While most people associate allergies with runny noses, sinus congestion, hacking and sneezing, in fact allergies can affect various organs, including the eyes. Because the eyes are often a significant component of your allergies, they deserve specific attention and treatment.

1. Ocular Allergies
While mostpeople associateallergies with runny noses, sinus congestion, hacking
and sneezing, in fact allergies can affect various organs, including the eyes.
Because the eyes are often a significant component of your allergies, they deserve
specific attention and treatment.
Many who have ocular allergies experience itching as the primary source of
discomfort, though some people have no itchiness but instead experience a
burning sensation and “eye fatigue” that causes them to rub their eyes. Other
common symptoms include redness, lid swelling, tearing, light sensitivity,
“grittiness” and swollen eye. On the other hand, if you have dryness, stinging and
the feeling that there is a foreign body in your eye, you likely have dry eye
syndrome.
Beyond being annoying, ocular allergies may be disabling. Allergic symptoms
typically occur when allergy sufferers are in situations that put them in close
contact with allergens to which they are sensitive, such as mowing the lawn,
spending time outdoors or playing with pets. Thus, it can affect your ability to
engage in these activities, as well as your efficacy at work and school. Beyond
activities, however, appearances may become a major quality of life factor. For
allergy sufferers, red eyes and puffy eyelids can be bothersome because they give
the appearance of fatigue or perhaps even illness or substance abuse.
Dry eye sufferers typically feel “tired eyes.” Their symptoms affect them most in
computer work, reading or TV watching.
Eye allergies are anything but rare. In the United States, an estimated 20 percent
of the population suffers from them, and the incidence appears to be on the rise.
Some researchers believe that our increasingly clean, modern society—which no
longer requires our bodies to fight off multiple childhood infections—has caused
our immune systems to shift from an infection-fighting stance to more of an
allergic stance. (Infection-fighting and allergies are opposites as far as the immune
system is concerned). When the body’s immune system becomes sensitized and

2. overreacts to substances such as seasonal pollens and pet allergens, an allergic
reaction can occur whenever they come in contact with your eyes.
So while many people enjoy the spring and fall, millions of others frequently live
in dread of those times when the trees, grass and weeds begin to pollinate.
People who are sensitive to these allergens experience seasonal allergic
conjunctivitis, the most common type of eye allergy. Conjunctivitis refers to a part
of the eye called the conjunctiva that becomes inflamed when triggered by an
allergen. All the signs and symptoms of allergy—itching, redness, tearing and
inflammation—occur when someonewho is sensitive is exposed to allergens such
as pollens, molds, house dust mites, animals and insects.
The reason the eyes are so sensitive to these substances is that they, like the skin,
are exposed, unprotected surfaces that are especially vulnerable to allergens and
other irritants. Allergens cause cells in the eye, called “mast cells,” to release
histamine and other substances or chemicals that cause blood vessels to dilate,
mucous membranes to itch, and the eyes and eyelids to become inflamed.
Tearing may also occur. Symptoms can range from mild eye annoyance to severe
itching with major effects on the tissues inside the eyes. When the blood vessels
expand, this allows for a greater flow of inflammatory and allergic molecules from
the bloodstream into the eye, the site of the allergic reaction. This causes the
redness and swelling of the eye. The itching is triggered by histamine binding to
nerve cell receptors.
To avoid allergens, some patients have to stay indoors and lose time from school
or work. Yet taking shelter is not always the answer. Some people must be
outdoors for work or other daily activities. Additionally, some allergens reside
indoors. Pet dander, dust mites and molds are common indoor allergens that can
trigger symptoms for some people year round, causing perennial allergic
conjunctivitis.
There are several more severe, although rare, forms of allergy, such as atopic
keratoconjunctivitis (AK) and vernal keratoconjunctivitis (VK). These conditions
may lead to corneal ulcers. However, the vast majority (80 to 90 percent) of eye
allergies are caused by seasonal and perennial allergic conjunctivitis.

