Whitby & Co. - Fleet Street Clinic

Hay fever : Allergic Conjunctivitis

The term conjunctivitis refers to inflammation of the conjunctiva and allergic conjunctivitis is when this is caused by an allergic reaction. Seasonal Allergic Conjunctivitis is the eye component of hayfever and one of the most common eye problems. Allergies are believed to affect around 20% of the UK population and of these around 20% experience eye problems.

It is caused when a substance called an allergen reaches the eye surface and sets off an allergic reaction. Allergens are usually airborne, grass pollen is the most common of these and in the UK is at its most concentrated from May to July. The allergic reaction releases histamine into the tears and the surface tissues of the eye, causing redness and swelling of the conjunctiva (the membrane covering the white of the eye), watering and itching, however, it does not damage the sight.
Perennial Allergic Conjunctivitis is rarer but produces similar symptoms. The main difference is that it is a reaction to a year-round allergen, such as house dust mite.

Although allergic conjunctivitis is generally not considered to be “serious” condition, it can have an impact on quality of life during an acute episode and can lead to significant distress and irritation if not resolved.

Signs & Symptoms

  • Itchy, pink eyes
  • Puffy / swollen eyelids
  • Clear watery discharge
  • Mild photophobia (discomfort to bright lights)
  • A runny nose
  • Sneezing and coughing
  • Itchy nose, mouth or throat
  • A headache from sinus congestion

In addition to these symptoms, you also may feel fatigued and could suffer from lack of sleep.

What Causes Eye Allergies?

see here for more information.

General Eye Allergy Treatment

 The most common “treatment” is to avoid what’s causing your eye allergy.

Itchy eyes? Avoid rubbing the eyes (causes further release of antigens) makes it worse.

Keep your home free of pet dander and dust and keep pets off the furniture.

Change bedding on a more regular basis and wash hair prior to going to bed

Stay inside with windows closed and keep air conditioning/specialist air filter systems on when you are aware there is a lot of pollen in the air.

Use cold compresses, to reduce the swelling

Wear wraparound sunglasses to shield your eyes from allergens, and drive with your windows closed during allergy season.

Pollen maps can help you determine when allergens are present.

Medications

If you’re not sure what’s causing your eye allergies, or you’re not having any luck avoiding them, your next step probably will be medication to alleviate the symptoms.

Over-the-counter and prescription medications each have their advantages; for example, over-the-counter products often are less expensive, however, prescription ones usually are stronger and may be more effective.

Options include simple eye washes or eye drops which contain one or more active ingredients such as decongestants, antihistamines, or mast cell stabilizers that inhibit inflammation. Antihistamines relieve many symptoms caused by airborne allergens, such as itchy, watery eyes, runny nose and sneezing. Decongestants help shrink swollen nasal passages for easier breathing.

Decongestants clear up redness. They contain vasoconstrictors, which make the blood vessels in your eyes smaller, lessening the apparent redness. They treat a symptom but not the cause of eye allergies.  In fact, with extended use, the blood vessels can become dependent on the vasoconstrictor to stay small. When you discontinue the eye drops, the vessels actually get bigger than they were in the beginning. This process is called rebound hyperaemia, and the result is that your red eyes could worsen over time.

Some products have ingredients that act as mast cell stabilizers, which alleviate redness and swelling. Mast cell stabilizers are similar to antihistamines. But while antihistamines are known for their immediate relief, mast cell stabilizers are known for their long-lasting relief, so ideally require to be taken prior to symptoms commencing and continued on a regular basis for several weeks.

Nonsteroidal anti-inflammatory drug (NSAID) eye drops may be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis.

Prescription corticosteroid eye drops also may provide similar, quick relief. However, steroids have been associated with side effects such as increased inner eye pressure (intraocular pressure) leading to glaucoma. Steroids have also been linked to the development of posterior subcapsular cataracts.

Check the product label or insert for a list of side effects of over-the-counter medications. For prescription medication, ask your doctor. In some cases, combinations of medications may be used.

Eye Allergies & Contact Lenses

Even if you are generally a successful contact lens wearer, allergy season can make your contact lenses less comfortable. Several of the medications oral and topical used to reduce symptoms have the undesirable side effect of reducing tear film secretion leading to symptoms of dry eye.

Airborne allergens can get on your lenses, causing discomfort. Allergens also can stimulate the excessive production of natural substances in your tears, which can bind to your contacts and cause blur and additional discomfort.

Recent Studies have shown that Daily Disposable (single use) contact lenses are least prone to accumulate airborne allergens / tear deposits which build up over time causing allergy-related discomfort. The wearing of daily disposable lenses has also been shown to reduce symptoms of itching as they act as a protective membrane whilst also reducing the temptation to rub the eyes.

Hay fever – Looking After Your Eyes

For the best course of action or if you have any concerns about the health of your eyes, please call us on 020 7353 4455 to arrange an appointment, or  you can make an appointment online here.

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