Itching for Answers

With the coming of Spring and Summer comes the rebirth of the plant world. And with that, for many of us, come itchy eyes and runny noses. Allergies generally indicate that we have become increasingly sensitive to airborne and contact allergens. Allergens are proteins that cause a sensitivity reaction in tissues upon contact.
The result of this contact is that mast cells, which are located in mucous membranes of the eyes, ears, nose, sinuses and respiratory tract, release histamine. This causes inflammation with the symptoms of itching, swelling, redness and tearing of the eyes, all of which often are clumped under the catch-all of “hay fever”.

Types of sensitivities may include:

Natural environment: seeds, pollen and dust-related sensitivities

Pollutants: Chemical and paint vapors, tobacco smoke, air pollution

Direct contact sensitivities: Sprays, lotions, bugs, pet dander

Sinus trouble: often related to food allergy (dairy or wheat)

Chronic blepharitis: Inflammation of the eyelid related to buildup of oils, scales, bacteria or dry eyes

So you need to be a medical detective to look for the source of your symptoms, and have your doctor help you select from the following therapies.

Immediate treatment options:

• Antihistamine eye drops. These will battle histamine that is released during the allergic reaction, if applied within an hour. There are weak ones, which can be obtained over the counter, and stronger ones, which require a prescription.
• Antihistamine eye drops in combination with vasoconstrictors, which help get the red out. These should not be used throughout an entire allergy season, because the redness will come back.
• Mast cell stabilizers are prescription eye drops. These can be used on a regular twice-daily regimen to prevent the release of histamine even before the eye symptoms begin.
• Cortisone eye drops come in either strong or weak concentrations. The weaker ones are not well absorbed into the eye, and therefore even with continual use are less likely to cause cataract or increased ocular pressure. The stronger steroids are more prone to increase side effects with long-term use, and should be limited to short-term therapy.
• Antihistamines by mouth are effective for runny nose and sinus symptoms, but may cause drowsiness. Likewise, cortisone by mouth should be reserved for severe problems such as poison ivy, asthma, or both eyes swollen shut.