Eye Conditions

Eye allergies: Causes and treatment of itchy, red and watery eyes

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

Eye allergies (also called ocular allergies) also appear to be on the rise worldwide. In particular, increases in environmental pollution in industrialized and developing nations appears to be a major contributor to the heightened sensitivity of allergic individuals and the increasing numbers of people suffering from ocular allergies.

In addition to symptoms of sneezing, congestion and a runny nose, most of these allergy sufferers also experience itchy eyes, water eyes, red eyes and swollen eyelids.

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.  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 airborne allergens, consider reducing your contact lens wear during allergy season. Or consider switching to daily disposable contacts that you discard after a single use to prevent allergens and other debris from accumulating on the lenses.

Often the best choice if allergies are bothering your eyes is to discontinue wearing contacts altogether — at least until all your allergy symptoms are gone. Also, wearing eyeglasses with photochromic lenses can reduce allergy-related sensitivity to light and can help shield your eyes from airborne allergens.

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, non-prescription eye drops for allergy relief may work very well for you. These also may be less expensive than prescription eye drops or other medications. Ask your eye doctor for recommendations.

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 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 doctors 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 buildup 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.

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