3. Ocular allergies may be further classified as either acute or chronic. An acute
reaction occurs with intermittent exposure to an allergen, such as is often the
case with seasonal allergic conjunctivitis, which may occur only at the height of
pollen season. Chronic reactions occur with persistent exposure to allergens and
are more likely to occur in perennial allergic conjunctivitis.
Diagnosis
To make the diagnosis, your eye care professional must identify the type of
allergic condition you are experiencing. The eye care professionalbegins by asking
you questions to create a thorough medical history for you and to rule out the
possibilities of other eye problems. In particular, your doctor will ask you to
describe your symptoms and when they occur most frequently. The main
indication of ocular allergies is itching, often accompanied by redness, swelling of
the conjunctiva (the transparent membrane covering the eyeball and
undersurface of the eyelid), eyelid swelling, light sensitivity, “grittiness,” and
sometimes tearing or mucus. Some people have no itchiness but experience a
burning sensation and “eye fatigue” that causes them to rub their eyes.
The health care professional will examine your eyes thoroughly, looking for some
of the classic signs of ocular allergy: fluid inside certain tissue layers in the eyes,
more than normalvisible redness of the blood vessels in the eyes, droopy or puffy
eyelids and mucus discharge. In some people, congestion of the blood vessels in
and around the eyes can cause dark circles to form around the eyes, called
“allergic shiners.” Eyelid swelling is also a sign of seasonal allergic conjunctivitis
that can have permanent effects on the skin surrounding the eye. The acute
reaction can cause rapid swelling and gradual “deflation,” which, over time and
repetition, can damage the collagen fibers and thin skin surrounding the eye,
lending the appearance of drooping, wrinkly or sagging eyelids.
Many people also haveitchy and runny noses. Somedoctors may take a sampleof
your eyes’ tears for laboratory analysis to help identify what is causing your eyes
to have an allergic response. It is important for the doctor to determine that you
are indeed having an allergic reaction. Other eye problems can cause similar
symptoms, including viral or bacterial conjunctivitis, dry eyes or a condition called

4. blepharitis, which occurs when tiny oil glands located near the base of the
eyelashes malfunction. If you do not respond to treatment, you should be treated
by a specialist such as an allergist/immunologist or an ophthalmologist.
Although the seasonal and perennial allergic conjunctivitis discussed above are
the mostcommon types of eye allergies, there are also four other types, which, as
mentioned above, are rare. While seasonal and perennial allergic conjunctivitis
represent 80 to 90 percent of ocular allergy cases, the severe forms described
here make up the remaining 10 to 20 percent.
Vernal keratoconjunctivitis usually occurs in adolescent boys, with symptoms first
appearing between the ages of 3 and 20. It is typically a seasonally recurring
disease, not typically present perennially. Often, children who suffer from
eczema, asthma or sinus allergies will find themselves experiencing eye allergies
as well. The symptoms are similar but more severe than those of allergic
conjunctivitis, including intensely itchy eyes that burn and feel as if something has
entered the eye to irritate it. Light sensitivity and blurred vision may be present.
This condition is considered to be potentially vision threatening.
Atopic keratoconjunctivitis usually occurs in adults who are highly sensitive to
allergens and is associated with asthma, rhinitis, skin rashes or food allergies.
Patients usually have the same signs and symptoms as those with the more
common types of eye allergies, except that these patients have perennial
inflammation and are at risk for cataracts or conjunctival and corneal scarring.
There is usually lid swelling, particularly on the lower lid, and the skin is scaly and
wrinkled. Corneal ulcers may form.
Contact lens-associated papillary conjunctivitis, also called giant papillary
conjunctivitis, or GPC, is a reaction to ill-fitting contact lenses, contact lens
overuse or to their solutions. People who wear disposable or gas permeable
lenses are less likely to develop this reaction. It is not a true allergy. Early
symptoms include blurred vision from the accumulation of deposits on the
contact lens surface, itching and mucus discharge from the eyes, especially
following sleep. Over time, you may be unable to tolerate the lenses in your eyes.

