Eye - Allergy

Symptoms

DEFINITION

• An allergic reaction of the eyes
• The eyes are itchy and watery

Symptoms

• Itchy eyes with frequent rubbing
• Increased tearing (watery eyes)
• Red or pink eyes
• Mild swelling of the eyelids
• No discharge or a minimal sticky, stringy, mucus discharge
• No pain or fever

Causes

• Pollens - grass, trees, weeds, molds. Pollens travel in the air.
• Pets - cats, dogs, rabbits, horses. Animal allergens may be transferred to the eyes by the hands, but can also be airborne.

See More Appropriate Topic (instead of this one) If

• Runny, itchy nose and sneezing are also present, see HAY FEVER.
• Yellow or green pus in eyes, see EYE - PUS OR DRAINAGE.
• Doesn't look like eye allergy, see EYE - RED (WITHOUT PUS).

Should I Call?

WHEN TO CALL YOUR DOCTOR

Care at Home

HOME CARE ADVICE FOR EYE ALLERGY

1. Wash Allergens Off the Face:
   • Use a wet washcloth to clean off the eyelids and surrounding face.
   • Rinse the eyes with a small amount of warm water (tears will do the rest).
   • Then apply a cold wet washcloth to the itchy eye.
   • Wash the hair every night because it collects lots of pollen.
2. Oral Antihistamines:
   • If the nose is also itchy and runny, your child probably has hay fever (i.e., allergic symptoms of the nose AND eyes).
   • Give your child an oral antihistamine, which should relieve the nose and the eye symptoms.
   • Oral antihistamines usually control the eye symptoms and avoid the need for eye drops.
   • Benadryl or Chlorpheniramine (CTM) products are very effective (no prescription needed). They need to be given every 6 to 8 hours (See Dosage table). The bedtime dosage is especially important for healing the lining of the nose.
   • Continue oral antihistamines every day until pollen season is over (usually 2 months for each pollen).
3. New Antihistamine Eye Drops (Ketotifen) for Pollen Allergies  - 1st Choice:
   • Usually an oral antihistamine will adequately control the allergic symptoms of the eye.
   • If the eyes remain itchy and poorly controlled, buy some Ketotifen antihistamine eyedrops (no prescription needed).  
   • Dosage: 1 drop every 12 hours
   • Ask your pharmacist to recommend a brand (e.g. Zaditor or Alaway)
   • For severe allergies, the continuous use of ketotifen eye drops on a daily basis during pollen season will give the best control.
4. Older Antihistamine/Vasoconstrictor Eye Drops - 2nd Choice:
   • Usually the eyes will feel much better after the allergic substance is washed out and cold compresses are applied.
   • If not, this type of eye drop can be used for intermittent eye allergy symptoms (no prescription needed).
   • Ask your pharmacist to recommend a brand. Examples are Naphcon A, Opcon A or Visine A.
   • Avoid vasoconstrictor eyedrops without an antihistamine (without an A in the name). Reason: they only treat the redness, not the cause
   • Dosage: 1 drop every 8 hours as necessary
   • Avoid continuous use for over 5 days. (Reason: rebound red eyes)

   • Disadvantage: less effective than Ketotifen eye drops.

5. Contacts: Some children with contact lenses may need to switch to glasses temporarily (Reason: to permit faster healing).
6. Expected Course: If the allergic substance can be identified and avoided (e.g., a cat), the symptoms will not recur. Most eye allergies continue through the pollen season (4 to 8 weeks).
7. Call Your Doctor If:
   • Itchy eyes aren't controlled in 2 days with continuous allergy treatment
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.