Eye Allergy (cont.)
What are eyelid allergies (also called contact eye
allergies)?
Contact eye allergies are essentially contact dermatitis of the eyelids. This is allergic inflammation of the eyelid from direct contact with certain allergens. Women in particular may experience this problem due to allergic reactions to preservatives in eye products and makeup (for
example, eye creams, eye pencils, mascara, and nail polish -- from rubbing the eye with the fingers). Other irritants include common over-the-counter (OTC) ointments such as neomycin/bacitracin/polymyxin (Neosporin or Bacitracin) as well as contact lens solutions (especially if they contain thimerosal). Symptoms that are similar to those of a poison ivy rash appear 24 to 48 hours after exposure to the offending agent. The eyelids may develop blisters, itching, and redness. The conjunctiva may also become red and watery. If the eyelids continually come into contact with the offending allergens, the lids may become chronically (long-term) inflamed and thickened.
The best treatment for eyelid allergies is avoidance of the sensitizing agent(s). Changing to hypoallergenic lens solutions, cosmetics, or topical eye products is usually necessary. Application of a mild topical corticosteroid cream for short periods will probably help. As is the case with atopic dermatitis, it is important to treat any secondary bacterial infection that may develop.
What conditions can be confused with eye allergies?
The following is a list of conditions, the symptoms of
which are commonly confused with eye allergy.
- Dry eye: This condition results from reduced tear production and is frequently confused with allergy. The main symptoms are usually burning, grittiness, or the sensation of "something in the eye." Dry eye usually occurs in people over 65 years of age and can certainly be worsened by oral antihistamines like diphenhydramine (Benadryl), hydroxyzine (Atarax), Claritin, or Zyrtec, sedatives, and beta-blocker medications.
- Tear-duct obstruction: This is caused by a blockage in the tear passage that extends from the eyes to the nasal cavity. This condition is also typically seen in the elderly. The main complaint is watery eyes that do not itch. Allergy testing will be negative in this case.
- Conjunctivitis due to infection can be caused by either
bacteria or viruses. In bacterial infections, the eyes are often "bright red"
and the eyelids stick together, especially in the morning. A discolored mucous
discharge is often seen, so-called "dirty eyes." Viral conjunctivitis causes
slight redness of the eyes and a glassy appearance from tearing. Adenovirus is
a major cause of viral conjunctivitis. The herpes virus, such as that which
causes chickenpox or shingles, can also affect the eye.
Adenovirus infection is very contagious and may be spread
by either direct contact, such as hand contact, or in
contaminated swimming pools. You should seek medical attention if you suspect any of the above.
Allergy assist
- If your eye itches and is "milky" red, it is most
likely allergy.
- If it burns, it is probably dry eye.
- If it "sticks" in the morning and is bright red, it is
usually bacterial or viral conjunctivitis.
Next: How do we care for allergic eyes? »
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- Sty (Stye) - Read about styes (hordeloa), bacterial infections of the eyelid. Learn sty causes, symptoms and treatment (OTC medication, ointment). A chalazion is often confused with a sty.
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