Eyes and Allergies

Published May 27, 2020

How do allergies affect your eyes?

Allergies are a common complaint and can cause a great deal of discomfort— sneezing, sniffling, stuffy nose, and itchy throat can all affect your daily functioning. 

What you may not realize is— your eyes can also be affected by allergies.

Up to 25 percent of people worldwide suffer from eye allergies.

Many eye allergies symptoms occur with the symptoms you may already be aware of. If your eyes are itchy, red and irritated, and there is no other explanation, allergies may be the cause.

What causes eye allergies?

A variety of allergens may be affecting your eyes. It is best to get tested by an allergist to determine the cause of your allergies.

The following are the most common causes:

  • Outdoor allergens: pollens from grass, weeds, and trees
  • Indoor allergens: dust mites, pet dander, and mold
  • Irritants: cigarette smoke, diesel exhaust, and perfume

Eye allergy symptoms

  • Itchy eyes
  • Redness
  • Burning
  • Watery eyes
  • Swollen eyelids

How do I know if I have eye allergies?

Eye allergies develop when the body overreacts to something in its environment. Eye allergies share symptoms with some ocular diseases, making an accurate diagnosis critical.

If you are experiencing eye allergy symptoms, make an appointment with your eye doctor for a thorough examination of your ocular health. Your eye doctor will use specialized tools to detect the presence of allergies.

With the use of a special microscope, your eye doctor will be able to detect the cause of any redness or swollen blood vessels on the surface of the eye.

Types of eye allergies

There are many different types of allergies:

  • Seasonal/perennial allergic conjunctivitis
  • Vernal keratoconjunctivitis
  • Atopic keratoconjunctivitis
  • Contact allergic conjunctivitis
  • Giant papillary conjunctivitis

Seasonal allergic conjunctivitis

Seasonal allergic conjunctivitis (SAC) is the most common type of eye allergy.

Allergy symptoms are experienced in spring, summer, or fall— depending on the type of plant pollen in the air.

Symptoms include:

  • Itching
  • Burning
  • Redness
  • Watery discharge
  • Dark circles under eyes
  • Puffy eyelids
  • Sensitivity to bright lights

These signs and symptoms usually present with a runny nose, nasal congestion, sneezing, and other typical hay fever symptoms.

Perennial allergic conjunctivitis (PAC) 

Perennial allergic conjunctivitis (PAC) occurs year-round. This type of allergy is caused by reactions to dust mites, mold, pet dander or other household irritants. Perennial allergic conjunctivitis produces the same symptoms as SAC, though they tend to be more mild.

Vernal keratoconjunctivitis

Vernal keratoconjunctivitis is a more severe eye allergy than SAC or PAC. It can occur year-round, but symptoms may worsen during certain seasons. This type of allergy is most prevalent in boys and young men.

Symptoms include:

  • Itching
  • Significant tearing
  • Production of thick mucus
  • Foreign body sensation
  • Sensitivity to light
  • Eczema or asthma

Vernal keratoconjunctivitis can be harmful to your vision if not treated properly.

Atopic keratoconjunctivitis

Atopic keratoconjunctivitis predominantly affects older with a history of allergic dermatitis. This type of allergy can produce symptoms year-round that are similar to those of vernal keratoconjunctivitis.

Symptoms include:

  • Severe itching
  • Burning
  • Redness
  • Thick mucus discharge
  • Eyelids that stick together

Atopic keratoconjunctivitis can result in scarring of the cornea if not treated properly.

Contact allergic conjunctivitis

Contact allergic conjunctivitis can result from eye irritation caused by contact lenses or by the proteins from tears that attach to the surface of the lens.

Symptoms include:

  • Itching
  • Redness
  • Lens discomfort
  • Mucous discharge

Giant papillary conjunctivitis

Giant papillary conjunctivitis is a severe form of contact allergic conjunctivitis and is associated with contact lenses. This type of allergy occurs when individual fluid sacs (papules) form in the upper lining of the inner eyelid.

