The arrival of spring brings warmer weather and longer days. But the change in season also brings tree, grass and ragweed pollen—widespread allergens that can cause itchy, watery eyes. Focus spoke with Austin Meeker, MD, a cornea specialist and comprehensive ophthalmologist about allergic conjunctivitis—the most common eye allergy issue—and how to treat it at home.
How do seasonal allergens affect the eyes?
The major eye issue brought on by seasonal allergies is allergic conjunctivitis. Conjunctivitis, or pink eye, refers to inflammation of the conjunctiva, which is a clear layer of tissue lining the eyelids and covering the white of the eye. Allergic conjunctivitis occurs when allergens reach the surface of the eye, and in response, mast cells (which help control immune system response) release histamine, causing itching and watering eyes, clear discharge, and redness. Blurred vision caused by excessive tearing is also common. If the allergic conjunctivitis becomes severe enough, it can also irritate the cornea (the eye’s clear, protective outer layer), causing pain and inflammation.
How do you treat allergic conjunctivitis?
Unlike bacterial conjunctivitis, which requires antibiotic eyedrops, allergic conjunctivitis can be treated at home. The first thing to do is stop rubbing your eyes—rubbing releases more histamine, making your symptoms worse. A cool compress over the eyes can help, and there are several over-the-counter eye drops that can treat the conjunctivitis symptoms, depending on how severe they are.
I recommend trying antihistamine eye drops first to help with the itching and redness. Pheniramine is a great antihistamine option that is sold under generic and brand names at most pharmacies. If those drops don’t provide symptom relief, the next step would be a more powerful medication that has an antihistamine and a mast cell stabilizer. These eye drops are also available over the counter under a couple of different names—olopatadine and ketotifen—with several generic and brand name options.
Can oral allergy medications help with allergic conjunctivitis?
Over-the-counter oral antihistamine medications like Zyrtec (Cetirizine) or Benadryl (Diphenhydramine) can help somewhat, but you really should use something specific for the eyes. Oral antihistamines can also be very drying, and if you take these medications daily it can lead to dry eye problems.
Can allergic conjunctivitis be prevented?
You can’t always prevent it from occurring, but you can try and decrease your exposure to the allergens through allergy avoidance. Small things like shutting your windows at home or driving with the car windows up can help keep allergens out of your eyes and prevent irritation from occurring. If it’s a windy day and pollen counts are high, that’s probably not a good day to be exercising outside or working in your yard. When you are outside, it can help to wear sunglasses or eye protection and then shower and change clothes when you get inside so that those environmental allergens aren’t coming inside the house with you.
When should you see a doctor?
If allergy avoidance, cold compresses, and over-the-counter eye drops are not helping, you should see an eye care provider. Sometimes, if an allergic reaction is severe, prescription steroid eye drops may be needed.
If the conjunctivitis continues to occur all year with no apparent trigger, you should also make an appointment to be seen. When the conjunctivitis symptoms are continuous, it can be a sign of atopic disease, like eczema or asthma, that needs to be treated differently. In those cases, a patient may need to be followed more closely to avoid other eye problems like cataracts or corneal scarring.
About Our Expert
Austin Meeker, MD, is a member of the Comprehensive Ophthalmology and Cornea Services who specializes in the medical and surgical care of corneal and anterior segment pathology.