How Should I Treat Them?
Approximately 50% of people with nasal allergies also have allergic eye symptoms, known as allergic conjunctivitis. The most common symptoms are some com-bination of redness, itching, and watering. If your eye symptoms are moderately severe and you have not had them before, you should always be checked by a physi-cian to ensure that you do not have an infection or some other eye condition. Patients often obtain initial treatment of allergic eye symptoms with over-the-counter medications, including oral antihistamines and eyedrops.
Oral antihistamines, are moderately effective for eye itching and discharge. Most over-the-counter allergy eyedrops contain topical vasoconstrictors, like those found in naphazoline (Visine), which should only be used for a few days at a time. When topical vasocon-strictors are used for more than 1 to 2 weeks, patients may develop habituation to the drops with rebound increases in eye symptoms when they are stopped. Ketotifen (sold over the counter as Zaditor, Alaway, and Zyrtec eyedrops) is a medication that both stops the effects of histamine on the eye and prevents mast cells from releasing histamine into the eye.
This med-ication is quite effective and does not cause any adverse effects with chronic use. If ketotifen is not effective in reducing eye symptoms, consult with a physician. If over-the-counter anti-allergic eyedrops do not relieve the symptoms of allergic conjunctivitis, your physician may recommend a prescription for eyedrops. There are a large number of prescription drops which have been demonstrated to effectively reduce eye itching, redness and watering, including emedastine (Emadine?), cro-molyn (Crolom and generics), nedocromil (Alocril and generics), lodoxamide (Alomide), pemirolast (Alamast), olopatadine (Patanol and Pataday), azelastine (Optivar), epinastine (Elestat), and ketorolac (Acular).
Patients with a history of aspirin intolerance (typically hives, wheez-ing, and/or throat swelling) should not use ketorolac, as it is a member of the nonsteroidal anti-inflammatory family of medications. Occasionally, the above medica-tions do not relieve severe symptoms of allergic conjunc-tivitis and steroid eyedrops are needed for a short (7 to 10 day) period of treatment. Loteprednol (Alrex) is a topical steroid for the eye which is approved for the short-term treatment of allergic conjunctivitis. It must be kept in mind that steroid eyedrops can lead to severe complications, including eye infections, cataracts, and glaucoma, if not used with caution under the close supervision of a physician.
Allergic conjunctivitis
Inflammation of the conjunctivae of the eye due to an allergic reaction. The con-junctivae is the membrane that cov-ers the front of the eye and extends onto the eyelids.