Allergies and Your Eyes Part One

By Perry Lucente, OD

For a lot of folks the spring allergies have been kept at bay by the unusually long and cold winter this year. Rest assured that all those invasive species such as the Bradford pear tree, will soon have buds signaling the beginning of the spring allergy season for many that are sensitive to tree pollen.

The eye is essentially enveloped in a very thin membrane called the conjunctiva. This tissue is very similar to the tissue that lines your nasal passages, sinus and lungs. Your eyes are connected to your sinuses via the tear ducts, which allow your tears to drain into your sinuses. The sinuses are connected to the back of the throat and finally your ears are connected by the eustachian tube.

Every one the aforementioned structures have mast cells. Mast cells are like zip lock bags full of different chemicals that represent second & third stages of the body's allergy warfare. Histamine is one we are most familiar with; it triggers dilation of vessels that also become leaky. The goal is to flush allergens away by turning on the water works. So if the only membranes exposed and overwhelmed are the eyes you are blessed, with just itchy, watery red eyes. Left unchecked you get postnasal drip sinus congestion and maybe the dreaded boggy feeling in your ears. The 3rd phase comes into play if the other two have failed, if we can't prevent contact or flush out allergens our body tries to chemically isolate the allergen by producing mucus. Unfortunately mucus, made up of sugar becomes a food source for bacteria in a warm wet environment and increases likelihood of secondary infections.

Newer treatments focus on prevention by stabilizing the mast cells making it harder for the zip lock bag to open. The key is you need to take a proactive position by either taking drops or nasal sprays starting 2 weeks before the worse part of the allergy season is upon you. By tuning into the daily news and paying attention to your body and your environment, you and your health care providers should be able to develop a strategy specific to your needs.

So if it's primarily your eyes that suffer then you need to focus your efforts there. If you have pre-existing dry eyes realize that a dry eye is more susceptible to the ravages of pollen, frequent use of lubricants, can often alleviate mild allergies and reduce moderate symptoms to a more tolerant level. Consider non-preserved drops. If you're a contact lens wearer, don't sleep with lens during your allergy season, and depending on severity, discuss daily disposable contacts and treatment options with your eye care provider. In part 2 I will discuss unique considerations in eye care and allergies.