Why Your Eyes Might Be Red and Itchy

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Eye allergies — red, itchy, watery eyes that are bothered by the same irritants that cause sneezing and a runny nose among seasonal allergy sufferers — are very common.

The American College of Allergy, Asthma and Immunology estimates that 50 million people in the United States have seasonal allergies, and its prevalence is increasing — affecting up to 30 percent of adults and up to 40 percent of children. In addition to having symptoms of sneezing, congestion and a runny nose, most of these allergy sufferers also experience itchy eyes, watery eyes, red eyesand swollen eyelids. And in some cases, eye allergies can play a role in conjunctivitis (pink eye) and other eye infections.

If you think you have eye allergies, here are a few things you should know — including helpful tips on how to get relief from your red, itchy, watery eyes.

What Causes Eye Allergies

Normally harmless substances that cause problems for individuals who are predisposed to allergic reactions are called allergens. The most common airborne allergens that cause eye allergies are pollen, mold, dust and pet dander. Eye allergies also can be caused by reactions to certain cosmetics or eye drops, including artificial tears used for treating dry eyes that contain preservatives. Food allergies and allergic reactions to bee stings or other insect bites typically do not affect the eyes as severely as airborne allergens do.

Eye Allergy Relief

To get relief from your eye allergies and itchy, watery eyes, you can take a few approaches:

Avoiding allergens

As the old saying goes: “An ounce of prevention is worth a pound of cure.” (By the way, Benjamin Franklin said that — the same guy who invented bifocals!) The best approach to controlling your eye allergy symptoms is to do everything you can to limit your exposure to common allergens you are sensitive to.

For example, on days when the pollen count is high, stay indoors as much as possible, with the air conditioner running to filter the air. Use high quality furnace filters that can trap common allergens and replace the filters frequently. When you do go outdoors during allergy season, wear wraparound sunglasses to help shield your eyes from pollen, ragweed, etc., and drive with your windows closed.

Removing your contacts

 Because the surface of contact lenses can attract and accumulate airborne allergens, consider wearing only eyeglasses during allergy season. Or consider switching to daily disposable contacts that you discard after a single use to avoid the build-up of allergens and other debris on your lenses.

Over-the counter eye drops

 Because eye allergies are so common, there are a number of brands of non-prescription eye drops available that are formulated to relieve itchiness, redness and watery eyes caused by allergies.

If your eye allergy symptoms are relatively mild, over-the-counter eye drops for allergy relief may work very well for you and may be less expensive than prescription eye drops or other medication. Ask your eye doctor to recommend a brand to try.

Prescription medications

 If your allergy symptoms are relatively severe or over-the-counter eye drops are ineffective at providing relief, you may need your eye doctor to prescribe a stronger medication.

Prescription eye drops and oral medications used to relieve eye allergies include:

Antihistamines

 Part of the body’s natural allergic response is the release of histamine, a substance that dilates blood vessels and making the walls of blood vessels abnormally permeable. Symptoms caused by histamine include a runny nose and itchy, watery eyes. Antihistamines reduce allergic reactions by blocking the attachment of histamine to cells in the body that produce an allergic response.

Decongestants

 Decongestants help shrink swollen nasal passages for easier breathing. They also reduce the size of blood vessels on the white (sclera) of the eye to relieve red eyes. Common decongestants include phenylephrine and pseudoephedrine. Combination drugs are available that contain both an antihistamine and a decongestant.

Mast cell stabilizers

These medications cause changes in mast cells that prevent them from releasing of histamine and related mediators of allergic reactions. Because it may take several weeks for the full effects of mast cell stabilizers to take effect, these medications are best used before allergy season starts as a method to prevent or reduce the severity of future allergic reactions (rather than to treat acute allergic symptoms that already exist).

Nonsteroidal anti-inflammatory drugs

 NSAID eye drops may be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis, also called hay fever.

Steroids

Corticosteroid eye drops are sometimes prescribed to provide relief from acute eye allergy symptoms. But potential side effects of long-term use of these medications include high eye pressure, glaucoma and cataracts, so they typically are prescribed for short-term use only.

Immunotherapy

 This is a treatment where an allergy specialist injects you with small amounts of allergens to help you gradually build up immunity.

