Eye Allergies: What to Do (and What Not to Do) About Itchy Eyes

Itchy, watery eyes during allergy season can drive you crazy. Mass. Eye and Ear’s Dr. Ryan Vasan has some tips on how to feel better.

After another snowy, cold winter in Boston, spring has finally arrived! As the weather warms and flowers begin to bloom, plants are shedding all kinds of stuff — like pollen and ragweed. Of all the ways spring allergies can drive you crazy, itchy, watery eyes may be the most frustrating and disruptive to daily life.

Our eyes are also perhaps the most vulnerable parts of our body to allergies, says Mass. Eye and Ear ophthalmologist Ryan A. Vasan, M.D., because the surface of the eye is always exposed.

“We have little hairs in our noses that trap allergens, and the acid in our stomachs often kills off anything that might cause a reaction to the food we eat,” he explained. “The main defenses for our eyes are tears, eyelids and eyelashes — but our eyes are otherwise exposed to allergens.”

Why the Itchy, Watery Eyes? 

When allergens reach the surface of the eye, cells that are part of our immune system (mast cells) release histamine, causing inflammation of the eye tissues and specifically in the conjunctiva — the mucous membrane covering the front of the eye and under the eyelids. This process leads to the swelling and itching symptoms of eye allergies, or allergic conjunctivitis.

What to Do

• Avoid whatever allergen is bothering you.
  If outdoor allergies are particularly bothersome, Dr. Vasan recommends staying inside as much as you can, and closing the windows as much as possible. Some of his patients even use air filters to keep allergens out of the house.
• Find out what’s triggering your allergies.
  If you don’t know what’s triggering your allergies, how can you avoid it? The only way to know for sure is to see an allergist for skin patch testing. Consider doing this if you can’t seem to get away from whatever is bothering you.
• Use artificial tears — and consider putting them in the refrigerator.
  Artificial tears (eye drops that coat the surface of the eye) can help to dilute any allergens hanging out on the surface of the eye. Dr. Vasan says that these are especially soothing when they are cold, so he recommends putting them in the refrigerator to really help relieve symptoms of itching and swelling. “Cold really helps to stop the itching by blocking the signal from the area of itching back to the brain,” he said. 
• Use medications (wisely!).
  There are plenty of allergy medicines that can help with eye allergies, or allergic conjunctivitis. Many are available over-the-counter, with more potent versions available by prescription.Vasan says to look for “mast cell stabilizers,” which prevent histamine release from the mast cells and “antihistamines,” which help to block any already-released histamine from causing further reaction. Some medications combine both of these things.

  But if symptoms last for more than a few weeks, it may be worthwhile to see an ophthalmologist.

  “We have stronger treatments we can consider prescribing,” Dr. Vasan said. “We can also consider steroids, often in the form of an eye drop, but those have potentially serious side effects and need to be taken while followed by a physician.”

What Not to Do

• Don’t rub your eyes.
  Though it may be tempting, this can spread the allergens around and irritate the eye further. “Although it feels great in the short-term, it often makes things much worse,” Dr. Vasan said.
• Avoid “redness reliever” medications.
  Eye drops marketed as “redness relievers” are effective in hiding signs of eye allergies — making the eyes nice and white — but they don’t do much to make you feel better. And, what’s worse is that people can build a tolerance to these medications. When they stop taking the drops, their eyes become red.
• Don’t ignore signs of other problems.
  Red, irritated eyes can be signs of eye conditions other than allergic conjunctivitis. If you notice a thicker discharge coming from the eye, see an eye doctor, as it could be a sign of a viral infection.

About Our Expert

Ryan A. Vasan, M.D., is an ophthalmologist at Mass. Eye and Ear, practicing at the Longwood and Stoneham locations.