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Eye - Allergy

Definition

  • An allergic reaction of the eyes
  • The eyes are itchy and watery

Symptoms

  • Itchy eyes with frequent rubbing
  • Increased tearing (watery eyes)
  • Red or pink eyes
  • Mild swelling of the eyelids
  • No discharge or a minimal sticky, stringy, mucus discharge
  • No pain or fever

Causes

  • Pollens - grass, trees, weeds, molds. Pollens travel in the air.
  • Pets - cats, dogs, rabbits, horses. Animal allergens may be transferred to the eyes by the hands, but can also be airborne.

When to call your doctor

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Sacs of clear fluid (blisters) on whites of eyes or inner lids
  • Eyelids are swollen shut (or almost)
  • Discharge on eyelids that's not cleared after taking allergy medicines for 2 days

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Eyes are very itchy after taking allergy medicines for 2 days
  • Diagnosis of eye allergies never confirmed by your doctor

Parent Care at Home If

  • Mild eye allergy and you don't think your child needs to be seen

HOME CARE ADVICE FOR EYE ALLERGY

  1. Wash Allergens Off the Face:

    • Use a wet washcloth to clean off the eyelids and surrounding face.
    • Rinse the eyes with a small amount of warm water (tears will do the rest).
    • Then apply a cold wet washcloth to the itchy eye.
    • Wash the hair every night because it collects lots of pollen.
  2. Oral Antihistamines:

    • If the nose is also itchy and runny, your child probably has hay fever (i.e., allergic symptoms of the nose AND eyes).
    • Give your child an oral antihistamine, which should relieve the nose and the eye symptoms.
    • Oral antihistamines usually control the eye symptoms and avoid the need for eye drops.
    • Benadryl or Chlorpheniramine (CTM) products are very effective (no prescription needed). They need to be given every 6 to 8 hours (See Dosage table). The bedtime dosage is especially important for healing the lining of the nose.
    • Continue oral antihistamines every day until pollen season is over (usually 2 months for each pollen).
  3. New Antihistamine Eye Drops (Ketotifen) for Pollen Allergies - 1st Choice:

    • Usually an oral antihistamine will adequately control the allergic symptoms of the eye.
    • If the eyes remain itchy and poorly controlled, buy some Ketotifen antihistamine eyedrops (no prescription needed).
    • Dosage: 1 drop every 12 hours
    • Ask your pharmacist to recommend a brand (e.g. Zaditor or Alaway)
    • For severe allergies, the continuous use of ketotifen eye drops on a daily basis during pollen season will give the best control.
  4. Older Antihistamine/Vasoconstrictor Eye Drops - 2nd Choice:

    • Usually the eyes will feel much better after the allergic substance is washed out and cold compresses are applied.
    • If not, this type of eye drop can be used for intermittent eye allergy symptoms (no prescription needed).
    • Ask your pharmacist to recommend a brand. Examples are Naphcon A, Opcon A or Visine A.
    • Avoid vasoconstrictor eyedrops without an antihistamine (without an A in the name). Reason: they only treat the redness, not the cause.
    • Dosage: 1 drop every 8 hours as necessary.
    • Avoid continuous use for over 5 days. (Reason: rebound red eyes)
    • Disadvantage: less effective than Ketotifen eye drops.
  5. Contacts: Some children with contact lenses may need to switch to glasses temporarily (Reason: to permit faster healing).
  6. Expected Course: If the allergic substance can be identified and avoided (e.g., a cat), the symptoms will not recur. Most eye allergies continue through the pollen season (4 to 8 weeks).
  7. Call Your Doctor If:
    • Itchy eyes aren't controlled in 2 days with continuous allergy treatment
    • Your child becomes worse

Author: Barton D. Schmitt, M.D.
Last reviewed: 9/15/2011
Last revised: 8/1/2011 3:00:56 PM

Copyright 1994-2012 Barton D. Schmitt, M.D.