What are the common causes of swollen eye allergies. How can you identify the symptoms of allergic conjunctivitis. What are the most effective treatments for eye swelling due to allergies. How do you distinguish between different types of eye swelling. When should you seek medical attention for swollen eyes.

Understanding Swollen Eye Allergies: An Overview

Swollen eyes can be a frustrating and uncomfortable experience, often caused by allergies or other underlying conditions. This comprehensive guide will explore the various causes of eye swelling, with a focus on allergic reactions, and provide detailed information on symptoms, treatments, and when to seek medical attention.

Common Causes of Eye Swelling: From Allergies to Infections

Eye swelling can affect one or both eyes and may involve the eye itself or the surrounding area, including the eyelids. The causes range from benign issues that resolve on their own to more serious conditions requiring urgent medical care. Let’s examine some of the most common causes:

1. Allergic Conjunctivitis

Allergic conjunctivitis is a frequent cause of swollen eyes. It occurs when the immune system overreacts to allergens such as pollen, dust mites, or pet dander. Symptoms often include:

• Swelling of the eyelids and sometimes the eyes themselves
• Itching and redness
• Excessive tearing
• General irritation and discomfort

In addition to eye symptoms, allergic conjunctivitis may be accompanied by upper respiratory symptoms like sneezing or a runny nose.

2. Hordeolum (Stye)

A stye, medically known as a hordeolum, is a common eye condition caused by clogged oil glands at the base of the eyelashes. Symptoms include:

• A small, painful lump on the eyelid
• Swelling and redness of the eyelid
• Tenderness in the affected area
• Crusting around the eye
• Increased tearing
• A feeling of something in the eye

3. Chalazion

A chalazion is a lump in the eyelid that forms when an oil gland becomes clogged. It may develop after a stye and can cause:

• A hard lump without pus or drainage
• Swelling, redness, and tenderness of the eyelid
• Blurry vision if the lump is large enough to press on the eye’s surface

4. Water Retention

Fluid retention can lead to periorbital edema, or swelling around the eyes. Common causes include:

• Irregular sleep patterns or lack of sleep
• Crying
• Air travel
• Excessive salt consumption

While usually harmless, persistent swelling accompanied by swelling in other parts of the body may indicate a more serious health condition.

5. Conjunctivitis (Pink Eye)

Pink eye occurs when the conjunctiva, the clear tissue covering the white part of the eye and inner eyelid, becomes inflamed. It can be caused by viruses, bacteria, or allergies, and symptoms may include:

• Redness in the white of the eye
• Swelling of the eyelids
• Increased tear production
• Itching or burning sensation
• Discharge that may crust over the eyelashes

Identifying Symptoms of Allergic Conjunctivitis

Allergic conjunctivitis has distinct symptoms that set it apart from other causes of eye swelling. How can you recognize if your swollen eyes are due to allergies?

• Itching: This is often the most prominent symptom and can range from mild to severe.
• Redness: The whites of the eyes may appear pink or red.
• Swelling: Both the eyelids and the conjunctiva may become swollen.
• Tearing: Excessive watering of the eyes is common.
• Burning or gritty sensation: The eyes may feel irritated or as if there’s something in them.
• Light sensitivity: Bright lights may cause discomfort.
• Mucus production: A stringy, clear mucus may be present.

It’s important to note that allergic conjunctivitis typically affects both eyes simultaneously, unlike some infections which may start in one eye before spreading to the other.

Effective Treatments for Swollen Eye Allergies

Managing swollen eyes due to allergies involves a combination of avoiding allergens and using appropriate treatments. What are the most effective ways to treat allergic conjunctivitis?

1. Antihistamines

Antihistamines are the primary treatment for allergic reactions, including those affecting the eyes. They can be administered in two ways:

• Oral antihistamines: These pills can help reduce overall allergy symptoms, including eye swelling.
• Topical antihistamine eye drops: These provide targeted relief directly to the eyes.

