When 10-year-old Kaitlyn came to play with my daughter, I would always limit their time in the basement – not just because that’s where the TV was, but also because Kaitlyn was allergic to our cats. These calico beauties scattered their dander throughout the house, but I knew it collected heavily in the carpeted, windowless room downstairs.
Kaitlyn’s mom knew to pretreat her with an antihistamine, but even though her breathing seemed to be okay at our house (she does not have asthma), she always left with drippy, red, itchy eyes.
I thought I knew a lot about allergies, having worked at Allergy & Asthma Network for years, but I didn’t know one important thing:
“Oral antihistamines don’t work well on eye allergies,” says William Berger, MD, MBA, author of Allergies & Asthma for Dummies and long-time AAT medical editor. “A topical medicine applied directly to the eye works much better. Plus, oral antihistamines can increase irritation by drying out the eyes.
Turning a Blind Eye
Kaitlyn’s biggest allergy problem happens to be with cats, but any allergens that swirl through the air can get into your eyes and set off an allergic reaction if you are sensitive to them. For many people at this time of year, it’s pollen.
“About half the people I treat for nasal allergies also have eye allergies – but they don’t always think about it,” Dr. Berger continues. “Quite often I’ll get a new patient who describes respiratory symptoms in detail, but I have to specifically ask about eye problems before they include them.”
So if antihistamines aren’t the answer, what is? We tried to keep Kaitlyn’s eyes clear by limiting her exposure to the cats (try explaining that to a 10-year-old animal lover!) but it was only slightly helpful — and most environmental allergens like pollen and mold are difficult to avoid. Staying in an air-conditioned building 24-7 just isn’t the lifestyle most of us enjoy.
Dr. Berger offers some tips for keeping eyes clear, clean and comfortable:
Visit an optometrist or ophthalmologist for eye exams; the recommended frequency will vary according to your vision, age and health. An optometrist deals with vision problems that require glasses or contacts; an ophthalmologist also gives vision tests but is an MD highly trained in eye diseases.
If you suspect you have eye allergies (allergic conjunctivitis), visit a board-certified allergist. Preventing and treating eye symptoms will be part of your overall allergy treatment plan.
“Never ever ever” put corticosteroid drops into your eyes without having a comprehensive eye exam. It is very difficult to tell the difference between conjunctivitis caused by allergy and that caused by bacteria, and steroids can be dangerous with certain bacterial diseases. Allergic conjunctivitis tends to cause clear secretions and itching, while bacterial infections more often involve yellow or greenish secretions.
Ask your allergist about nasal-spray allergy medications that may also reduce eye symptoms.
Use a preservative-free eyewash or artificial tears to soothe your eyes and help wash out allergens and pollutants.
Keep your hands out of your eyes; wash your hands and face after being outside on high-pollen or mold days, then wash your hair before going to bed to keep allergens off your pillowcase and out of your eyes.
If you have chronic, painful dry eye problems, talk with an ophthalmologist or eye allergist about some of the newly approved medications.
By Laurie Ross
First published: Allergy & Asthma Today, Volume 8, Issue 1
Medical Review by William Berger, MD and Peyton Eggleston, MD