
Are you familiar with the aggravating symptoms of an allergic reaction? If you are one of the millions affected by allergies, the following list should seem quite familiar:
Sneezing
Congestion
Runny nose
Sore throat
Itchy, burning and watery eyes
Often the most irritating symptom on this list are the red, weepy, burning eyes that are often a result of exposure to an allergen.
Though appearing to cry while talking to a new acquaintance may cause make-up or pride to run, it may not be the worst that eye allergies can serve up. The blurred vision associated with tears and mucous produced by irritated eyes can make simple tasks very difficult—even dangerous. In the most severe cases, there is a chance that eye allergies can threaten your eyesight permanently.
It is important not to confuse this type of itchy, burning sensation that causes your eyes to water with the tears that come from allergy-related sinus pressure. A “stuffed up” head may put pressure on the almond-sized glands that produce tears, causing your eyes to start flowing, but with no major discomfort to the delicate areas of the eye. Eye allergies differ from sinus related eye watering because of the redness and irritation that comes with this condition. Do you think that you might have eye allergies and wonder what can you do to curb the burn and tearfulness? This article should give you an edge when it comes to facing eye allergies.
Know Your Enemy
What are eye allergies?
Eye allergies are more formally known as ocular allergies. Not matter what term you use to describe it, this condition 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 conjunctiva tissue acts as a barrier to protect your eyes from invading particles, microbes and other debris. Another irritating element in ocular allergy is the tear gland—tears actually contain important immune defense substances, like immunoglobulin (antibodies), lymphocytes (specialized white blood cells) and enzymes.
As airborne allergens collide with your eyes, an allergic reaction is sparked within the cells of the conjunctiva which causes itching and burning sensations, red color and swelling. In response, your tear ducts reflexively do their best to flush the offensive allergen from the eyes, causing your eyes to flood with tears.
The ironic aspect of this variety of allergies is that it is caused by your body’s attempt to protect you—but accidentally making you feel miserable in the process!
How are eye allergies different than other allergies?
The truth is that eye allergies are working in the same way as your nasal or seasonal allergies, but instead of affecting your nose and airways, it remains localized in the tissue of the eyes. Some people have both nasal and eye allergies, and simply do not realize that treating one may not help the other. Individuals with hay fever (nasal allergies) and even eczema (skin allergies) are most likely to also experience eye allergies.
Ocular allergies can take two different routes to your eyes, whereas, nasal allergies are usually only triggered by inhaling airborne allergens like pollen or animal dander. Eyes are affected by allergens in the air, but another way that the irritating substances find your eyes is by traveling there on your hands. Rubbing or touching the area around your eyes can result in exposing yourself to allergens on your hands.
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.
If you have Seasonal Allergic Conjunctivitis (PAC), you:
A) Usually have symptoms for a short period of time.
B) May be bothered by the spring tree pollen, or in the summer by grass pollen, or in the fall by weed pollen.
C) Generally have period during the year where your symptoms are resolved—especially in the winter.
If you have Perennial Allergic Conjunctivitis (PAC), you:
A) Have symptoms that last throughout the year.
B) Instead of outdoor allergens, you have problems with indoor allergens like dust mites, cockroaches and pet dander.
C) Seasonal outdoor allergies may worsen your eye allergies if you are sensitive to them as well.
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 allergens:
· Cigarette smoke
· Perfume
· Diesel Exhaust
Symptoms of Eye Allergies:
· Redness
· Tearing
· Mattering and/or mucous production
· Swelling of the eye
When to seek medical care
If you know what elements you are allergic to, sometimes avoiding contact with them can help improve your eye allergies dramatically (i.e. if allergic to pets, refrain from petting them or keep no pets yourself). However, if you are unable to indentify the source of your reactions—or simply cannot avoid contact—you might consider seeing an ophthalmologist (a doctor who specializes in condition 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 start feeling symptoms.
If you have PAC, you may want to routinely have appointments with you ophthalmologist to make sure that your eye allergies are being monitored. Regular 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 your doctor:
· Is there a specific cause of my eye allergies? Can it be indentified?
· How can I reduce my symptoms or control occasional flare-ups?
These two questions are important 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 is frequently confused with allergies. The main symptoms: burning, grittiness or the sensation of “something in the eye”. Most people with dry eye 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.
· Tear Duct Obstruction: Blockage 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 no itching or burning.
· Conjunctivitis Due to Infection: Infections caused by bacteria or viruses. In bacterial infections, the eyes are often bright red, the eye lids stick together (especially in the morning). Discolored mucous is often seen (so-called “dirty eyes”). In viral infections cause slight redness and glassy appearance in the eyes. Some eye viruses are spread very easily, by either direct contact or in contaminated swimming pools.

For all of these conditions, it is recommended that you see your primary care doctor immediately.
To determine whether you have eye allergies, your ophthalmologist can check for the signs usually associated with the condition. Most cases, this involved 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—or, all the usual signs of an allergic reaction in the eye and surrounding 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, this are certain 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 come with 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 were the cause with ocular 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)
Whether you feel your ocular allergies are troublesome enough to bring you to visit an eye doctor, or you prefer to suffer through the brief seasonal flare-up’s, here are a few tips to help you help yourself.
Avoidance of Allergen Triggers:
1. Reduce the number of places where allergens can hide 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 allergen in your home—the same things that trigger nasal allergies and allergic asthma will affect you 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, like Air Quality Tips.com and Allergizer.com.
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.
4. Use HEPA filters in your furnace and air conditioning units like those made by
Dynamic Air Quality Systems. You might even want to consider using a bedroom sized
allergy air filter for your room. Just remember to change the filters regularly—mark it on your calendar.
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. Try your best to remember not to rub your eyes during an allergic reaction.
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/eye area.
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.
