Doctor Bristol answers your questions on Allergy Eyes.
Q: What are the common symptoms of eye allergies?
A: The #1 symptom we see in our patients with allergies is itchy eyes. Other common symptoms are watery, burning, and red irritated eyes.
Q: What are the most common things that cause allergic reaction of the eyes?
A: The allergic reaction we see most often and which tends to be severe is allergy to Cedar pollen.
This allergy is worse in the wintertime, beginning in December and lasting through February. Other common allergies we see a lot are allergies to grass, mold, pets, other trees and flora.
Q: How do allergies directly affect the eyes?
A: When the eyes have an allergic reaction, the allergen causes mast cells in the eyes to spill histamines. The histamines cause itching, burning, redness, and watery eyes. Allergy medications are called anti-histamines or histamine blockers.
Q: What is meant by the term Allergic Conjunctivitis? Is that the same as “Pink Eye”?
A: They are similar. Conjunctivitis is inflammation of the conjunctiva. That is the clear covering over the white part of the eye. Allergic Conjunctivitis is inflammation of that part of the eye, secondary to allergy. Pink Eye is a general term people outside of the medical field use to describe the irritated pink/red eye. The physician's job is to determine the cause of the irritated pink/red eye. Is it bacterial, viral, or allergic conjunctivitis? What exactly is making the eye pink/red?
Q: What is the difference between seasonal and perennial allergies? How would I know the difference?
A: Seasonal means you are having an allergic reaction during a particular time of the year. Something blooming in that season is causing an allergic reaction. Perennial means year-round. For instance, if your allergy symptoms are felt year-round, you have perennial allergies. If you only feel the symptoms at certain times of year, then they are most likely seasonal allergies. Another example is if you are allergic to your pet, which you live with, then you have a perennial pet allergy.
Q: In the Austin area in the fall/winter, the Cedar allergy is very common. What can you do to alleviate a patient’s eye discomfort from this?
A: With Cedar allergies, staying indoors will help the most. Since remaining indoors for 3 months is not practical, we have other treatment options. If it's a severe allergic reaction, which is not that uncommon to Cedar, topical steroids are a fantastic treatment option.
If the allergy is not so severe, then we will use what they call combination drops, which have a mast cell stabilizer and an anti-histamine in it. If it's a very mild eye allergy, we will use only lubricant drops to flush out the Cedar pollen. Generally, I know we will need to use a steroid when a patient comes in and says "I feel like I am going to claw my eyes out!" Their eyes are itching so severely they just want to scratch them out. That is a clear indicator to me that we will use a steroid.
Q: Can allergies do permanent damage to my eyes?
A: They can. It's not common but, if someone has very severe ocular allergies for a long time, left untreated, this could lead to scarring of the cornea and permanent damage. Fortunately, this is very rare.
Q: What are the treatment options available for eye allergies?
A: The best treatment is avoidance of the allergen altogether, if that is possible. Next step is a mild saline rinse or lubricant drops to flush out the allergen.
If the allergy is more severe, then we will use combination drops which have a mast cell stabilizer and an anti-histamine in it. If it's a very severe allergic reaction, we will use topical steroids.
Q: Are adults more prone to allergies than children?
A: We see a lot of allergies in both children and adults. Children can have more severe ocular allergic reactions due to the fact they are younger and their immune systems are still developing.
Q: For children who cannot speak yet, what can you do to determine if they are indeed having an ocular allergic reaction?
A: For younger children who cannot speak yet, or have difficulty explaining/describing what is bothering them, a very common allergy symptom we see is a 'hard blink'. Many parents will bring in a younger child and tell us "He's just blinking a lot lately." Many times this is an allergic reaction. They may not rub their eyes a lot, but we will see them blinking constantly.
We can also look at the eyelids of the child. The inner part of the eyelid that lays against the eyeball will be red and bumpy. That is usually a sign they are having a mild allergic reaction and which is making them blink hard.