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Spring is in the air—birds are singing, flowers are blooming… and your eyes won’t stop itching or watering. If this sounds familiar, you likely suffer from allergic conjunctivitis (eye allergies).
Eye drops for allergies can give you some relief from your discomfort. Keep reading to learn about what options are available to you.
What are eye allergies?
Allergies can cause many bothersome symptoms, one of the most common of which is eye allergies. Eye allergies are a common problem, with about 40% of people reporting eye allergy symptoms. Of this group, 98% have allergic conjunctivitis (Kimchi, 2020).
Eyes get affected faster than other body parts because the eye’s surface is in direct contact with the environment and the trigger for the allergies, called an allergen (Dupuis, 2020).
Allergic conjunctivitis or eye allergies symptoms can include (Leonardi, 2015):
- Watery eyes
- Swelling around the eye
- Swollen eyelids
- Stinging, burning, soreness, or pain
- Red eyes
- Light sensitivity
Itching is the most common symptom, and both eyes are usually affected. These symptoms can affect your productivity and make you feel miserable (Leonardi, 2015). You don’t have to keep suffering, though. There are helpful treatments available.
What causes eye allergies?
So, what’s making your eyes itch so much anyway? It’s likely allergic conjunctivitis.
Allergic conjunctivitis is an allergic reaction where your body’s immune system overreacts to a substance that most people aren’t sensitive to (Akhouri, 2019).
Pink eye or allergies: how to tell the difference
Some of the substances that cause allergic conjunctivitis include (Dupuis, 2020):
- Pollen—These come from the outdoors from trees and plants. Pollens cause the most common type of allergic reaction, called seasonal allergies. It’s called this because it generally occurs when plants and trees are releasing pollen (usually around springtime, although ragweed pollen and leaf molds can lead to symptoms in the fall).
- Animal or pet dander—These come from your pets and last all year. This type of allergy is called chronic or perennial conjunctivitis.
- Chemicals—Eye makeup, perfumes, or other chemicals near the eye can cause contact conjunctivitis.
- Contact lenses—Some people are allergic to their contacts. They can get bumps inside their eyelids, called giant papillary conjunctivitis. This allergic reaction can make your eyes red, itchy, and very sensitive, whether or not you’re wearing your lenses.
Allergic conjunctivitis swells your eye’s blood vessels and causes eye redness, tearing, and itching. Many people have other allergy symptoms with allergic conjunctivitis, such as sneezing and a runny or stuffy nose (Bielory, 2020).
Treating allergic conjunctivitis
The best way to find the right treatment is to find the cause of your allergic conjunctivitis. Other eye conditions can cause itchy and red eyes, including viral or bacterial infections. Only about 10% of people go to a healthcare professional to see what’s causing their red and itchy eyes. You may want to schedule a visit to a healthcare professional to get the right diagnosis so you can start the most effective treatment immediately for your itchy eyes (Bielory, 2020).
There are different treatments, and sometimes you may have to take a pill and use eye drops to get relief from eye allergy symptoms.
Allergy relief eye drops
You can use eye drops for allergic conjunctivitis in two different ways. Some are used when you have symptoms, and others are used before you have itching, swelling, and redness (Dupuis, 2020).
Allergy vs. cold: how can you tell the difference?
It is crucial to check the ingredients of your over-the-counter (OTC) eye drops. Some of these eye drops have preservatives that can increase eye allergy symptoms like itchiness and redness. Benzalkonium chloride, found in 70% of eye drops, can cause eye damage with long-term use or in sensitive individuals (Walsh, 2019).
Some people want relief so badly they will use two or more types of eye drops. It’s important to know both the brand and generic name of the eye drops, so you don’t overdo it. Using too much can decrease the effectiveness and increase both the side effects and dose. You may also cause an eye injury if you use too much (Walsh, 2019).
