Treating Eye Allergies – A Fast, Easy Plan to Feel Better
Treating Eye Allergies
(and a story of a crying allergist)
Most commercials are trying to compete to become the most recommended antihistamine (read my recommendations on antihistamines here) so I can understand why they don’t address it. But many medical providers ALSO don’t do a good job treating eye allergies!
If you are one of the people with eye allergies (or if your child is), then you know that it is UNFAIR that your symptoms aren’t addressed better.
Well, this post will help you and/or your child today!
My Medical Background on Eyes
Most medical providers don’t get an extensive education on eye problems. In general, most primary care providers are trained to identify emergencies and call an optometrist or ophthalmologist. I am no exception.
In fact, I have to admit that eyes really creep me out (medically).
My ophthalmology rotation was one of the few times that I almost passed out from a stress response (they put a needle in someone’s eye!) and I have always been a little skittish with eye problems.
So what that meant to me was:
- Knowing it was a “deficiency” for me, I studied harder for eye symptoms so that I could get to the right answer quickly and not miss anything.
- I was an absolute BABY when I had to wear contacts.
My promise to you today is first I’ll help you with your eye problems and second that I’ll finish the story of a grown allergist crying!
NOTE: Adults and kids are both treated with this same plan so whenever I mention your eye symptoms, the advice applies to either you OR your child!
Symptoms of Eye Allergies
If you have eye allergies, you should have the following symptoms:
- ITCHY eyes
- Red, watery, irritated eyes
- You should also have regular “nose” allergy symptoms
- Most eye allergies have a “trigger” such as pets or pollens/seasons
This list is pretty simple but contains a few key points:
- If you have red, watery eyes and they don’t itch, then you may not have eye allergies.
- Eye allergies are also NOT usually associated with pus or thick mucous
- There should NEVER be pain or vision changes.
- If you DON’T have nose/regular allergy symptoms and ONLY have “eye allergies” then often this is not truly eye allergies (not sure if you have nose symptoms? Take 5 minutes to do this quiz and find out).
- There is often a “trigger” to your eye symptoms
IMPORTANT: Eye allergies should NEVER be painful and NEVER cause vision loss. These are two of the warning symptoms that mean you should get it checked out by an ophthalmologist immediately!
If you have eye allergies you should ALSO have regular / “nose” allergies.
Take this QUIZ to see what type of allergies you have!
Treating Eye Allergies
I have developed a pretty good treatment strategy to help you feel better and treat your eye allergy symptoms. You canor create your own strategy with these tips:
Treating Eye Allergies – Step 1: Identify Triggers
Most of the people I talk to have pretty bad allergy symptoms overall but only have eye allergies around certain triggers. These are most commonly pets (dogs or cats) or perhaps when you mow the lawn.
This article can help you identify your triggers, but if you fall into this category then identifying and avoiding your triggers may be all you need to do!
Treating Eye Allergies – Step 2: Treat the Nose FIRST!
Many people trying to treat eye allergies go straight to eye drops. This is most often NOT the best step. Instead, I want you to treat your nose first!
Think of the nose as the “Gateway to the Eyes” for your allergy symptoms. You should ALWAYS treat the nose first and make sure that your baseline allergy symptoms are controlled.
Note: Not sure what to add? Email me and I’ll be happy to help guide you.
Treating Eye Allergies – Step 3: ADD Eye Drops if needed
After you treat the nose symptoms, the next step is to add eye drops.
There are many different eye drops to choose from and each one has its own list of plusses and minuses. I’ll review these specifically in a future article (request it early by clicking here) but in general the progression should be:
Start with Over the Counter (OTC) Eye Drops
Treating eye allergies with OTC eye drops comes in many different forms: topical moisturizers (Refresh, Artificial Tears), topical decongestants like Visine-A, and topical mast-cell stabilizers like Zatidor (ketotifen).
- In general, I recommend you try the Zatidor (ketotifen) first.
- Since it’s a mast cell stabilizer, it doesn’t just treat your symptoms but also the underlying cause of eye allergies.
Change to Prescription Eye Drops
If the OTC eye drops don’t work well enough (and, honestly, most of them don’t for people with significant eye allergies) then it is time to change to prescription strength eye drops.
These are usually topical antihistamines but may also be topical cromolyn or prescription strength topical mast cell stabilizers.
- I recommend a topical antihistamine, such as Patanol/Pataday (olopatadine) or Optivar (azelastine).
- These medications should really be considered equal in efficacy and benefit.
Treating Eye Allergies – Putting it All Together
These 3 steps are a good general plan for treating your eye allergy symptoms. With so many different options and treatment strategies out there, this one is pretty straight forward and textbook to getting you feeling your best.
The benefit of this plan is that usually you won’t need your eye drops all the time, but can use them “as needed” or only during specific bad times of the year/bad trigger exposure.
If you would like a more specific strategy to treat your eye allergies, you canand download it right now!
Your Crying Allergist
As you can see, I’ve given you a good evidence-based comprehensive plan for treating eye allergies. This fulfills my first promise.
Now, for the second promise:
This story actually takes place in allergy fellowship – I had already been an internal medicine attending for an Air Force tour and was about 32 years old. I had recently started to wear glasses and wanted to wear contacts. All pretty normal.
What wasn’t normal was me sitting at the kitchen table (with the encouragement of my wife Kristie) trying to put in a contact but dodging my own finger as if I were a ninja. For about 30 minutes I would psych myself up, move my finger to my eye and then swiftly move my head out of the way and breathe a sigh of relief. And then do it again! It was ridiculous.
Eventually Kristie offered to help do it for me and was trying to put my contact in for me (again, I am 33!) and I roll out of the chair to the floor, cover my eyes and start to cry about how scared I was to put anything in my eye.
It was not my finest moment.
Eventually I DID learn how to put contacts in. And even eye drops (oh, man, that was also not my finest moment). Although I got my eyes lasered since then and it is amazing!
If any of you are thinking of doing it, I highly recommend it. Let me fix your allergies online and save up your allergist copays and spend it on laser eyes! You’ll be so pleased with your decision!