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The itch you can’t scratch – Your Eyes

Antihistamines for the Eyes

Allergies can be a real pain, especially when the affect the eyes. Allergies come in several forms, but most people suffer from seasonal allergies. Seasonal allergies are exactly what they sound like, allergic reactions to the environment during a specific season, or time of year. Most are affected by allergies in the spring and summer, when trees and flowers are in full bloom, spreading their pollen throughout the air. If your body thinks a certain pollen is a threat, it will mount an immune response to try to neutralize it. As we know, pollen and other common allergies are often harmless, but the reactions our body can have definitely are not! Some of the most common and irritating symptoms of seasonal allergies are red, itchy, watery eyes. People around the country regularly flock to drug stores searching for a drop to soothe the pain, but are overwhelmed and lost in a sea of different drops all claiming to do the same thing. Here, we will aim to simplify the process, and hopefully provide relief for this acute, and sometimes chronic condition.

See our blog on Pet Allergies

When our bodies detect something foreign, one of the chemicals produced is histamine, this chemical is responsible for most of our symptoms. This is why over the counter and prescription medications are called, anti-histamines. The main way these drugs work is by stopping the release of histamine, so we can encounter allergens, but don’t suffer the symptoms that histamine is responsible for. For treating eye allergies, allergy pills like Zyrtec and Allegra can help, but the most direct route is with a drop.

Two allergy drops I like to recommend are Ketotifen and Olopatadine. These are both over the counter and readily available at most grocery and drug stores. Ketotifen is found in the two common drops, Alaway and Zaditor. These two drops are very similar in how they function, but are produced by different manufactures. Alaway and Zaditor should be the first line treatment for mild to moderate allergic eye symptoms as they are inexpensive and easy to find. Both of these drops are dosed twice daily and can be used for long periods of time without significant side effects.

Olopatadine is a drop that used to available by prescription only, but has now moved over the counter. Olopatadine is marketed by the brand name, Pataday, and comes in three formulations. The lowest 0.1% concentration called “Pataday Twice Daily”, a 0.2% concentration labeled “Pataday Once Daily”, and a 0.7% concentration “Pataday Extra Strength”. These medications work in the same way, but are usually more effective at treating allergies than the previously mentioned drops, however at a much steeper price. This is why I recommend starting with Zaditor or Alaway first.

If neither of these options work, it is recommended to step up to prescription antihistamines or other anti-inflammatory drops. Other allergy medications often prescribed for allergies include Cromolyn and Lastacaft. Sometimes the only way to quickly calm down a red, itchy eye is with the use of a steroid like Prednisolone Acetate. Steroid eye drops are used to prevent and control inflammation of the eye, however they can come with severe side effects like cataracts and glaucoma if not properly used. If prescribed, your doctor will give you detailed instructions on how and when to use them.

Eye drops that I do not recommend are any that claim to relieve redness or “get the red out”. Drops that commonly fall into this category include Visine and Rohto. These drops contain ingredients that may make your eyes appear healthier, but are actually harmful to the surface of the eye, and can cause dependence if used long term. If you feel your symptoms do not improve with the use of antihistamines, it may not be allergies, especially if you notice colored discharge or experience any changes in vision. As the above remedies may help some, it is recommended to talk to your doctor about any eye conditions that are affecting you.

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Dr. Ryan Dugan, OD

Dr. Ryan Dugan, OD is an Optometrist specializing in the treatment and management of ocular disease. He graduated from Pacific University College of Optometry, and went on to pursue a residency program at the Southern Arizona VA Health Care System (SAVAHCS) receiving advanced education in ocular disease and low vision rehabilitation. He has worked in private, commercial, and hospital settings helping patients with eye conditions such as glaucoma, cataracts, and macular degeneration. He currently practices at an ophthalmological surgery center in Colorado comanaging complex disease states and surgical operations. He has participated in both local and international trips to bring eye care to underserved populations, and is passionate about providing quality eye care while empowering patients to understand their diagnoses. When not in the clinic, Dr. Dugan enjoys the outdoors and spending time with his family.




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