RSS

Category Archives: Diseases of the Eye

ALLERGIES AND RED ITCHY EYES

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.

Advertisements
 
 

Ocular Surface Disease (Dry Eye Syndrome)

Dry eye syndrome (DES) is an underestimated and under diagnosed condition.  There are millions of Americans that put up with symptoms, think that it’s just the norm, and never seek treatment.  Fortunately we know more about the cause and contributing factors of this disease than ever before.  This has spawned new medications and treatments that help us help patients deal with this very real disease.

Symptoms of DES

  • Stinging
  • Burning
  • Foreign body sensation
  • Redness
  • Excessive tearing
  • Blurred vision

Factors that increase your risk of having DES

  • Age – DES increases with age
  • Gender – Females have a much higher incidence of DES
  • Contact lens wear
  • Environmental

                 Dry windy environments

                 Heat and air conditioning

                       Computer use

                       Smoking

  • Systemic Disease

                 Sjogren’s syndrome

                 Rheumatoid Arthritis

                 Lupus

                 Diabetes

                 HIV/AIDS

                 Hypertension

                 Parkinson disease

                 Sarcoidosis

                 Crohn’s disease

                 Vitamin A deficiency

  • Ocular Conditions

                       Blepharitis

                       Allergic conjunctivitis

                       Meibomian gland dysfunction

                       Corneal dystrophies

  • Medications

                       Antianxiety

                       Antidepressants

                       Antihistamines

                       Diuretics

                       Hormone replacement therapy

                       Oral steroids

                       Preservative eye drops

                       Systemic Beta blockers

                       Topical Glaucoma medications

  • Diet

                 Diets low in Omega 3’s or with a high ratio of Omega 6 to Omega 3

Treatment of DES starts with an evaluation to determine which of the above factors you are dealing with.  A treatment program based on those findings and appropriate monitoring and follow up care are set in place.  The treatment of DES may include some or many of the following medications and strategies:

  • Non preserved eye drops
  • Lid heat and massage
  • Omega 3 supplementation
  • Anti inflammatory medications

                       Lotemax

                       Restasis

                       AzaSite

                       Doxycycline

  • Punctal plugs
  • Environmental considerations

                       Work space ergonomics

                       Computer lenses to create a microclimate around the eyes

Dry eye syndrome is a true disease process with concrete treatments available.  Call our office and set up a dry eye evaluation today.

 
Leave a comment

Posted by on December 13, 2011 in Diseases of the Eye