5. Contact ocular allergy or toxic keratoconjunctivitis can result from a reaction to
medications used in or around the eye, such as antibiotics and antivirals and other
medications. It may also result from other types of substances, such as
preservatives in some eyewashes and eyedrops, or from chemicals found in
cosmetics and hair spray, when used excessively. Fluid in and around the eye is a
typical sign, and the skin around the eyes and eyelids may show signs of an
allergic reaction (redness, puffiness and/or vertical wrinkles). Symptoms improve
when you stop using the product that is causing the problem.
Treatment
The treatment of ocular allergies is based largely on the degree to which
symptoms interfere with quality of life. The more severe the symptoms, the more
likely they are to interfere with everyday activities. The first step is to be
evaluated by an allergist to identify the allergens causing your symptoms and to
be educated by the allergist on how to avoid or remove the allergens that are
creating the problem.
Some people find that applying cold compresses to the eyes is very soothing.
That’s because the compresses cause vasoconstriction, or a reduction of
inflammation in the eye’s blood vessels. Artificial tears, cooled by storing in a
refrigerator, might produce similar results. It may also be necessary to avoid
wearing contact lenses. Treating any associated eyelid problems, such as rashes
or eczema, with lid scrubs and topical antibiotics may also help.
It may be necessary to get symptoms under control quickly by using a more
aggressive approach. Following is a list of medications that are sometimes used.
Over-the-Counter Medications
Artificial tears are extremely safe and can be used at any age. The use of
lubricants or saline washes helps to remove allergens from the eye’s surface to
relieve mild symptoms. However, artificial tears contain no pharmacologically
active ingredients to specifically combat the allergic reaction. Instead, these
products mimic the soothing properties of natural tears and provide fast relief. If
your eyes are especially sensitive, you might consider using preservative-free

6. products, which may be helpful for patients complaining of both allergy and dry
eye symptoms or “itchy, burny” eyes.
Over-the-counter eyedrops, which frequently contain decongestants and
antihistamines, are used by many people for short-term relief of some symptoms.
They also help to reduce redness by constricting conjunctival blood vessels.
However, they may not relieve other symptoms. Another shortcoming is that
some may only be used for short periods, no more than four times a day for no
more than two to three days. Prolonged usemay worsen your symptoms, causing
more swelling and redness that persists even after you stop using the drops.
Tachyphylaxis, or a rebound effect, sometimes occurs with the use of other
decongestants as well, such as nasalsprays. Although initially they seem to relieve
stuffiness, after a few days your nose feels stuffier than ever. It’s especially
important to note that if you have heart disease, arteriosclerosis or narrow angle
glaucoma, some eyedrops may pose a danger to your health. Nonsteroidal anti-
inflammatory eyedrops may also work to relieve the itching associated with
ocular allergies. You may need to use these drops four times a day, however, and
they may cause burning or stinging when you first put them in your eyes. Your
health care professional can tell if the solutions you are using might jeopardize
your health or worsen your condition.
Over-the-counter oral antihistamines, available in both liquid and pill forms, can
relieve itching slightly, but at the same time may cause dry eyes, worsening eye
allergy symptoms. Side effects are sometimes very unpleasant and can include
drowsiness, agitation, dizziness or poor coordination. Theseshould not be used as
primary therapy for ocular allergy. Direct, topically applied ophthalmic medication
is a much better treatment. If you’re taking over-the-counter oral antihistamines
for nasal symptoms, consider adding an eyedrop to adequately address eyeocular
complaints. An eyedrop can aid in treatment of nasal symptoms as well.
Prescription Medications
Antihistamines are available in both oral and topical forms. Topical antihistamines
come in the form of eyedrops and are sometimes preferred over oral forms
because they are applied directly to the eye and act more rapidly. Eyedrops are

7. less likely to cause side effects because they are not taken into the body
systemically as oral medicines are. Antihistamines provide quick relief, though
sometimes only for a few hours. Some of the oral prescriptions are formulated to
be non-sedating and so do not cause the drowsiness of over-the-counter
formulations, but they still can cause some drying effect on the eyes, contributing
to or worsening symptoms of dry eyes. Some topical antihistamines need to be
reapplied four times a day. They last about two hours, but shouldn’t be taken
more than four times a day, so it could be difficult to get daylong coverage for
your allergies if you’re relying solely on ophthalmic antihistamines.
Combination mast cell stabilizers and antihistamines are the most recently
developed drugs available for topical ophthalmic treatment of allergic
conjunctivitis. They combine the mechanisms of both an antihistamine and a mast
cell stabilizer in a single drug. This allows for rapid blocking of the histamine
receptors on nerves and blood vessels that are the cause of the itching and
redness of allergy, as well as stabilizing the mast cells to preventfurther release of
substances/molecules that would induce further allergic reaction. Dosing is
typically two times a day. Drugs in this class include olopatadine (Pataday,
Patanol), azelastine (Optivar) and nedocromil (Alocril, Lastacaft).
Second-generation mast cell stabilizers work to prevent those cells from releasing
the substances responsible for itching and, if chosen as allergy therapy, must be
used regularly to prevent problems in people with seasonal allergic conjunctivitis.
Mast cell stabilizers are not thought of as a fast-acting choice for allergic
conjunctivitis. In fact, it usually takes two weeks, using them twice a day, before
they reach their peak effectiveness. Additionally, they require regular, consistent
dosing throughout the allergy season, not just when an acute attack occurs.
Corticosteroids tend to be prescribed carefully, using the minimum dose and
mildest type of steroid for the shortest possible time. One topical corticosteroid,
loteprednol etabonate (Alrex, Lotemax), is prescribed when a rapid response to
treatment is necessary and other drugs have not worked. Corticosteroids should
never be used for any length of time, as they have been linked to cataracts,
glaucoma and superinfections of the eye’s surface.

