General guidelines applicable to all allergic conjunctivitis, whatever its cause:
- If you wear contact lenses: In general, do not wear them until your symptoms have cleared up, and for 24 hours after the last dose of any eye drops or ointment. However, your ophthalmologist will advise you whether you can wear lenses with certain types of drops.
- Try not to rub your eyes, as this can cause more inflammation.
- Avoid the cause of your allergy, if possible. For example, if you have seasonal conjunctivitis, during pollen season, avoid exposure to the pollen that triggers it as much as possible. If you're driving, close the windows, turn on the internal air conditioning, and wear sunglasses.
- People with dust mite and mold allergies should not use humidifiers and should frequently clean their homes to avoid dust buildup, which is highest in items such as stuffed animals, carpets, and curtains.
Guidelines for seasonal, perennial, and animal-related conjunctivitis.
- Treatment may be needed if symptoms are mild.
- Eye drops that reduce allergic reactions are often prescribed. Antihistamine tablets can also relieve symptoms, and corticosteroid injections may be indicated during the most acute phase of the illness.
- The most commonly used eye drops are antihistamines and mast cell stabilizers. Mast cells and histamine are part of the body's mechanism that triggers allergic reactions. Eye drops can counteract the effects of histamine or destabilize mast cells, which leads to histamine release.
- The drops usually work well. But you'll need to use them regularly to keep symptoms to a minimum, even after the allergy has cleared up. If your eyelids are very swollen, it may take several days for the drops to completely relieve your symptoms.
- Antihistamine eye drops, such as olopatadine or azelastine, are usually only needed twice a day. They have few side effects and can be very effective in reducing symptoms.
- Eye drops containing mast cell stabilizers, such as sodium cromoglycate, have been around for a long time. They are very effective and relatively free of side effects. They need to be used frequently, as they are short-acting: four times a day or more.
- Antihistamine tablets, such as chlorphenamine, loratadine, and ebastine, are taken to try to reduce the overall allergic response in the body. They are not usually very effective in severely inflamed eyes, but they can help. Antihistamines can cause drowsiness, so caution is needed when taking them while driving or operating heavy machinery. Modern antihistamines, such as desloratadine, are taken once a day and do not cause as much drowsiness. Chlorphenamine, however, is short-acting, may need to be taken four times a day, and causes more drowsiness.
- Steroid eye drops, such as those containing dexamethasone, betamethasone, or fluorometholone, are very effective for eye irritation. They quickly soothe irritation and inflammation. However, they increase the risk of eye infection, which can rapidly become severe when these drops are used. They can also lead to glaucoma. Therefore, they should only be used if other treatments fail and under the supervision of an ophthalmologist.
- Intramuscular steroid injections, such as triamcinolone, can be very effective; however, the side effects and consequences of repeated injected steroid use are considerable. Steroids reduce immunity, cause weight gain, and can lead to osteoporosis, among other complications, when used long-term. Therefore, they should be avoided whenever possible for allergic conjunctivitis.
- Steroid tablets can be used for several days when symptoms are severe. They work very well, but always under the supervision of a doctor.
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Eye drops and contact lenses.
Most eye drops contain preservatives. Preservative-free drops are available because preservatives can cause eye irritation or allergies. Contact lenses should not be worn while using eye drops, as preservatives can be absorbed by the lenses and further irritate the eyes.
Treatment for allergic contact conjunctivitis.
Treatment involves avoiding the trigger. When the reaction is caused by a cosmetic, symptoms should be allowed to subside completely before trying an alternative product. It may be necessary to switch brands or types of eye makeup. Makeup contains tiny fibers, such as lengthening mascara, which is a common cause of allergic contact conjunctivitis.
Some cases are caused by an allergy to eye drops used for another eye condition. Glaucoma eye drops can commonly cause this, so consulting a specialist may be necessary to switch to a different eye drop.
The general measures described above can help soothe the eyes until the symptoms disappear.
What should I keep in mind?
Sometimes it's difficult for a doctor to distinguish between allergic and infectious conjunctivitis. Allergic conjunctivitis usually affects both eyes; if only one eye is red, it's unlikely to be due to allergic conjunctivitis.
Many other eye conditions can cause one or both eyes to be red, and this can initially be mistaken for conjunctivitis. These include inflammatory conditions affecting the inside of the eye, such as herpes and eye ulcers (although all of these conditions tend to cause blurred or reduced vision, along with pain), as well as the diseases discussed earlier that can affect the episclera or sclera.
You should see an ophthalmologist if you are unsure of the cause of your symptoms and they do not resolve within a few days. Additionally, consult a doctor urgently in any of the following situations:
- The symptoms change (for example, the eyes start to hurt in the light)
- You have pain in your eye.
- Spots or blisters develop on the skin next to the eye.
- His vision narrows.
- The eye becomes very red – particularly if it is only one eye.
We hope you found this post helpful, and if you have any questions, please contact us.
Dr. Pedro Rocha Cabrera
Ophthalmologist. Specialized in eye inflammations.
NIVARIA CLINIC