2. Artificial Tears

Artificial tears help flush allergens from the eyes and provide soothing relief. They can be used as often as needed and are available over-the-counter.

3. Cold Compresses

Applying a cold compress to the eyes can help reduce swelling and provide relief from itching and discomfort. Use a clean, damp cloth or a specially designed eye mask for 10-15 minutes at a time.

4. Corticosteroid Eye Drops

For severe cases, an eye doctor may prescribe corticosteroid eye drops. These should be used only under medical supervision due to potential side effects.

5. Mast Cell Stabilizers

These medications prevent the release of histamine and other chemicals that cause allergy symptoms. They are often used as a preventive measure.

6. Allergen Avoidance

Identifying and avoiding triggers is crucial in managing allergic conjunctivitis. This may involve:

• Using air purifiers in your home
• Keeping windows closed during high pollen seasons
• Washing bedding regularly in hot water
• Avoiding rubbing your eyes
• Wearing sunglasses outdoors to reduce exposure to allergens

Distinguishing Between Different Types of Eye Swelling

Given the various causes of eye swelling, how can you differentiate between them? Here are some key distinctions:

Allergic Conjunctivitis vs. Infectious Conjunctivitis

• Allergic conjunctivitis typically affects both eyes simultaneously and is accompanied by itching.
• Infectious conjunctivitis often starts in one eye and may spread to the other. It’s usually accompanied by a thick, colored discharge.

Stye vs. Chalazion

• A stye is usually painful and appears as a red, swollen bump on the edge of the eyelid.
• A chalazion is typically painless and appears as a firm lump on the eyelid, often further from the edge than a stye.

Allergic Swelling vs. Fluid Retention

• Allergic swelling is often accompanied by itching and redness.
• Fluid retention swelling is usually painless and may be worse in the morning, improving throughout the day.

When to Seek Medical Attention for Swollen Eyes

While many cases of eye swelling can be managed at home, certain situations warrant professional medical attention. When should you consult a healthcare provider?

• Severe pain or vision changes
• Swelling that persists for more than 24-48 hours despite home treatment
• Signs of infection, such as fever or thick, colored discharge
• Swelling accompanied by difficulty breathing or swelling in other parts of the body
• History of severe allergic reactions
• Symptoms that interfere with daily activities or sleep

If you experience any of these symptoms, it’s important to seek prompt medical care to prevent potential complications and receive appropriate treatment.

Prevention Strategies for Swollen Eye Allergies

While it’s not always possible to prevent allergic reactions completely, there are several strategies you can employ to reduce the likelihood and severity of swollen eye allergies:

1. Identify and Avoid Triggers

Keep a diary of when your symptoms occur to help identify potential allergens. Common triggers include:

• Pollen from trees, grasses, and weeds
• Dust mites
• Pet dander
• Mold spores
• Certain cosmetics or eye care products

2. Maintain a Clean Environment

Reduce allergens in your home by:

• Using high-efficiency particulate air (HEPA) filters
• Vacuuming regularly with a HEPA-equipped vacuum cleaner
• Washing bedding weekly in hot water
• Keeping pets out of bedrooms
• Using allergen-proof covers for pillows and mattresses

3. Practice Good Eye Hygiene

• Avoid touching or rubbing your eyes
• Remove contact lenses before sleep and clean them properly
• Wash your hands frequently, especially before touching your face
• Use artificial tears to flush out allergens

4. Consider Immunotherapy

For severe or persistent allergies, your doctor may recommend immunotherapy. This treatment involves gradually exposing you to small amounts of allergens to build up your tolerance over time.

Long-term Management of Chronic Eye Allergies

For individuals with chronic eye allergies, developing a long-term management plan is crucial. What strategies can help in managing ongoing symptoms?

1. Regular Check-ups

Schedule regular appointments with an allergist or ophthalmologist to monitor your condition and adjust treatment as needed.

