Care for itchy eyes

When you find yourself rubbing your eyes in irritation due to dust, smoke or other external factors, it is prudent to take preventive measures against allergic conjunctivitis, urges Dr Niranjan K Pehere.

Conjunctiva is a thin transparent film covering the white portion of the eye. Inflammation (reaction) of conjunctiva in response to some irritating element in the environment or allergens is called allergic conjunctivitis.

The most common allergens are dust, pollens (of grass, weed, trees), mould (spores of some fungi) and dander (animal hair/particles of shed skin).

Allergic conjunctivitis is usually broken down into different categories and Vernal Keratoconjunctivitis is one of the severe forms of seasonal allergic conjunctivitis that affects children in particular.

It can affect people of all ages, although it is seen more commonly in children and young adults. It usually starts in late childhood and is more common in boys than girls. It may last between 5-10 years and is rarely seen after the age of 30. It is mostly prevalent in tropical and temperate climates.

Some people suffer from allergic conjunctivitis for the whole year (perennial allergic conjunctivitis). This is mostly seen in response to allergy to house dust mite, animal dander, indoor and outdoor mould spores and, occasionally, food or food additives. Some suffer during particular seasons like in spring or summer.

This usually happens due to pollens being released in air in that season and the dry air, which makes them freely float in the atmosphere. During rainy season, the pollens settle down, hence the patients are symptom-free.

Symptoms

Itching
Burning sensation
Redness
Watering
Stringy discharge
Puffy eye lids
Sensitivity to light

Usually these symptoms are present in both eyes, though the severity may be different in each eye. Sometimes, allergic conjunctivitis can be a part of generalised allergic reaction in body. Along with eye problem, patient may have runny nose, wheezing or asthma, and skin rashes or urticaria (hives) or eczema.


Treatment

Patients must understand that the goal of medical treatment is, basically, to relieve the patient of symptoms, with least possible side-effects and to maintain good quality of life. There may not be any cure as such. It is best to identify the allergen and keep away from it.

There are several immunological tests available to identify them, but usually patients themselves can identify the cause. If the allergen is known, immunotherapy for that specific allergen may benefit some patients with persistent, severe allergic conjunctivitis.

Common medications (eye drops)

Topical lubricants: These help flush
allergens from the eye

Antihistamines: This medication acts against histamine, one of the key mediators of inflammation

Mast cell stabilisers: These medications ‘quieten’ the mast cells, which
release histamine

Prevention

Try to identify the allergen and reduce exposure as much as possible
Avoid rubbing eyes
Avoid self-medication
Wash your bed linens, pillowcases and towels in hot water and detergent to reduce allergens
Avoid wearing eye makeup and don't share eye makeup with anyone
Never wear another person's contact lenses
Remember to wear glasses whenever you are outdoors
Clean your eyes with cold water or cold compress at least two to three times a day

(The writer is a paediatric neuro-ophthalmologist, The David Brown Children’s Eye Care Centre, Hyderabad)

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