8. Allergy shots, or immunotherapy, are sometimes used when other therapies do
not help control your symptoms. These shots inject increasing amounts of the
allergens that are affecting your eyes into your body to help curb your eyes’
reaction. The treatment usually takes several months to achieve maximum
results.
Selecting the Proper Treatment
Your health care professional will recommend or prescribe the medication
needed to treat the symptoms that are most troublesome to you. The most
common and most effective medications used to treat ocular allergies are
topical—that is, they are applied as eyedrops directly to the surface of the eye.
Topical medications offer several advantages. They are noninvasive and deliver
medication directly to your eyes where it can be speedily absorbed. This also
reduces the risk of side effects within other parts of your body becausethe drug is
not absorbed throughout your system the way an oral drug would be. The effect
of a topical eyedrop depends on severalfactors, including the size of the drop, the
size and condition of the eye and your willingness to consistently use it as
directed.
Some medications are safe for children but others are not, so be sure to read the
packaging information carefully before offering your children any type of
medication. Medication available by prescription should, of course, be used only
by the individual to whom it was prescribed and not shared with any others.
Your health care professional may recommend more than one medication for
you. In that case, be sure to administer eyedrops or ointments at least five
minutes apart to allow enough time for your eyes to absorb each medication and
to prevent one drug from diluting the other. In addition, contact lens wearers
should carefully follow instructions regarding medication instillation prior to lens
insertion, typically a 15-minute wait between medication and lens insertion. If
you are using a solution and an ointment, use the solution first, followed by the
ointment, since an ointment can prevent the drops from entering the eye.

9. Prevention
The best way to prevent eye allergies is to avoid the source of the allergen. Once
you and your eye care professional identify what substances are triggering your
allergies, you can take steps to reduce contact with them. Take the following
environmental control measures to minimize contact with pollens, molds and
other substances.
 Close windows and doors.
 Avoid window or attic fans.
 Reduce outdoor exposure to allergens by staying indoors when allergens
are at their peak, usually in the morning.
 Shampoo and shower following outdoor exposure to allergens.
 Stay away from damp areas, such as a basement, that may harbor molds.
 Avoid lawn mowing or raking leaves.
 Minimize humidifier use to reduce the spread of molds.
 Wash bedding in very hot water (at least 130 degrees F) frequently and dry
in a hot dryer so that dust mites don’t proliferate. Use allergen-proof covers
for pillows, mattresses and box springs.
 Stay away from curtains or drapery that may harbor dust.
 Remove stuffed toys from children’s reach.
 Avoid furry animals.
 Avoid irritants such as tobacco smoke, perfume, potpourri, chalk dust and
markers.
You can take a number of additional measures. For example, try not to rub your
eyes, even though they may itch horribly. Rubbing the eyes can worsen the
allergic reaction. Your condition may clear up more quickly if you don’t rub.
Facts to Know
Twenty percent of people in the United States suffer the discomfort of eye
allergies.