2. Seasonal Preparedness

If your allergies are seasonal, start preventive treatments before the allergy season begins. This may include:

• Beginning antihistamine use a few weeks before your typical allergy season
• Increasing the frequency of house cleaning during peak allergy times
• Planning outdoor activities around pollen forecasts

3. Lifestyle Modifications

Consider making changes to your daily routine to minimize exposure to allergens:

• Wear wraparound sunglasses when outdoors to reduce eye exposure to allergens
• Shower and change clothes after spending time outdoors during high pollen seasons
• Use air conditioning instead of opening windows during peak allergy periods
• Consider using a dehumidifier to reduce indoor humidity and prevent mold growth

4. Dietary Considerations

While not a direct treatment for eye allergies, maintaining a healthy diet can support overall immune function. Some studies suggest that certain foods may help reduce allergy symptoms:

• Foods rich in omega-3 fatty acids (e.g., fatty fish, walnuts, flaxseeds)
• Fruits and vegetables high in vitamin C and quercetin (e.g., citrus fruits, berries, onions)
• Probiotic-rich foods (e.g., yogurt, kefir, sauerkraut)

However, it’s important to note that dietary changes should not replace prescribed treatments, and you should consult with your healthcare provider before making significant changes to your diet.

The Impact of Eye Allergies on Quality of Life

Chronic eye allergies can significantly impact an individual’s quality of life. How do these conditions affect daily activities and overall well-being?

1. Work and School Performance

Eye allergies can interfere with reading, computer use, and other visually demanding tasks, potentially affecting productivity and academic performance.

2. Social Interactions

The visible symptoms of eye allergies, such as redness and swelling, may cause self-consciousness in social situations. Additionally, constant itching and discomfort can be distracting during conversations and activities.

3. Sleep Disturbances

Nighttime itching and discomfort can disrupt sleep patterns, leading to fatigue and decreased overall well-being.

4. Emotional Impact

Chronic symptoms can lead to frustration, anxiety, and even depression in some individuals, especially if the condition is poorly managed.

5. Limitations on Outdoor Activities

Severe eye allergies may limit participation in outdoor activities, particularly during high pollen seasons, potentially leading to a more sedentary lifestyle.

Given these potential impacts, it’s crucial for individuals with chronic eye allergies to work closely with healthcare providers to develop effective management strategies that allow them to maintain a high quality of life despite their condition.

Emerging Treatments and Research in Eye Allergy Management

The field of allergy treatment is continually evolving, with researchers exploring new approaches to managing eye allergies. What are some of the promising developments in this area?

1. Targeted Immunotherapies

Researchers are developing more specific immunotherapy treatments that target the exact mechanisms involved in allergic reactions. These may offer more effective relief with fewer side effects.

2. Novel Drug Delivery Systems

New methods of delivering medications to the eye are being explored, including:

• Extended-release formulations that provide longer-lasting relief
• Nanoparticle-based treatments that can penetrate deeper into eye tissues
• Contact lenses that slowly release medication

3. Biologics

Biologic drugs, which target specific components of the immune system, are being investigated for severe allergic eye conditions. While currently used primarily for other allergic conditions, their potential in treating eye allergies is being explored.

4. Combination Therapies

Researchers are studying the effectiveness of combining different types of treatments, such as antihistamines with anti-inflammatory drugs, to provide more comprehensive relief.

6 Causes and How to Treat Them

• A stye or a chalazion can cause clogged glands on your eyelids that lead to swelling.
• If your eyes are swollen, itchy, and red, it could be because of allergies to pollen, dust, or other allergens.
• Graves’ eye disease is an autoimmune condition that may cause swelling, light sensitivity, and double vision.

When people talk about eye swelling they could be referring to the area around the eye, like the eyelids, or the eye itself. Eye swelling can affect one or both eyes and result in symptoms ranging from discomfort to redness to pain.

