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Focus on Eye
Health
Articles by Dr. Peter Schwartz
July,
2006
Eye Allergies, Nothing to Sneeze At!
Each year, millions of people suffer from eye allergies. In fact,
according to a recent Gallup study, 50% of the population has allergies
and 83% of those people suffer from ocular symptoms. While the hallmark
of allergic conjunctivitis is itching, people also experience tearing,
eyelid swelling, redness, and swelling of the conjunctiva (the white
surface of the eye). Patients may have associated allergic rhinitis
(sneezing, runny, itchy nose).
Allergic eye disease can be chronic, occurring all year long. This may
be related to contact lens wear, certain eye drops, or a general
allergic condition such as vernal or atopic conjunctivitis.
Alternatively, allergic eye disease can be acute, such as a reaction to
cat dander or seasonal, as in hay fever.
Seasonal allergic conjunctivitis tends to peak in the spring and fall
and is typically a reaction to outdoor pollens and grasses. These agents
act as allergens, inciting an immune response. The cascade of events
that occurs is complex and involves immunoglobulins like IgE and IgA,
which are small substances that circulate in the bloodstream and mucus
lining of the intestines, nose and eyes. More important are a group of
cells called mast cells which are stimulated to release many
pro-inflammatory mediators including histamine. These chemicals cause
dilation and leakage of blood vessels and, of course, itching.
People who endure ocular allergies know how unpleasant they can be. But
there are treatment options. Typically if the allergies are isolated to
the eyes, certain eye drops can provide relief. Antihistamines work by
preventing the histamine mediator from acting on its receptor site.
These drops have an immediate effect but can wear off. Other medicines
have mast cell stabilizers, which prevent the mast cell from releasing
its mediators at all. This type of drop takes longer (a few weeks) to
reach peak effect but continues to work all season. Often an
antihistamine is combined with a mast cell stabilizer in a prescription
eye drop.
Oral antihistamines are available for more generalized allergies but can
also provide relief from ocular symptoms. Using cool compresses,
irrigating with artificial tears and remaining in an indoor, air
conditioned environment during peak allergen exposure are also indicated
at times.
Allergies result in 4 million days of lost work or school productivity
annually. This national statistic may be interesting, but when you,
yourself, can’t stop rubbing your tearing, swollen, itchy eyes, you
realize the problem goes beyond economics and centers on quality of
life. A visit to your ophthalmologist can help determine if your red,
itchy eyes are from allergies. He can tell you what to do to obtain
relief and enjoy your eyes in any season.
~Peter S. Schwartz, MD
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