Eye Allergy (cont.)
Jay Robert Woody, MD
Jay Robert Woody, MD
Dr. Jay Woody is a diplomat of the American Board of Emergency Medicine, a Fellow of the American College of Emergency Medicine and is an Attending Physician at Parkland Health and Hospital System, Children's Medical Center of Dallas as well as several other north Texas facilities. He is a well-known and widely published authority in the field of emergency medicine and the former regional medical director of a freestanding emergency medicine practice.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
What are symptoms and signs of eye allergies?
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Typical symptoms associated with eye allergies include inflammation of the conjunctiva that is caused by a reaction to allergens. The inflammation causes enlargement of the blood vessels in the conjunctiva ("congestion"), resulting in a red or bloodshot appearance of the eyes. These symptoms can range from very mild redness to severe swelling associated with discharge.
What are allergic eye conditions?
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.
The treatments of choice are topical antihistamine drops such as olopatadine (Patanol), decongestants, and the newer mast-cell stabilizer medications. Topical steroids should be used only if prescribed by a doctor for severe reactions and on a short-term basis because of the potential for side effects. In general, oral antihistamines like loratadine (Claritin) or cetirizine (Zyrtec) are the least effective option, but they are often used for treating allergic rhinitis together with allergic conjunctivitis.
Conjunctivitis with atopic dermatitis
Commonly called "atopic keratoconjunctivitis," this condition is a notorious cause of severe eye changes, particularly in young adults. Atopic keratoconjunctivitis implies inflammation of both the conjunctiva and cornea. "Kerato" means pertaining to the cornea. This form of conjunctivitis usually affects adolescent boys (three times more frequently than girls) and is more common in those who had atopic dermatitis in early childhood. The condition is characterized by intensely itchy, red areas that appear on the eyelids. A heavy discharge from the eyes can occur, and the skin of the eyelid may show scales and crusts. In severe cases, the eyes become sensitive to light, and the eyelids noticeably thicken. If managed poorly, there can be permanent scarring of the cornea due to chronic rubbing and scratching of the eyes. This scarring can cause visual changes.
The triggers for atopic keratoconjunctivitis appear to be similar to those of atopic dermatitis. A search for common food allergies, such as eggs, peanuts, milk, soy, wheat, or fish is important. Airborne allergens, particularly dust mites and pet dander, have been overlooked as a significant contributing factor and should be evaluated and controlled.
The hallmark of treatment for allergic conjunctivitis is the use of potent antihistamines (similar to those used in atopic dermatitis) to subdue the itching. Topical antihistamines, mast-cell stabilizers, and the short-term use of oral steroids are all beneficial for relief of the itching. Occasionally, an infection of the area (usually with staphylococcus, commonly referred to as "staph") worsens the symptoms, and antibiotic treatment may help control the itching. Allergy shots are useful in selected cases.
Improper treatment of vernal keratoconjunctivitis can lead to permanent visual impairment. The most effective treatment appears to be a short-term course of low-dose topical steroids. Topical mast-cell stabilizers and topical antihistamines can also be beneficial. Wraparound sunglasses are helpful to protect the eyes against wind and dust.
Giant papillary conjunctivitis (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, such as cromolyn (Opticrom) or lodoxamide (Alomide), often are used in this condition, sometimes for several months. Contact lenses should not be worn while these medications are being used.
Reviewed by Melissa Conrad Stöppler, MD on 10/5/2011
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Eye Allergies - Causes Question: Why do you think you developed an eye allergy? Did treatment help?
Eye Allergies - Symptoms Question: What symptoms do you experience with eye allergies? Do you have other allergies?
Eye Allergies - Eyelids Question: Do you have eyelid allergies? What were your symptoms? Have you found a helpful treatment?
Eye Allergies - Personal Experience Question: Please describe your experience with eye allergies.
Eye Allergies - Prevention Question: What are the triggers for your eye allergies? How do you prevent them?
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