Allergies and Contact Lenses in the Allergy Season

Today’s Strategy to keep allergic patients happy in their contact lenses

Allergies are the number one reason for contact lens dropout, the point of which contact lens wearers can no longer wear contact lenses comfortably. In fact, the prevalence of allergic reactions has risen to as much as 40% of the U.S. population each year. What is even more alarming that there is a trend seen in optometric offices that allergy sufferers, as much as 78%, experience ocular symptoms that are aggravated by dry eye disease (DED). Dye eye disease can increase a patient’s susceptibility to allergic conjunctivitis (AC) because it impairs the eyes ability to remove ocular surface allergens. Often both allergy and dry eye co-exist to make sufferers miserable with and without contact lenses.

Allergies are defined as seasonal allergies (SAC) and perennial allergies (PAC). There is another type of allergy, called giant papillary conjunctivitis (GPC) that is an immune response to protein that deposit on over-worn contact lenses. Although GPC is not a hypersensitivity reaction, similar to what is seen with seasonal and perennial allergic responses, it is mediated by lymphocytes in the immune response.

What can you do if you begin feeling discomfort with your contact lenses?

First of all, see your eye doctor. He or she will be able to see the ocular surface damage and perform tear film stability tests. The treatment often involves many office visits. “The first part of my education to my patients, is to explain, this is not a ‘one and done’ type treatment scenario”, adds Dr. Fisher, “you may need to see your eye doctor 2-3 times before the allergic reaction is over or the dry eye condition is resolved. Often, without this crucial knowledge, patients will try a therapy for one to three days, and when they see no improvement or relief, they stop taking the eye drops. Keep in mind, most people wait 2-4 weeks before going to the eye doctor, and the allergic reaction is initially unresponsive or slow to respond to drug therapies when the condition goes untreated for weeks. Medication can also be stopped too soon, especially when allergies are the problem.

Key points to remember while you are being treated.

1. Using a rewetting eye drop (artificial tear) like Systane Ultra or Refresh Gel/Refresh Optive can flush the allergens, the agent that initiate the allergic reaction, from the eye. Using them as often of 4-6 times a day can be very effective. Stay away from Visine or Cleareyes, which are “get the red out” vasoconstrictors. They reduce blood flow to the white part of your eye, which is not healthy.

2. Wash your bedsheets weekly. If pets sleep with you, kick them out of the bedroom for a month, to see if your eyes feel better. When cats sit on your pillow while you are away, and your face is buried in your pillow nightly, the cat hair left might be the problem.

3. Use dust/allergen covers on your pillows and change the cover annually

4. Take a shower after being outside. Whether you’re doing yardwork, going to a sporting event, or just taking a walk, allergens are everywhere, but especially in grass, leaves and brush. Flush all the allergens from your eyebrows, eyelashes and hair, before you go to bed.

5. You might need to take eye drops prescribed by your doctor for a period of 1-3 months before you can get back into contact lenses. If allergies are the culprit, you will need to take a mast cell stabilizer/antihistamine before you insert your lenses and after you take them out.

6. Wear your contact lenses as directed by the manufacturer. If you wear a two week lens, throw them away after two weeks. Maximum wearing time of daily wear lenses is 14 hours. Sleeping in lenses (extended wear) can cause GPC and should be avoided.

7. Finally, daily lenses (lenses that are thrown away after 12 hours of wear) might be a suitable alternative when runny, watery eyes cannot be corrected with medication. Allergens and histamine can sometimes become attached to the lens and are difficult to remove. If daily lenses aren’t available in your prescription, review your contact lens solution and care regimen with your doctor. It has been proven that peroxide systems, like Clear Care, is more effective than multipurpose solution ( Pure Moist or BioTrue)

Remember, you don’t need to show symptoms to prove you have allergies. You can exhibit sub-clinical allergies and without contacts, you are perfectly comfortable. By adding contact lenses you add a surface that proteins in your tears can adhere to, and create an inflammatory cascade that results in discomfort, watery, red, swollen, itchy and burning eyes. It may not necessarily be the specific type of contacts that is the problem; it is the un-diagnosed allergies that if treated with anti-histamines, can allow a person to wear contact lenses comfortably. Finally, remember your immune system is a constantly changing and evolving organ system that can develop allergy responses out of the blue later on in your adult life.