Clearing the Air: Understanding and Managing Ocular Allergies

Allergies and allergic responses are the body's response to a foreign substance, generally a protein, like pollen, pet dander, medications, or foods. In most cases, an allergic response is the body overreacting to an allergen, which can cause significant problems. In the eye, allergy symptoms are not life-threatening, but they are annoying. Itching, watering, sticky and redness are the most common symptoms we see in our patients. 

Allergic responses are caused by our immune system trying to protect us from allergens, but our body tends to overdo it. When our eyes come into contact with pollen, pet dander, our mast cells degranulate like a dandelion in the wind. When these mast cells are full of histamines, they can cause problems like itching, inflammation, and redness. Histamines also cause the eye (Conjunctiva) to secrete mucus; the same mucus your nose produces during allergy season.

When eye doctors look for signs of ocular allergies, we look for bumps inside the eyelids called papillae. Papillae allow us to confirm the diagnosis of allergies and rule out bacterial or viral conjunctivitis. Allergic conjunctivitis is the most common cause of red eyes in the United States. Because we see more allergic conjunctivitis than we do bacterial or viral, most patients likely will not need antibiotic eye drops of any kind. Antibiotic drops will NOT help against allergic conjunctivitis and should not be prescribed. Red eye is not typically considered contagious by eyecare specialists because bacterial and viral conjunctivitis are rare. However, some doctors may prescribe antibiotics for all red eyes. 

Eye care specialists recommend using dual action drops called antihistamines (or mast cell stabilizers) to treat ocular allergies. Some of the best antihistamines are available over the counter. These drops keep the mast cells from releasing their histamines and block histamine receptors. They help to stop ocular allergy symptoms before they start. Our favorites are Lastacaft and Pataday Extra Strength. We like these drops because they are taken once-a-day and have nearly no side effects. Some may burn or cause blurred vision for a few seconds after application, but that's normal. It is best to start using these drops at the beginning of allergy season and continue daily – no matter what. For those with pets, you will need to use these drops daily, no matter what. Stop the symptoms before the start. It’s important to remember that symptoms of allergic conjunctivitis are annoying, not vision or life-threatening.

Other treatments for ocular allergies include cool compresses, oral antihistamines like Claritin, Zyrtec, Allegra, or Xyzal (the newest), and even ibuprofen. If you are trying to figure out what to do, text or call us; that is what we are here for. We will figure out which type of conjunctivitis it is and get the proper treatment for you.