Treating eye allergies

It is estimated that 20 percent of all Americans will suffer ocular (ocular means “related to the eye”) allergies this year. The degree of the allergy can vary from mild itchiness to such severity that it can render a person unable to carry on daily activities.

New treatment options make “suffering in silence” or home remedies for the most part unnecessary. This spring and summer is supposed to bring record levels of airborne pollen, one of the chief causes of eye and throat allergies, so, unfortunately, allergy sufferers should be prepared for the worst.

What is an allergy? Basically, a material called an antigen is introduced to the body, causing a hypersensitive reaction. In effect the body is fooled into thinking that this otherwise harmless substance is infecting it, so it brings out the “artillery” to wipe it out. To continue the metaphor, the individual becomes the victim of “friendly fire.” Inflammatory proteins called histamines are released from specialized mast cells, causing a reactive cascade of swelling, rash or redness.

The more frequently the antigen comes in contact with the individual, the more rapid and dramatic the reaction. When the antigen is ingested or injected, the potential for serious, even life-threatening reaction is quite real. If it’s on the surface, or topical, it usually ranges from just uncomfortable to intolerably itchy. The hallmark symptom of ocular allergy is itching or burning. It usually affects the protective membrane called the conjunctiva, so the most common allergic reaction is called allergic conjunctivitis.

How do we treat AC? First, let me tell you what you shouldn’t do. The top of the list is rubbing the eyes. Rubbing the eyes is like scratching a rash. What actually happens is that the mast cells rupture, releasing histamines and producing more mast cells — what a mess! Next are the over-the-counter anti-histamines. First, they can neutralize some histamines, but they do not prevent and can often stimulate the release of more histamines. In addition, almost all of them have a drug that shrinks the blood vessels, making the eyes look better. Frequent use will cause the vessel walls to lose their elasticity, causing chronic redness and congestion. If you feel you have to self-treat, you’re better off simply using cool compresses and artificial tears to flush the antigens out of your eyes.

These days, the best treatments are prescription drops. Oral anti-allergy medications sometimes won’t have a concentrated enough effect on the eye’s surface and can cause dryness. The newest eye-drop medications will often be effective with daily or twice-daily doses. These drops usually will suppress mast cell production, heading off histamines before they’re released instead of after. These drops will reduce inflammation as well. Several previously prescription-only drops in this category are now available over-the-counter. If that’s not enough, other more potent drops are available. Side effects are rare with any of the new medications.

When it comes to ocular allergies, you should use the resources of modern medicine rather than far less effective home remedies.

Dr. David Eilbert is an optometrist with North Fork Optical Center in Mattituck.