You would think that eye allergies would be easy to treat. In the US alone, up to 40% of the population has been affected by eye allergies, AKA allergic conjunctivitis. However, the poor eyes often get overlooked in order to treat the more obvious allergic diseases like asthma, allergic runny nose, or eczema. Underdiagnosis and undertreatment can lead to chronic annoyance and, rarely, a serious eye condition.
Did you know the eyes are “privileged”?
The eyes are considered an immune privileged site, and for good reason. They have evolved in a variety of ways to stop immune responses and preserve vision. Sounds like nirvana from an immune perspective, right? Slight problem, we need a large surface area over our eyes to see the world around us. Thus, making the eyes one of the easiest access points for allergens to deposit, in fact, much larger than your nostrils.
From an allergist’s point of view, the first question we ask is, if your eye allergies are a seasonal or an everyday problem? That helps us determine who are the major allergy players. Seasonal allergies are often triggered by trees, grass or weed pollen. Perennial or everyday symptoms are triggered by indoor allergens, such as dust mites, pet dander, mold, cockroaches and rodents. Seasonal or perennial allergies are the mildest form of allergic conjunctivitis. Serious forms of eye allergies are diagnosed as atopic keratoconjunctivitis or vernal conjunctivitis, and at this stage there is physical remodeling of the eye, potentially leading to and rare vision issues.
It’s okay, I know you already tried everything at the drugstore
I know most patients are going to drugstore before they go to their doctor if it’s just mild, itchy eyes. But, what are other signs of eye allergies? Symptoms are usually involved with both eyes and are associated with a runny nose. Other allergy symptoms include tearing, eye redness, feeling grit in your eyes, thick eye mucous, difficulty wearing contacts, and maybe mild eyelid swelling. You definitely need to see a professional if you have blurry vision, photophobia (light hurts your eyes) or if you have eye pain. Otherwise, my friend, go forth and trudge on toward the allergy aisle at your local drugstore. I personally don’t understand why there are 50 options for nose saline. But if you’re going, read this article in detail, A contemporary look at allergic conjunctivitis https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-0403-9
Now if this seems overwhelming to you, I’m going to make a few valid points of why you should see an allergy doctor.
You may have tried all of these steps at some point, and you didn’t get any better still suffer. Or your insurance company won’t pay for the good prescription meds, or you’re tired of taking a small pharmacy of allergy medicines for an entire season every year. I hear you. Then you may be a good candidate for allergy immunotherapy. Environmental allergy skin testing comes next. Allergists need to know exactly what you are allergic to before we create your personalized immunotherapy. Immunotherapy is where we slowly trick your body into thinking an allergen like oak tree pollen isn’t a foreign invader, and thus no need for your allergy soldiers to release their precious ammo. It’s the only allergy treatment option that isn’t a band-aid, like medications. You are training your immune soldiers to do the right thing.
There are three good options for immunotherapy available: allergy shots, allergy drops under the tongue, and prescription dissolvable tablets. I think they each have their pros and cons, and I work with the patients to get the right fit.
Another good option for severe allergy patients is an injectable drug called a biologic. This is reserved for allergic patients with other allergy conditions such as severe asthma or eczema.
If you’ve read this far into the article, I’m going to guess you are looking for real help for your eye allergies. So, what are you waiting for, give us a call. We are happy to help.
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