There are many potential causes for swelling of the eye and eyelid. The causes can range from very benign issues that will resolve on their own with home care to more serious infections that require urgent medical care.

Here are eight causes of eye swelling:

1.

Hordeolum (AKA stye)

A hordeolum is the medical term for a very common eye ailment –– a stye.

“At the base of the eyelashes are oil glands called meibomian glands. These glands can get clogged, leading to a back-up of oil and a swollen bump on the eyelid or even an infection,” says Dr. Annie Nguyen, an ophthalmologist with Keck Medicine of USC. 

If a gland gets infected, this results in a stye.

A stye is a small, painful lump that is similar to a small abscess and might have a small spot of pus like a pimple, Nguyen says. Other stye symptoms include: 

• Eyelid swelling
• Eyelid redness or tenderness 
• Crusting around the eye
• Tearing from the eye
• The sensation of having something in the eye 

How to treat it: The main treatment is simple and DIY. Simply apply a warm compress to the area for up to 15 minutes, says Nguyen. 

You can do this a few times throughout the day, or as often as your doctor recommends. In cases where the warm compress isn’t enough, your doctor may prescribe you topical antibiotics or administer antibiotics through an injection.

Additionally, Nguyen says to refrain from wearing contact lenses or eye makeup as the area heals.

2. A chalazion

This lump in the eyelid occurs when a gland in your eye gets clogged with oil, says Nguyen. Sometimes, one forms after having a stye. 

“The lump may feel hard without any pus or draining. Sometimes, you may have blurry vision if the lump is large enough to press on the surface of the eye,” Nguyen says. There will likely be swelling, redness, and tenderness.

How to treat it: First line of treatment for a chalazion is using warm compresses to attempt to break down the obstruction, says Dr. Vicente Diaz, an ophthalmologist at Yale Medicine and assistant professor of clinical ophthalmology at Yale School of Medicine. 

However, if the warm compresses aren’t enough, you may need a steroid injection or a procedure to remove it, says Diaz.

3. Allergies

Allergies can cause the eyelids to swell, and in some cases, the eyes themselves to swell, too, says Nguyen. The medical term for this is allergic conjunctivitis. Nguyen says on top of swelling, you may experience:

• Itching
• Watering or tearing
• Overall irritation and discomfort

This occurs when the immune system has a hyperactive response to an allergen in the indoor or outdoor environment, such as pet dander, dust mites, or pollen. 

In these cases, you will also experience upper respiratory tract symptoms, too, like sneezing or a runny nose. Other times, Nguyen says you may experience an allergic response to products like soap, makeup, or eyedrops. This will result in more localized eye allergy symptoms.

How to treat it: Allergy medications known as antihistamines can help relieve swelling and discomfort caused by allergies, says Nguyen. You can take antihistamines orally as pills or topically as eye drops. To further help with irritation, you can also use artificial tears and cold compresses.

4. Water/fluid retention 

Fluid retention can lead to periorbital edema, or swelling around the eyes, says Nguyen. Typically, the only symptom will be puffiness or swelling surrounding the eyes. 

Nguyen says there are many benign causes of this, including:

• Irregular sleep/lack of sleep
• Crying
• Flying in an airplane
• Consuming too much salt

However, if the swelling lasts for multiple days and you also have significant welling elsewhere in your body, like your hands and feet, Nguyen says this could indicate a more serious overall health condition.

How to treat it: This will typically pass on its own if the cause resolves and as time passes. Cold compresses can help ease swelling, Nguyen says. If the symptoms persist for more than a couple of days, see your doctor.

If you’re experiencing swelling in other areas of the body along with other symptoms such as difficulty breathing or heart palpitations, seek medical attention immediately.  