10. Steroids are sometimes used to treat eye allergies, but they carry a much greater
risk of short- and long-term side effects than other therapies, including risks for
glaucoma and cataracts. Steroid use should be reserved only for cases that do not
respond to other treatment and for severe forms of allergy.
The most effective way to treat the eye is with eyedrops. If you’re taking a pill for
nasal allergy symptoms, consider adding eyedrops to more effectively and
specifically treat the ocular complaint.
Combination mast cell stabilizers and antihistamines, which combine mechanisms
of both antihistaminic and mast cell stabilization in a single drug, are the most
recently developed drugs for topical treatment of ocular allergies.
More and more people seem to be suffering from allergies these days. The exact
reason why is unclear, but some researchers believe that our clean, modern
society no longer requires us to fight off multiple childhood infections, thus
causing our immune systems to take on a more of an allergic stance
Key Q&A
What are ocular allergies?Common things in the environment such as dust or
pollen irritate some people’s eyes. These substances are called “allergens,” and
they can cause symptoms such as itching and swelling in the eyes. This reaction is
usually centered in a part of the eye called the conjunctiva, which becomes
inflamed when triggered by a substancethat a person is especially sensitive to. An
ocular allergy can happen suddenly or some time after you come in contact with
the allergen.
The most common form of ocular allergy is seasonal conjunctivitis. When a
susceptible person is exposed to allergens from the environment, such as pollens
in the fall and spring, they experience seasonal conjunctivitis. However, some
people suffer year round from perennial allergies caused by other substances
such as molds, house dust mites, animals and insects. They may have chronic
allergies, which occur with persistent exposure to allergens, or acute attacks from
intermittent exposure to these triggers.

11. Are there any other types of eye allergies besides seasonal and perennial?Yes,
though these severe forms of ocular allergy are rare. Vernal keratoconjunctivitis
usually occurs in adolescent boys who suffer from eczema, asthma or sinus
allergies. Atopic keratoconjunctivitis usually occurs in adults who are highly
sensitive to allergens associated with asthma, rhinitis, skin rashes or food
allergies. Contact lens-associated papillary conjunctivitis appears to be an allergic
reaction to contact lenses or their solutions. Contact ocular allergy or toxic
keratoconjunctivitis can result from a reaction to medications used in the eye,
such as antibiotics and antivirals.
What happens when allergens affect the eyes?When your eyes come in contact
with something your body considers foreign—such as pollen, dust or pet
dander—special cells in your eyes go on alert. These cells then release different
kinds of chemical substances that can causeyour eye allergy symptoms. This does
not happen in all individuals, but only those who have been “sensitized” to these
specific foreign substances.
Can cigarette smoke cause eye allergies?Although cigarette smoke, diesel exhaust
and other environmental substances may cause your eyes to become inflamed
and irritated, they do not trigger an allergic response. But they can make your
allergy symptoms worse.
How do I know if I have eye allergies?Itching is the symptom that allergy sufferers
complain about most. Other common reactions are redness and watery eyes. You
may also have swelling, puffiness or throbbing. Some people find that their
allergies make their eyes very sensitive to light. However, they only way to be
certain that you are having an allergic response instead of some other type of eye
problem is to visit your eye care professional for a diagnosis.
How can I prevent eye allergies?The best way to prevent eye allergies is to avoid
the source of the allergen. Once you and your health care professional identify
which substances are triggering your allergies, you can take steps to reduce
contact with them.

12. The nonprescription medicines I am buying are not helping enough. What else can
I do?Many new therapies are available to help relieve the symptoms of eye
allergies and even to prevent them. Discuss the options with your eye care
professional, who can tell you which medication is best for you.
What is the most common treatment for eye allergies?An effective allergy
medication specifically aimed at halting ongoing symptoms and preventing future
symptoms of allergy is best. Today, this would be the dual-action agents
(antihistamine/mast cell stabilizers).
Topical antihistamines, usually in combination with decongestants, are another
treatment option. They act quickly and effectively to block allergen receptors.
However, they may need to be used up to four times a day.
Do allergy shots help eye allergies?Allergy shots, or immunotherapy, are
sometimes used when other therapies do not help control your symptoms.
However, they can take months to work and therefore are not typically the first
choice for treatment.
Metabolic syndrome is not a disease, but a clustering or “constellation” of health
markers. Although there are several definitions of what is required to be
diagnosed with metabolic syndrome, in the United States most health care
professionals use criteria from the National Heart, Lung, and Blood Institute
(NHLBI) and the American Heart Association.
That definition says you must have at least three of the following five markers to
be diagnosed with metabolic syndrome:
A waist measurement of more than 35 inches around (more than 40 inches in
men).
A fasting blood glucose level of 100 mg/dL or higher; or you’re already taking
medication because you have high blood glucose levels.
A triglyceride level at or above 150 mg/dL. Triglycerides are a form of fat in your
blood.

13. An HDL cholesterol level (the “good” cholesterol) below 50 mg/dL (below 40
mg/dL in men); or you’re already taking medication to increase your HDL level.
For more Information visit us our website: safegenericpharmacy.com