Conjunctivitis is an inflammation of the conjunctiva of the eye. This is the membrane covering the white of the eyes and the inside of the eyelids. If something irritates this clear membrane, your eyes may itch, tear, hurt, and become red or swollen. In some people, conjunctivitis is due to an allergy. In these instances, the condition is called either allergic conjunctivitis or ocular allergy. It can occur alone, or it may be associated with nasal allergy symptoms. Unlike conditions such as pink eye, allergic conjunctivitis is not contagious. Ocular allergies are very common, and may even be more common than nasal allergies.
CAUSES AND TRIGGERS
If you have an allergy, your immune system identifies something as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release chemicals, causing an allergic reaction. This reaction usually causes irritative symptoms in the eyes, nose, lungs, throat, sinuses, and intestinal tract.
The most common allergen is pollen, which is seasonal. People with seasonal allergic conjunctivitis (eye) or rhinoconjuntivitis (nose and eye) will experience symptoms at certain times during the year – usually from early spring, into summer, and even into autumn (fall). Those with perennial allergic conjunctivitis are susceptible at any time of year. These irritations may be triggered by dust, perfumes, cosmetics, skin medicines, or smog and second-hand smoke.
Most people suffering from allergic conjunctivitis have problems in both eyes, and symptoms may appear quickly, soon after the eyes have come into contact with the allergen. The most common symptom occurs when the eyes become red, and the clear skin of the eye becomes swollen. The hallmark of eye allergies is extreme itchiness and the desire to rub the eyes. Other symptoms include swollen and red eyelids, or even a burning sensation.
There are many different treatment options, depending upon the severity of the symptoms.
As with any allergy, the first approach for successful management of seasonal or perennial forms of eye allergy should be avoidance of the allergens that trigger your eye symptoms. When avoidance is not possible, then drops or even oral medications may be helpful. Over-the-counter (OTC) eye drops and oral medications are commonly used for short-term relief of some eye allergy symptoms.
OTC medications: Akwa tears, genteal etc. (artificial tears), vasocon-A (antihistamine and vasoconstrictor) – also known as “Visine-A” with side effects of increase in blood pressure, chronic red eyes on discontinuation.
Artificial tears can be used to sooth the eyes, and dilute the irritating allergens on the eyes. For mild, short outbreaks of symptoms, a mild anti-histamine drop with a medicine to reduce red eye injection can be used for a few days at a time. However, they may not relieve all symptoms, and prolonged use of some “get-the-red out” OTC eye drops may actually cause more harm than good.
For chronic allergies, a medication that is called a “mast-cell stabilizer” can be used. your doctor may prescribe a short-term steroid eyedrop to control your symptoms quickly, while continuing the long-term use of a mast-cell stabilizer. Prescription eye drops can be used with oral allergy medications from your doctor to treat eye allergies, which can also be a benefit to reduce eye symptoms, along with reducing any nasal allergy symptoms.
Prescription medications: Livostin, Emadine (antihistamines), Alamast, Alomide, Alocril, Cromolyn sodium (mast-cell stabilizers), Patanol, Zaditor, Optivar (antihistamines and mast cell stabilizer), Acular, Voltaren (non-steroidal anti-inflammatory), Loteprednol, Fluromethalone, Pred Forte (steroid)
Many patients find that they get more relief of their symptoms if the eyedrops are kept cold in the refrigerator.
February 10, 2010 Modified from AAAAI website by David Bloom, MD and Matthew Rings, MD.