Allergies and Dry Eyes

Allergies and Dry Eyes

Do you have an allergy problem or do you have a dry eye problem? Just because it is “allergy season” doesn’t necessarily mean that your eye problem is related to allergies….but it could be!

Symptoms of Dry Eyes

The hallmark symptom of an eye problem due to allergy is itch. If the eye is not itchy then a diagnosis of allergic conjunctivitis or allergic irritation should be questioned.

Other symptoms of allergic conjunctivitis (itch must also be present) include:

  • Tearing
  • Burning
  • Foreign-body sensation
  • Ocular dryness
  • Clear or white crusting of eyelids

Typically the dryness is from taking antihistamine medications for allergies such as Benadryl, Claritin, and Zyrtec.

With dry eyes the most common symptoms are:

  • Burning
  • Sandy, gritty feeling
  • Redness
  • Reflex tearing

It doesn’t make sense, but it’s true that eyes water when they are dry. Your body is trying to fix itself.

Using artificial tears or lubricant eye drops will typically get rid of the reflex tearing, and other symptoms, but not always. It is typically the first line of treatment though.

Causes of Dry Eyes

Medications can also cause dryness. Common ones include:

  • Antihistamines (mentioned above)
  • Nasal decongestants
  • Blood pressure lowering drugs
  • Antidepressants
  • Antipsychotics
  • Parkinson’s drugs
  • Hormone therapy
  • Oral contraceptives
  • Acne medication
  • Eye drops (believe it or not) – We will discuss this separately below

Treatment for Dry Eyes

If someone truly has allergic conjunctivitis then I recommend trying some over the counter antihistamine eye drops such as Opcon A, Naphcon A, Visine A, etc. If they don’t help we can prescribe some that may work better, such as Patanol or Pataday.

For dry eyes, I recommend Systane Ultra, Refresh, Optive and others. Everyone’s eyes are different. What works for me, may not work for you, and vice versa. Try a drop and if it relieves your symptoms, stick with it. Don’t get the drops that are on sale this week because they may not help as well. Restasis is a prescribed drop for dry eyes that can also be tried, but not currently on our formulary.

One ingredient to avoid in treating dry eyes is tetrahydrozoline. This is the ingredient to “get the red out.” It does this by shrinking or narrowing of the blood vessels to make them look less red. A common one is Visine, very popular in our clinic I have noticed. This can be a problem, especially for people with hypertension….I have heard of cases where people have induced a stroke from doing this. It may have other side effects as well such as dizziness, rash, and trouble breathing. Always read labels, don’t take medications more than recommended doses. Common sense stuff, right? Hope this helps.