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Eye Allergies Q&A with Dr Gerdes

We interviewed our optometrist, Dr. Gerdes, to find out what allergy sufferers can do to get relief this spring. Book your consultation at Eye Fashion Optical, today.

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1) Please describe the more common symptoms, as well as some of the less common and less known symptoms of Eye Allergies.

Food Allergies, Seasonal Allergies, and Pet Allergies. Other allergies are Hay Fever, Allergic Conjunctivitis (Pink Eye), Hives, Allergies to Poison Ivy, Oak and Sumac. Allergies to Insect Stings (Bee Stings), Mold, Pollen, Sun Reactions of the Skin, Aspirin, Cosmetic, Nickel, Drug, Dust, Chemical and Penicillin Allergy.

2) Is there anything unique about allergies that affect the eyes, or is this the same as general allergies?

Approximately 54 million people, about 20% of the U.S. population, have allergies. Almost half of these people have allergic eye disease. People who are more susceptible to allergic eye disease are those with a history of allergic rhinitis and atopic dermatitis and those with a strong family and/or personal history of allergy. Symptoms usually appear before the age of 30.

The scenario for developing allergy symptoms is much the same for the eyes as that for the nose. Allergens cause the allergy antibody IgE to coat numerous mast cells in the conjunctiva. Upon reexposure to the allergen, the mast cell is prompted to release histamine and other mediators. The result is itching, burning, and runny eyes that become red and irritated due to inflammation, which results in congestion. The eyelids may swell, even to the point of closing altogether. Sometimes, the conjunctiva swells with fluid and protrudes from the surface of the eye, resembling a "hive" on the eye. These reactions may also induce light sensitivity. Typically, both eyes are affected by an allergic reaction. Occasionally, only one eye is involved, particularly when only one eye is rubbed with an allergen, as this causes mast cells to release more histamine.

3) What causes Eye Allergies?

Allergic conjunctivitis, also called "allergic rhinoconjunctivitis," is the most common allergic eye disorder. The condition is usually seasonal and is associated with hay fever. The main cause is pollens, although indoor allergens such as dust mites, molds, and dander from household pets such as cats and dogs may affect the eyes year-round. Typical complaints include itching, redness, tearing, burning, watery discharge, and eyelid swelling. To a large degree, the acute (initial) symptoms appear related to histamine release.

Eye allergies usually are associated with other allergic conditions, particularly hay fever (allergic rhinitis) and atopic eczema (dermatitis). The causes of eye allergies are similar to those of allergic asthma and hay fever. Medications and cosmetics can play a significant role in causing eye allergies. Reactions to eye irritants and other eye conditions (for example, infections such as pinkeye) are often confused with eye allergy. Any kind of irritant, whether environmental, infectious, or manmade, can cause symptoms consistent with eye allergies.

4) Is it true that there are certain times of the year that are worse, or is the whole year a problem?

Pollen is the most common allergen to cause conjunctivitis in countries that have cold winters (not near the equator like Waco, TX is). If you get conjunctivitis from pollen you will probably have symptoms of hay fever, which includes sneezing, blocked or runny nose, itchy nose, and itchy and watery eyes. When the conjunctivitis occurs along with sneezing and blocked nose, etc., the whole thing is called hay fever. This type of conjunctivitis is called seasonal allergic conjunctivitis (allergic rhinoconjunctivitis) because it almost exclusively occurs during the spring and summer months when plants, especially grass, trees, and flowers are in pollen. Some people even have symptoms during early autumn (fall).

5) What type of treatment options are available for patients that come in to see their optometrist with eye allergy symptoms?

Most allergic eye conditions are more irritating than dangerous.

– Allergic or vernal keratoconjunctivitis may result in scarring of the cornea and visual problems.

– Itchy eyes are probably allergic eyes.

– Topical antihistamine/decongestant preparations are effective and safe for mildly itchy, red eyes.

– Patanol, a topical mast-cell stabilizer, is a safe, highly effective, long-acting treatment.

– Topical steroids should be used with caution and under the supervision of an Optometrist.

If in doubt, seek medical advice at Texas State Optical sooner rather than later.

6) Are there treatments for eye allergies that offer permanent relief, or only temporary?

The prognosis is favorable for most patients with eye allergies. Typically symptoms clear up quickly with OTC/home treatment or when the offending allergen is not present any more. Unfortunately the symptoms may reoccur depending on the cause of the eye allergy. Complications are very rare, but medical attentions should be sought immediately for any pain or vision loss that occurs or for symptoms that do not resolve within 12 hours.

Avoiding the triggers is the cornerstone of allergy treatment. It is particularly important to avoid both airborne and contact allergens. Remember, rubbing your eyes is a physical trigger and therefore must be avoided.

7) Is it possible to wear contact lenses without causing additional discomfort?

Allergy to contact lenses is most common among wearers of hard contact lenses and is least common among those who use disposable lenses, especially the one-day or one-week types. Sleeping with the contact lenses on greatly increases the risk of developing GPC. The most effective treatment is to stop wearing the contact lenses. Occasionally, changing the type of lens in addition to more frequent cleaning or using disposable daily wear lenses will prevent the condition from recurring.

The giant papillae on the conjunctiva, which are characteristic of GPC, however, may persist for months despite these measures. Eye medications often are used in this condition, sometimes for several months. Contact lenses should not be worn while these medications are being used.

8) Can you provide general recommendations that may help people suffering from Eye Allergies?

Most commonly, home care consists of flushing the eye with water and applying cool compresses as needed along with OTC ocular lubricants. With exposure to an allergen to the eye, it is important to thoroughly flush the eye with lukewarm tap water or commercially prepared eyewash solution. If these remedies are not working or if there is eye pain, extreme redness, or heavy discharge, you should seek medical advice. Some conditions, for example, are serious with potential sight-threatening complications if required treatment is delayed.