There are four main types of eye drops used to treat allergic conjunctivitis:
- Antihistamine eye drops
- Mast cell stabilizer eye drops
- Steroid eye drops
- Non-steroidal anti-inflammatory eye drops
Antihistamine eye drops
Antihistamines block histamine, one of the main culprits in allergic reactions. For allergic conjunctivitis, they block histamine to the eyes, relieving the itching, redness, and swelling (Kimchi, 2020).
Use these drops when you have symptoms. The over-the-counter (OTC) drops work well, but you shouldn’t use them for more than three days without consulting your healthcare provider. Some antihistamine eye drops are combined with decongestants and say “redness relief.” If you use them longer than indicated on the packaging, they can cause “rebound” redness, where the redness comes back stronger. These drops can be problematic for some people with glaucoma, so check with your healthcare provider first if you’ve been diagnosed with glaucoma and have allergic conjunctivitis (Kimchi, 2020).
Allegra vs. Claritin vs. Zyrtec for allergies
If you’re prescribed antihistamine eye drops, use them as directed.
These are the main over-the-counter antihistamine eye drops available:
- Opcon-A, Naphcon-A, Visine-A (decongestant and antihistamine)
- Zaditor (ketotifen fumarate)
- Patanol and Pataday (olopatadine)
Prescription antihistamine eye drops include:
- Optivar (azelastine hydrochloride)
- Zerviate (cetirizine ophthalmic)
- Emadine (emedastine difumarate)
- Livostin (levocabastine)
Mast cell stabilizer eye drops
Mast cell stabilizers work by preventing the release of histamine from mast cells (cells that make and store histamine). Mast cell stabilizers in the form of eye drops may cause burning, stinging, or blurred vision when administered. Other eye drops combine antihistamines together with mast cell stabilizers (Amin, 2012).
Mast cell stabilizer prescription eye drops include:
- Crolom (cromolyn)
- Alomide (lodoxamide)
- Alocril (nedocromil sodium)
- Alamast (pemirolast potassium)
Combination antihistamine and mast cell stabilizer eye drops include (Kimchi, 2020):
- OTC: Alaway, Claritin Eye, Refresh Eye Itch Relief, Visine All Day Eye Itch Relief, and Zaditor (ketotifen fumarate), as well as Patanol and Pataday (olopatadine)
Steroid eye drops
Steroid eye drops can help with severe eye allergies but can cause serious side effects, especially if used for a prolonged period or in people with glaucoma. They are usually prescribed for a short time only and require a healthcare provider’s supervision (Kimchi, 2020).
Prescription steroid drops include:
- Alrex, Lotemax (loteprednol)
- Maxidex (dexamethasone ophthalmic)
Non-steroidal anti-inflammatory eye drops
These eye drops are a topical form of oral anti-inflammatory medications like Advil. If you are allergic to aspirin, you should not use these eye drops (Dupuis, 2020).
How does Flonase work to help relieve allergies?
Non-steroidal anti-inflammatory eye drops include:
- Acular, Acuvail (ketorolac)
If you continue to have eye allergy symptoms, please visit your healthcare provider. You may need to change eye drops, add an oral medication, or take allergy immunotherapy shots or pills.
In some cases, you may need to try oral medications, often in the form of antihistamine pills.
Common antihistamine OTC oral medications include:
- Allegra (fexofenadine)
- Benadryl (diphenhydramine): this pill may cause drowsiness
- Claritin, Alavert (loratadine)
- Zyrtec (cetirizine)
Allergen immunotherapy, also known as allergy shots or pills under the tongue, is a form of long-term treatment that gradually increases your ability to tolerate allergens. If you have persistent allergic conjunctivitis or allergic rhinitis, your healthcare provider may recommend immunotherapy (Dupuis, 2020).
Allergy shots decrease sensitivity to allergens and often lead to lasting relief of allergy symptoms even after treatment is stopped. This makes it a cost-effective, beneficial treatment approach for many people.
