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Ocular Allergies

By Greg Evans, DO

Little_Girl_SneezingSpring is allergy season and in our desert the spring season starts earlier and runs later (due to the multitude of plants) than most American cities. This means daily and persistent high pollen counts, which can soar when the wind blows and agitate most allergy sufferers.

Patients often show multiple allergy symptoms related to more than one underlying cause. For example, dry eye can cause excessive tearing, redness and irritation. Allergy mediated inflammation in turn can exacerbate underlying dry eye.

Managing allergies involves three steps: 1) identifying the triggers/antigens;
2) preventing exposure; and 3) treatment.

Before any ocular exam, make sure to bring a list of not only oral prescribed medications, but also any over-the-counter eye drops and oral medication you may be using. Oral antihistamines dry up the sinus and nasal mucosa, but also dry up the eye’s moisture membranes.

Treatment for ocular allergies has traditionally involved topical antihistamines and topical mast cell stabilizers. With greater understanding of the inflammatory cascade pathway involved, doctors are now treating with topical and nasal steroids and non-steroidal agents. Treating the inflammation associated with allergies allows other drugs an opportunity to work faster and relieves the symptoms (runny nose, watering eyes, itching) of allergies quickly. Newer ester-based steroids are now available and have a greater safety profile – just as topical non-steroidal eye drops tend to have fewer side effects than earlier generation steroids.

If patients are treating themselves with over-the-counter oral allergy medicine, they should tell their doctor. Some oral antihistamines such as loratadine (the active ingredient in Claritin) cause more drying of the mucous membranes than others. Switching oral allergy medication can often reduce the amount of dry eye symptoms (burning) associated with allergies.

Relief is available if you suffer from itching, burning eyes. It just takes a coordinated approach. If you’re using topical eye drops of any kind more than three times per day seek an eye doctor. Chances are you have an underlying problem that can be addressed.

Dr. Evans is the founding owner of Evans Eye Care in Palm Desert and can be reached at 760.674.8806.

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