Eye Allergies

Definition:
Eye allergies, called allergic conjunctivitis, are a common condition that occurs when the eyes react to something that irritates them (called an allergen). The eyes produce a substance called histamine to fight off the allergen. As a result, the eyelids and conjunctiva — the thin, filmy membrane that covers the inside of your eyelids and the white part of your eye (sclera) — become red, swollen and itchy, with tearing and burning. Unlike bacterial or viral conjunctivitis, allergic conjunctivitis is not spread from person to person.
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People who suffer from eye allergies usually (though not always) have nasal allergies as well, with an itchy, stuffy nose and sneezing. It is usually a temporary (acute) condition associated with seasonal allergies. However, in other cases, eye allergies can develop from exposure to other environmental triggers, such as pet dander, dust, smoke, perfumes, or even foods. If the exposure is ongoing, the allergies can be more severe, with significant burning and itching and even sensitivity to light.

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Seasonal allergic conjunctivitis is the eye equivalent of hay fever and affects up to 25 per cent of the general population. The eyes become itchy, watery and red in the summer pollen season, usually from exposure to grass and tree pollen.

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Vernal conjunctivitis is a more severe form of this disease seen in children. The eyes are sticky with a stringy discharge, and it’s painful, especially when opening the eyes on waking.

The inner membranes of the eyelid swell and the conjunctiva develops a cobblestone appearance. Corneal damage may occur if the condition is left untreated.

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Perennial allergic conjunctivitis tends to occur all year round, with house dust mite and cat allergies. The symptoms are usually milder than those in seasonal allergic conjunctivitis.

Eczema eyes:
Although rare, atopic keratoconjunctivitis is the most severe manifestation of allergic eye disease. It occurs predominantly in adult males and is the eye equivalent of severe eczema.
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This persistent condition results in constant itching, dry eyes and blurred vision. It’s associated with corneal swelling and scarring. Eyelid eczema and infection are common, and lens cataracts may develop over time.

Contact lens allergy:
Contact lens wearers may develop giant papillary conjunctivitis, triggered by constant local irritation by the contact lenses on the conjunctival surfaces. The lining of the upper eyelid is usually most affected. Disposable contact lenses may help settle symptoms, but occasionally wearing contact lens has to be suspended.
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Never use steroid eye drops unless under the direct supervision of a doctor. Although they’re effective for treating eye allergies, they can lead to unwanted side-effects such as glaucoma and cataract formation.

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They may also encourage infections of the eye, with resultant corneal scarring.

Symptoms:
Symptoms of eye allergies, or allergic conjunctivitis, include watery, itchy, red, sore, swollen and stinging of the eyes. Itching of the eyes is the most important symptom of allergic conjunctivitis. Without itching, it is much less likely that a person is suffering from allergies of the eyes. Both eyes are usually affected, although one eye may be more symptomatic than the other.

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Seasonal allergic conjunctivitis (SAC) is the most common form of eye allergy, with grass and ragweed pollens being the most important seasonal triggers. Perennial allergic conjunctivitis (PAC) is also very common, with animal dander, feathers and dust mites being the most important triggers.

Other symptoms :-
People with SAC usually note the onset of symptoms during the spring and fall, and frequently note symptoms of allergic rhinitis. Symptoms include itchy eyes, burning of the eyes and eye watering. In some cases, people notice sensitivity to the light and blurred vision. The eyes are usually red, and the eyelids may become swollen. When the inside of the eyelid (the conjunctiva) is also swollen, the eyes may have a watery, gelatinous-like appearance – this finding is called “chemosis”.

PAC typically occurs year-round, although many people notice some seasonal flares to their symptoms. The severity of PAC is less than that of SAC, and PAC is much more likely to be associated with perennial allergic rhinitis.

Diagnosis:
The diagnosis of allergic conjunctivitis is made with a history of symptoms suggestive of eye allergies, an examination by a healthcare professional with findings consistent with conjunctivitis, and allergy testing showing seasonal or perennial allergies. A response to typical medications is helpful in the ultimate diagnosis of allergic eye disease, and failure to respond to medications may lead to a search for a different diagnosis.

Treatment:

Regular use of anti-allergy eye drops such as sodium chromoglycate, nedocromil, olopatidine and lodoxamide can help to treat mild seasonal disease.If avoidance of allergic triggers fails to prevent symptoms of allergic conjunctivitis, some people notice mild benefit from cold compresses on the eyes, and eyewashes with tear substitutes. However, medications may be necessary to treat the symptoms. Medications for allergic conjunctivitis include oral anti-histamines and eye drops.

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Oral anti-histamines. Many people with allergic eye disease will receive benefit from oral anti-histamines, such as over-the-counter loratadine (Claritin®/Alavert®, generic forms), and prescription cetirizine (Zyrtec®), fexofenadine (Allegra® and generic forms) and desloratadine (Clarinex®). Older, first-generation anti-histamines (such as Benadryl®) are also helpful, but are generally considered too sedating for routine use.

Over-the-counter eye drops. Medicated eye drops are available in over-the-counter and prescription forms. Over-the-counter eye drops for allergic conjunctivitis are currently only available in decongestant (Visine®, Naphcon®, generic forms of naphazoline), and decongestant/anti-histamine combinations (Visine-A®, Naphcon-A®, generic forms of naphazoline/pheniramine).

Decongestant eye drops (with or without anti-histamines) should only be used for short periods of time, as overuse can lead to conjunctivitis medicamentosa (characterized as rebound eye redness/congestion and dependence on the eye drops). These eye drops should not be used by people with glaucoma, and used with caution by people with heart or blood pressure problems.

Ketotifen works by a dual action mechanism, with anti-histamine activity and prevention of the release of chemicals from mast cells. Unlike decongestant eye drops, ketotifen would not be expected to result in conjunctivitis medicamentosa with long-term use.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/in_depth/allergies/allergicconditions_eye.shtml
http://allergies.about.com/od/eyeallergies/a/conjunc.htm
http://www.thirdeyehealth.com/eye-allergies.html
http://www.medinik.com/allergy/contact-lens-allergy
http://www.clivir.com/lessons/show/eyelid-eczema-swelling-pictures-causes-and-natural-treatment.html

 

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