Spring is in the air! For some people it is a time to look forward to enjoying warmer weather, longer days and the beauty of blossoms, while for others it is a time to dread the discomfort of allergies with red itchy eyes and runny noses. While some people are packing away winter woollies, others are unpacking allergy remedies. Spring is typically the season for allergies to emerge, due to an increase in allergens in the air both indoors and outdoors. These allergens include pollens from grass, trees and other plants, dust, pet dander and mold. Allergic reactions to perfume, cosmetics or drugs can also cause the eyes to have an allergic response. Allergy to contact lenses, particularly hard contact lenses, can occur in some cases. 

Eye allergies, also called allergic conjunctivitis, are quite common. Although they tend to run in families, anyone can experience allergic reactions, which are essentially an over-reaction of the body’s immune system in response to an irritant. A substance called histamine is produced to fight off the allergen. As a result, the eyelids and conjunctiva become red, swollen and itchy, and the eyes tear and burn. The eyes are an easy target for allergies because they are directly exposed to the environment without the help of a filtering system such as the hairs found in the nose. Sometimes the eyes can react to allergens that do not necessarily come into direct contact with them, such as insect bites or certain foods. 

The most common eye allergy symptoms include red, swollen or itchy eyes, burning, tearing and sensitivity to light. These allergy symptoms can range from very mild redness to severe swelling associated with discharge. If accompanied by nasal allergies, there may be a stuffy itchy nose, sneezing, and sometimes an itchy or sore throat, headache and coughing. 

contact eye allergy is an allergic inflammation of the eyelids from direct contact with certain allergens, such as eye makeup or cosmetic products, over the counter ointments and sometimes contact lens solutions. Symptoms and signs include itching, blisters and redness which appear 24 to 48 hours after exposure to the offending agent. The conjunctiva may also become red and watery. 

The symptoms of certain eye conditions can be confused with eye allergy. Dry eye, which usually occurs in people over 65 years of age, is characterised by burning, watering and a sensation of grittiness. Watery eyes usually without itching could be a sign of tear duct obstruction, also typically seen in the elderly. Conjunctivitis due to infection can be caused by either bacteria or viruses. In bacterial infections, the eyes are often “bright red” and the eyelids stick together, especially in the morning. Viral conjunctivitis causes slight redness of the eyes and a glassy appearance from tearing. 

The key to treating eye allergies is to avoid or limit contact with the allergen. This is often easier said than done! If you are allergic to pollen, avoid going outdoors as much as possible when pollen counts are highest, usually in the mid-morning and early evening. Keeping windows closed both in the car and home will help lower exposure to pollen and other irritants while you are inside. 

Rubbing itchy eyes is a natural response. However, rubbing usually worsens the allergic reaction by triggering a further immune response. Eye drops can provide relief. Keeping eye drops refrigerated helps to make their application more soothing. Moistening the eyes with artificial tears helps to dilute and rinse away accumulated allergens while lubricating the eyes and preventing the allergens from sticking to the conjunctiva. 

Antihistamines prevent the release of histamines and other compounds that cause itchy eyes. Decongestant drops minimise the appearance of redness by shrinking the blood vessels on the conjunctiva. Different active ingredients treat different aspects of allergies and sometimes long-term use of certain eye drops may actually increase the symptoms. Discuss the most suitable treatment with your optometrist. 

Steroid anti-inflammatory eyedrops are very effective in treating eye allergies, but they are reserved for severe symptoms that are unresponsive to other treatments. Side effects of long -term use of steroids can increase the risk of developing cataracts and glaucoma. Their use should be supervised by a medical professional. 

Oral antihistamines which target the chemical causing the symptoms of the allergic reaction may be helpful in relieving itchy eyes. However, they can make eyes dry and potentially worsen the uncomfortable symptoms. 

For those with severe allergy symptoms which are not controlled by allergen avoidance, eye drops or oral medication, immunotherapy injections may be an option. This involves a series of injections which help the immune system become less sensitized to allergens. 

Your optometrist can help determine which treatments are best for you.