Effective ocular allergy treatment improves quality of life

Andrea L. Fisher O.D., North Coast Eye Care

Spring is infamous for showers, blooming flowers, green grasses and allergies. However, this allergy season, for the 40 million allergy sufferers, expect the things: bugs and allergies. Allergy season this year is bit delayed with the cold 20’s temps finishing off the third week of March. Patients are still coming into our offices with symptoms of dry eye due the colder temps. Spring allergy sufferers will begin to experience those dreaded symptoms of itchy red and watery eyes in the first week of April.

The problem that most allergy suffers find is that they take so much antihistamines, such as Pataday, Pazeo Bepreve, Lastacaft and Zaditor (topical ocular medication) and Claritin, Zyrtec, and Allegra (over the counter oral medication) that it most often results in dry eye situations because of the decrease in production of aqueous secretion, a side effect of antihistamines. This, in fact, hinders the eyes’ ability to wash away allergens, such as pollen and dust. With all the inflammatory debris on the surface of the eye, it can cause a local surface inflammation on the eye. An alternative to our allergy eye drops is simply a nasal rinse with saline, or artificial tears to wash allergens off the surface of the mucosal membranes of the nose and eyes. This will stop the cascade of antihistamine use, resulting in lower itching and watering, then proceeding to lower tear production, followed by increased ocular inflammation from allergens not washed away from the surface of the eye, then burning from dryness, more antihistamine cause the itching comes back, and the process repeats.

Another tool optometrist s have is topical steroids and non-steroidal anti-inflammatory drugs (NSAIDs). These medications play a significant role in late-phase reactions by stopping the inflammatory cascade mentioned above. However, it must be noted they are inappropriate for long term use. In addition to artificial tears, as a non-pharmacological treatment, cool compresses aid in the relief of the itching and watering of allergy symptoms. Another thing to consider is that blepharitis, a low grade inflammation at your lid margin most definitely needs to be addressed with allergy symptom treatment. Lid scrubs in the form of OCCuSOFT lids scrubs or SteriLids eyelid cleanser each have a two fold benefit: they remove the allergens caught in your eyelashes (which is in fact their purpose in protecting the eye), as well as removing the debris in your lashes that provoke a low grade inflammation, which is blepharitis. A clinical pearl that is also non-pharmacologic, is to shampoo your hair before bedtime, since debris and allergens get trapped in hair as well as in your eyelashes. Washing your bed linens weekly also helps with both perennial and seasonal allergies. Well known allergists recommend that not only using a dust/microbial cover on your pillows, but also replacing pillows every two years for those who have allergies helps keep reactions to a minimum.

For allergy sufferers who also wear contact lenses, the unfortunate truth is contact lenses make your eyes feel more dry, more irritated, and provoke itching when allergies symptoms are at their worst. If you must continue to wear your contact lenses and everything mentioned above has been attempted, the smartest thing to do is to stay away from the things that you’re allergic too. For example, if you are allergic to ragweed, don’t go for a bicycle ride at the height of ragweed season. Avoidance is a very valid form of treatment. If daily disposable lenses are an option in your prescription, these lenses work the best with allergy suffers. By placing a fresh lens on your eye every day and maximally wearing the lenses 12 hours, you reduced the continued contact of irritating allergens that get deposited on the lenses. Daily Disposable torics and multifocals are readily available. While two years ago, these advanced perimeters were not available in dailies, today, they are. Talk to your eye care provider on availability.