Natural ways to reduce allergic conjunctivitis symptoms
There are also some natural remedies or techniques you can use to decrease your allergic symptoms. These include (Baab, 2020; Dupuis, 2020):
- Decrease allergens in your home with a no-pet policy, allergy-reducing mattress pads and bed linens, HEPA filter vacuums, air-purifiers, keeping windows closed and running the air conditioner, removal of carpets and drapes, and stopping use of chemicals that cause you eye irritation.
- Use a clean, cold, wet washcloth on your eyes and face when you get home, especially if your eyes are swollen.
- Use preservative-free OTC saline eye drops to rinse your eyes (brands include Refresh and Systane).
- Use OTC artificial tears or lubricant eye drops to keep your eyes moist if they are dry (brands include Refresh, TheraTears, Bion Tears, Visine Tears, GenTeal, Systane, Blink Tears, and Murine Tears).
- Try not to rub your eyes because doing so will make them even itchier.
- Don’t sleep in your contact lenses.
- Block outside allergens by wearing sunglasses to protect your eyes from pollen.
- Limit your time outside when pollen counts are high.
Singulair for allergies: what is it and how does it work?
Reach out to your healthcare professional immediately if you develop eye pain or vision loss. This is a medical emergency. Please go to the emergency room if you have severe eye pain, impaired vision, black spots floating, colored halos, or increased light sensitivity.
Keep an eye out
While eye allergies may not be life-threatening, they can really affect your quality of life. There are many treatment options that decrease or, in some cases, eliminate your symptoms. Consult your healthcare provider to find the best eye drops and symptom relief for your itchy eyes.
- Akhouri, S., & House, S. A. (2019). Allergic Rhinitis. StatPearls [Internet]. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK538186/
- Amin, K. (2012). The role of mast cells in allergic inflammation. Respiratory medicine, 106(1), 9-14. doi: 10.1016/j.rmed.2011.09.007. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0954611111003325
- Baab, S., Le, P. H., & Kinzer, E. E. (2020). Allergic conjunctivitis. StatPearls [Internet]. Retrieved from: https://www.statpearls.com/ArticleLibrary/viewarticle/19890
- Bielory, L., Delgado, L., Katelaris, C. H., Leonardi, A., Rosario, N., & Vichyanoud, P. (2020). ICON: diagnosis and management of allergic conjunctivitis. Annals of Allergy, Asthma & Immunology, 124(2), 118-134. doi: 10.1016/j.anai.2019.11.014. Retrieved from: https://www.sciencedirect.com/science/article/abs/pii/S1081120619313948
- Dupuis, P., Prokopich, C. L., Hynes, A., & Kim, H. (2020). A contemporary look at allergic conjunctivitis. Allergy, Asthma & Clinical Immunology, 16(1), 5. doi: 10.1186/s13223-020-0403-9. Retrieved from: https://link.springer.com/article/10.1186/s13223-020-0403-9
- Kimchi, N., & Bielory, L. (2020). The allergic eye: recommendations about pharmacotherapy and recent therapeutic agents. Current Opinion in Allergy and Clinical Immunology, 20(4), 414-420. doi: 10.1097/ACI.0000000000000669. Retrieved from: https://journals.lww.com/co-allergy/Fulltext/2020/08000/The_allergic_eye__recommendations_about.15.aspx
- Leonardi, A., Castegnaro, A., Valerio, A. L. G., & Lazzarini, D. (2015). Epidemiology of allergic conjunctivitis: clinical appearance and treatment patterns in a population-based study. Current opinion in allergy and clinical immunology, 15(5), 482-488. doi: 10.1097/ACI.0000000000000204. Retrieved from: https://www.ingentaconnect.com/content/wk/aci/2015/00000015/00000005/art00014
- Walsh, K., & Jones, L. (2019). The use of preservatives in dry eye drops. Clinical ophthalmology (Auckland, NZ), 13, 1409. doi: 10.2147/OPTH.S211611. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6682755/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.