allergic conjunctivitis


Sniffling and sneezing aren’t the only results of allergies, either seasonal or year-round. You might end up with an allergic reaction in your eyes that causes eye redness, as well as itching of the eyes and eyelids.

Called allergic conjunctivitis, this allergy finds its home in the conjunctiva, which is the mucous membrane lining the inner surface of the eyelid and the front part of the eyeball.

Common Complaints

If you develop this allergy, a primary complaint will be itching, but your eyes will also be red, and you might have irritation that causes burning or a full feeling of the eyes. People with this condition also have a tendency to rub their eyes, and they might have some discharge or blurry vision. Although an allergy, conjunctivitis might not be accompanied by other familiar allergic symptoms such as congestion or sneezing, just as nasal and sinus symptoms won’t necessarily be accompanied by an allergic reaction in your eyes.

Although the symptoms can be so severe as to be disabling, allergic conjunctivitis won’t cause vision loss or other sicknesses. However, if severe itching and discharge become prolonged problems or if your vision is affected, ask to be referred to an ophthalmologist. Other diseases of the eye that could cause permanent vision problems need to be ruled out.

What Happens

The release of substances by mast cells causes most of the symptoms. Mast cells, which launch an itching assault, are abundant in the eyelid and conjunctiva but are infrequently found within the eye. This restricts most allergic reactions to the lid and surface of the eye.

When you rub your eyes, mast cells in the eyelids and conjunctiva degranulate easily and thus release an itch-producing cocktail. Simply rubbing your eyes for several minutes can reproduce all the signs and symptoms of allergic conjunctivitis. Unfortunately, rubbing the eyes is a common response to eye itching and will worsen the symptoms of allergic conjunctivitis.

Treatment

First, try to eliminate exposure to whatever is causing your allergic reactions. For example, many people experience symptoms only when allergens, or substances to which they are allergic, contact their eyes. Some patients with sensitivity to cat dander may be fine in a room full of cats as long as they do not touch their faces with their hands.

Second, avoid rubbing your eyes and thereby aggravating the condition. Try applying cool compresses to the eyelids to soothe the irritation. Artificial tears can help reduce symptoms and wash away allergens and inflammatory mediators.

Often, prescription medications are needed to calm the allergy. The topical nonsteroidal anti-inflammatory eyedrop ketorolac (Acular) has been shown to be effective in reducing the itching associated with allergic conjunctivitis. Acular can break the itch-rub cycle that prolongs the disease in many individuals. Other drugs are available. See your physician.

Although rarely needed, topical corticosteroids also are effective in treating allergic conjunctivitis. Corticosteroids may induce cataracts and glaucoma and are therefore only appropriate in certain severe cases. The correct potency is critical so oversight by an ophthalmologist is necessary to avoid eye damage.

Oral antihistamines can help reduce itching, but they also reduce tear production. This drying effect may actually worsen your symptoms.

Proper treatment and avoidance of allergens can provide relief, but above all, try to stop rubbing your eyes.

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