Symptoms include:

  • Itching
  • Tearing
  • Swollen eyelids
  • Mucous discharge
  • Blurred vision
  • Discomfort from contact lenses
  • Foreign body sensation

How to alleviate eye allergy symptoms

Many mild allergy symptoms can be alleviated with over-the-counter medications.

If your allergy symptoms are not relieved by these medications, your eye doctor can prescribe medicated eye drops or oral medication.

Artificial tears lubricating eye drops

Non-prescription eye drops may be sufficient in providing short term relief of mild symptoms. Artificial tears both moisten the eyes to soothe irritation, and wash allergens away. These drops can be used as often as needed and are available over-the-counter at your local drug store.

There are many different brands of artificial tears on the market, so ask your eye doctor for a recommendation.

Preservative free eye drops

Preservative-free drops are recommended because they contain fewer additives which can further irritate the eyes. Keep in mind that many of these preservative-free eye drops may only be used for a few weeks after the bottle is opened— it is important to follow the directions on the bottle.

In addition, many eye drops come in two forms, single-use preservative free vials and multi-use bottles, with or without preservatives. There are advantages and disadvantages to both.  Ask your eye doctor what he recommends for your individual needs.

Eye drops for moderate to severe allergies

Decongestant eye drops

Important safety notice: These drops are NOT recommended if you have glaucoma.

These eye drops are over-the-counter and are used to reduce redness by narrowing the blood vessels in the eye. They are available in two forms: decongestant only, and decongestant with an antihistamine— recommended for relief of severe itching.

Decongestant eye drops should only be used for up to three days. Prolonged use can produce a rebound effect and increase redness and swelling.

Prescription eye drops and medications

Prescription eye drops and medications also are used to treat eye moderate to severe allergies, and provide both short- and long- term relief.

There are many different types of prescription eye drops:

Antihistamine eye drops reduce itching, redness and swelling. These drops provide fast relief, but need to be used frequently throughout the day, as the effects tend to last only a few hours.

Mast cell stabilizer eye drops prevent the release of histamine and other chemicals that cause the allergic reaction. These drops must be used before allergen exposure to prevent itching.

Antihistamine and mast cell stabilizer eye drops are a combination eye drop that treats and prevents eye allergies. These drops are inserted twice a day for fast, long-lasting relief of itching, burning, tearing, and redness.

NSAID eye drops (Nonsteroidal anti-inflammatory drugs) relieve itching, but may cause burning or stinging when inserted, and need to be used four times a day.

Corticosteroid eye drops treat chronic and severe itching, redness and swelling. These steroidal eye drops should only be used long term (more than two weeks) under a doctor’s supervision as they can cause an increased risk of infection, glaucoma and cataracts.

Oral antihistamines

If eye drops are not sufficient in treating your allergies, your eye doctor may recommend an oral antihistamine for further relief. 

Oral antihistamines, both over-the-counter and prescription, can be mildly effective in relieving the itching associated with eye allergies. In addition, these medications can cause dry eyes and actually worsen your allergy symptoms.

Allergy shots (immunotherapy)

Allergy shots improve tolerance to an allergen by gradually increasing exposure to the allergen over time. Optimal results are generally noticed after several months of treatment, and medications to alleviate symptoms may still be required.

How to prevent eye allergy symptoms

Avoid allergy triggers by implementing the following suggestions:

  • Use air conditioning. Keep windows closed during high pollen seasons.
  • Wear glasses or sunglasses. This will help to protect your eyes from pollen.
  • Limit dust accumulation. Use “mite-proof” bedding covers and wash your bedding frequently, using hot water (at least 130 degrees Fahrenheit). Clean shelves with a wet rag and floors with a mop, instead of dry-dusting or sweeping.
  • Control mold. Use a dehumidifier to control mold growth. Treat visible mold with detergent and a five percent bleach solution.
  • Wash your hands.  This will help to eliminate any allergens you may have come in contact with, such as when touching a pet or cutting the grass.
  • Avoid rubbing your eyes. This can further irritate your eyes.

While allergies are a common complaint, there is no need to continue suffering! 

There are a variety of treatments available to alleviate your symptoms. Schedule an eye exam to determine which treatment is right for you.