23 Mar

Spring is the time of the year we see a spike in patients with red, itchy and watering eyes.  As the trees and plants start to waken from the cold winter they release pollens that can cause these annoying symptoms.  While not sight threatening, the discomfort can be mild to borderline debilitating.  Typically symptoms are redness, itching, burning, scratchy and watering eyes with a white stringy discharge.  In more severe cases the eyelids can be red and swollen. 

Seasonal allergies are type I allergies.  The pollen is the antigen.  When the eye’s surface comes in contact with the antigen floating in the air there is a release of histamine and other pre-formed chemical mediators that cause the symptoms.  The key to treating allergic conjunctivitis is to give the patient practical strategies to minimize antigen exposure and prescribing the appropriate drugs for the severity of the clinical presentation.

Avoiding the pollens can be as simple as wearing a good pair of wrap-around sunglasses when you are outdoors, especially if it is windy.  Using a lubricating eye drop to rinse the pollen out of your eyes is also effective in reducing the contact time of the pollen with your eye. Cold compresses can temporally decrease swelling and itching.  One of the biggest and overlooked strategies is to make sure you shampoo your hair before bed time and to change your pillow case regularly.  Your hair is like a giant filter that traps airborne antigens.  When you go to bed, your hair releases the trapped pollens onto your pillow and then into your eyes.

There are over the counter antihistamines that are inexpensive and will give 3 to 4 hours of relief from itching.  While this is helpful, remembering to consistently dose without overdosing is a problem.  There are prescription medications that can be used once or twice a day that are much more effective.  Your eye doctor will determine if you are in an early or late phase of the type I allergic reaction.  In the early phase we prescribe anti-allergy drugs that have antihistamine and mast- cell stabilizing effects.  Mast-cell stabilizing drugs stop the cascade of the allergic response a step earlier than a basic antihistamine.  They actually prevent the release of the histamine rather than trying to counteract it once it has been released.  After three days of dosing with mast-cell stabilizers, symptoms are dramatically improved.  If the doctor feels you are in the later phase of a type I reaction, topical steroids can stop the immune response.  Once under control, mast-cell stabilizers can maintain the therapeutic effects and will replace the steroid drops. 

With the therapies we have available, we can dramatically reduce the symptoms of eye allergies.  Our doctors are ready and able to treat you.  Come see us.


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