Summer is here and grass pollen is swirling, causing those with allergies to suffer.
When the body thinks it is being assaulted it increases the blood supply to carry away the intruder. Unfortunately the intruder is not a germ but is something in the environment, either a sudden encounter such as cat dander or long-term exposure to dust or mold.
Allergies cause dry, itchy, twitchy, watery, puffy, red eyes. Sinus blood vessels become congested causing black circles under the eyes known as “allergic shiners.” Mast cells control our allergic response. Like an electrical outlet, there are receptor sites on the mast cells’ membranes which can accept certain pollens and other allergens. When the allergen plugs into the receptor site the mast cell membrane explodes, releasing histamine, causing red, itchy, irritated eyes.
There are many ways to treat allergies. Easing allergy eyes can be as simple as using cold water compresses or as complex as using medications to prevent future attacks. Other easy measures include closing doors and windows, using eye lubricants to wash away pollen or avoiding exposure to the irritant. Wash sheets in scalding hot water for dust allergies, eliminate then slowly re-introduce soaps and cosmetics and keep pets bathed and out of the bedroom.
Over-the-counter medications (OTC) are available. Antihistamines block the receptor site; therefore the mast cell does not explode. That is why an antihistamine before allergen exposure increases effectiveness. Eyedrops put the medication only where it is needed. Older-style OTC drops are short-lived and may cause dilation. Some drops which were previously prescription-only are now available over the counter; these last longer and have fewer side effects.
Calming extreme eye allergies requires a visit to the optometrist for a prescription. Anticipating the allergy season and receiving proper instruction on medication use greatly increase effectiveness. Pataday, a prescription combination antihistamine/mast cell stabilizer, is a once-daily drop which is quite effective. Severe itching and swelling are relieved quickly with steroid eye drops but long-term these can have serious side effects.
Contact lens wear during allergy attacks varies from mildly irritating to impossible. Allergic response to the debris that builds up on contacts can aggravate symptoms. Sometimes removing the contact lenses for a period of a few days alone can calm an allergy attack. Many allergy drops should not be used during contact lens wear. Dirty lenses are a time-bomb for allergic wearers. Lenses should be replaced often; one-use lenses can allow some sufferers to wear their lenses even in the worst times. Backup glasses that can and will be worn are vital for contact lens wearers who have allergy eyes.
Oral medications such as Benadryl and Zyrtec help with skin and nasal allergies but do little for the eyes; indeed they can dry eyes which actually increases symptoms. Other medical treatments are nasal steroids, HEPA air-filters, HEPA vacuum cleaners and allergy shots.
Allergies are uncomfortable and can be unsightly but rarely threaten vision. Identifying the cause of an allergy and avoiding it is the best approach. If that is impossible there are medications and treatments to help one through the allergy season. Seasonal allergies are more effectively dealt with by seeking care early.
Dr. Scarbrough’s office is Eagle Eye Vision Care at 17320 135th Ave NE, Suite D, Woodinville. 425-398-1862.