Eye Allergies Self-Test

Common allergens include pollen, animal dander and mold.

Take this quiz to see if you might have eye allergies. Always consult your doctor if you suspect you have an eye condition needing care.

  • Do allergies run in your family?
  • Do your eyes often itch, particularly during spring pollen season?
  • Have you ever been diagnosed with “pink eye” (conjunctivitis)?
  • Are you allergic to certain animals, such as cats?
  • Do you often need antihistamines and/or decongestants to control sneezing, coughing and congestion?
  • When pollen is in the air, are your eyes less red and itchy when you stay indoors under an air conditioner?
  • Do your eyes begin tearing when you wear certain cosmetics or lotions, or when you’re around certain strong perfumes?

If you answered “yes” to most of these questions, then you may have eye allergies. Make an appointment with an optometrist or ophthalmologist to determine the best course of action.

Eye Allergies And Contact Lenses

Contact lens discomfort is a common complaint during allergy season, leading some wearers to question whether they are becoming allergic to contact lenses. The issue of being allergic to contacts also comes up from time to time when a person starts wearing silicone hydrogel contact lenses after successfully wearing standard soft (hydrogel) contact lenses and experiences allergy-like symptoms.

Studies have shown that the culprit behind eye allergies associated with contact lens wear is not an allergic reaction to the contact lens itself, but to substances that accumulate on the surface of the lenses. In the case of switching from regular soft contacts to silicone hydrogel lenses, the surface and chemical characteristics of the lens material may attract lens deposits more readily than the previous lens material, causing discomfort.

Many eye care practitioners believe the best type of soft contact lenses for people prone to eye allergies are daily disposable lenses that are discarded after a single use, which decreases the build-up of allergens and other debris on the lens surface. Silicone hydrogel often is the preferred lens material for these lenses, because it allows significantly more oxygen to pass through the lens, compared with conventional soft contact lens materials

How Are Eye Allergies Treated?

The best way to treat an eye allergy is to avoid the allergen that is causing it. However, this isn’t always possible, especially if you have seasonal allergies. Luckily, there are numerous different treatments that can relieve eye allergy symptoms.

Medications

Certain oral medications can help alleviate eye allergies, especially when other allergy symptoms are present. These medications include:

  • antihistamines, such as loratadine (Claritin) or diphenhydramine (Benadryl)
  • decongestants, such as pseudoephedrine (Sudafed) or oxymetazoline (Afrin nasal spray)
  • steroids, such as prednisone (Deltasone)

Allergy Shots

Allergy shots may be recommended if symptoms don’t improve with medication. Allergy shots are a form of immunotherapy that involves a series of injections of the allergen. The amount of allergen in the shot steadily increases over time. The allergy shots modify your body’s response to the allergen, which helps reduce the severity of your allergic reactions.

Eyedrops

Many different types of prescription and over-the-counter eyedrops are available to treat eye allergies.

Eyedrops frequently prescribed for eye allergies contain olopatadine hydrochloride, an ingredient that can effectively relieve symptoms associated with an allergic reaction. Such eyedrops are available under the brand names Pataday and Patanol. Over-the-counter options include lubricating eyedrops, such as “artificial tears,” which can help wash allergens from the eyes. Other eyedrops have antihistamine or nonsteroidal anti-inflammatory (NSAID) medications. Some eyedrops must be used every day, while others can be used as needed to relieve symptoms.

Eyedrops may cause burning or stinging at first. Any unpleasantness usually resolves within a few minutes. Some eyedrops may cause side effects, such as irritation. It’s important to ask your doctor which over-the-counter eyedrops work best before selecting a brand on your own.

Natural Remedies

Several natural remedies have been used to treat eye allergies with varying degrees of success, including allium cepa (made from red onion), euphorbium, and galphimia. Make sure to contact your doctor about the safety and effectiveness of these remedies before you try them.

A cool, moist washcloth may also provide relief for people with eye allergies. You can try placing the washcloth over closed eyes several times a day. This can help alleviate dryness as well as irritation. However, it’s important to note that this method doesn’t directly treat the underlying cause of the allergic reaction.

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