Allergies and Your Eyes Part Two

By Perry Lucente, OD

To review Allergy symptoms can vary for the same individual depending on which mucus membranes are exposed to the greatest amount of allergen. Pre-existing conditions or habits such as dry eye and/or contact lens wear can predispose you to more eye related symptoms. The Center for Disease Control reports allergies affect more then 30% of the population as a whole and 70% of those folks have ocular symptoms. Allergies are more common in urban then rural settings.

There are basically two forms we will limit our discussion to seasonal and perennial. Typically seasonal is related to outdoor environmental factors and perennial is most often associated with indoor factors. The distinction can be difficult to resolve sometimes.

During an eye exam, your eye care provider may observe overt signs of ocular allergies, dryness, or contact lens complications that can predispose you to ocular irritation. The eyes do pose some interesting challenges for allergy management that your eye care provider can assist with. As an example the primary form of treatment of allergies is an oral antihistamine. Through out the body there are different types of mast cells and histamine receptors. The eyes receptors are often not responsive to the use of oral antihistamines because they tend to dry the eyes and thus aggravating your eyes' normal defense strategy.

Despite all the progress over the years, both over the counter and prescription oral antihistamines are not free of side effects. They can aggravate high blood pressure, destabilize blood sugar control in diabetics, trigger irritability or palpitations, interact dangerously with other meds, over stimulate some and induce drowsiness in others. Some patients may also be predisposed to a narrow angle glaucoma attack (your eye care provider can determine if your at risk). The addition of a decongestant can add to potential side effects. For these reasons, topical treatment with non-preserved lubricants and mast cell stabilizers tend to be the treatment of choice for ocular symptoms.

Contact lens wearers may need to switch to one-day contacts and topical agents, which require once a day dosing.

The goal should be to target your typical symptoms with the least invasive treatment and realize the same patient can have different allergy symptoms through out the year, however, what ever your allergic too will have a pattern. It's up to you to help your providers identify the pattern and formulate a strategy.