like dust mites and pollen.
  2. Follow the prescribed method of reducing nasal allergens in your home - the same things that trigger nasal allergies and allergic asthma will affect your eyes as well. So, if you are allergic to dust mites, consider getting a dust mite-proof mattress cover and bedding. Eliminate water leaks or excess condensation if you are allergic to mold spores. There are a number of resources to help you remove allergens from your environment
  3. Avoid pet dander - this means staying away from animals, but also being cautious about dander that may spread onto your clothing or hands while visiting a friend with pets, sitting in a chair where a pet usually sleeps, etc

Ease Allergic Reactions at Home:

  1. Do not rub your eyes. This is the most natural reaction to the itchiness you might feel in your eyes, but by rubbing your eyes, you are stirring up the irritation even more. Also, the hand-to-eye contact may actually introduce more allergens to your eyes. Remember: do not to rub your eyes during an allergic reaction, because this will actually cause more irritation.
  2. Splash your face with water if you are starting to feel like your eyes are getting itchy. The water will actually help rinse allergens off of your face and away from your eyes.
  3. If you sense that you have come into contact with allergens or start to feel your eyes burn, use artificial tears/lubricating drops to flush allergens out of your eyes.
  4. Apply cold compressed to your eyes to reduce the swelling and irritation caused by the allergic reaction.