5. Conjunctivitis (Pink Eye)

Pink eye occurs when the conjunctiva –– the lining of the white surface of the eye and inside of the eyelids –– becomes inflamed due to a bacteria (bacterial conjunctivitis) or virus (viral conjunctivitis), Nguyen says. Pink eye symptoms include: 

• Pinkness or redness of the eye
• Yellow or green discharge from the eyes that can get crusty
• Redness and swelling of the eyelids
• Discomfort
• Feeling like you have something in your eye

How to treat it: Nguyen says specific treatment will depend on the underlying cause of the conjunctivitis. If the cause is a bacterial infection, your doctor can prescribe you antibiotic ointments or drops to clear the infection. If the cause is viral, antibiotics will not help and the infection will have to pass on its own, but topical steroid eye drops can ease inflammation.  

In either case, Nguyen says cool compresses and artificial tears can help to relieve your discomfort. Additionally, avoid wearing contacts and using eye makeup, and wash your hands frequently. 

6. Cellulitis

Cellulitis is an infection around the eye. There are two types of cellulitis. If it is pre-septal, Diaz says the infection is more superficial. 

In this case, it’s likely that just the skin of the eyelid is inflamed. An orbital cellulitis infection is deeper and even more potentially dangerous. 

In general, the infection spreads quickly and needs medical attention ASAP.

Diaz says cellulitis usually stems from another infection or ailment –– such as starting as a chalazion or extending from a sinus infection.

Some cellulitis symptoms are: 

• Redness and swelling of the eyelid
• Swelling of the tissue around the eye 
• Eye bulging
• Difficulty moving the eye
• Problems with vision
• Fever
• Fatigue

How to treat it: If the infection is pre-septal, oral antibiotics will typically clear the infection, but if the infection is orbital, you may need more intense intravenous (IV) antibiotics, Diaz says. Furthermore, your doctor might need to drain fluid from the area or perform surgery. 

7. Dacryoadenitis

Dacryoadenitis occurs when there is swelling of the lacrimal gland, which is in the upper outer corner of the eye socket, Diaz says. This gland helps produce tears. If you have this condition, the upper eyelid will become very swollen and may get a droopy appearance. 

Aside from the swelling, symptoms of dacryoadenitis include:

• Pain and discomfort when moving the eye
• Eyes watering
• Discharge from the eye
• Redness
• Warmth 
• Lymph node swelling

How to treat it: The treatment will depend on the cause. The root cause of dacryoadenitis could involve an infection or an autoimmune disease, Diaz says. 

If it’s caused by a virus, you need antiviral medication. If it’s caused by bacteria you need antibiotics. If you have an autoimmune condition that is causing this, your doctor will determine the best course of treatment, and may prescribe a steroid to decrease inflammation.  

8. Graves’ eye disease

Graves’ eye disease is directly linked to Graves’ disease, an autoimmune disease associated with hyperthyroidism, which means your body is producing excessive amounts of thyroid hormone. 

The disease is linked to eye bulging as well as eyelid swelling and puffiness, which usually affects both eyes, Nguyen says. 

Other Graves’ eye disease symptoms include: 

• Redness and irritation of the eyes
• Pain or pressure in the eyes
• Difficulty moving the eyes around
• Dry or gritty eyes
• Light sensitivity
• Double vision
• Eyelids that won’t close fully

How to treat it: Ultimately, you need to treat the underlying Graves’ disease to help with hyperthyroidism. Treatment may involve radioactive iodine therapy or anti-thyroid medications. 

For the eye-specific symptoms, Nguyen says your doctor may prescribe steroids to help with the swelling, and in more severe cases, you may need surgery.

Insider’s takeaway

There are many different potential causes of eye swelling, whether it is affecting the eye itself, the eyelid, or both. It’s important to take note of any other symptoms you’re experiencing to help differentiate one condition from another. 

See a doctor for a proper diagnosis and to receive necessary treatments. 

Ashley Laderer

Ashley Laderer is a freelance writer from New York who specializes in health and wellness. Follow her on Twitter @ashladerer

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Allergic Conjunctivitis | Johns Hopkins Medicine

Allergic conjunctivitis is inflammation of the conjunctiva, which is the tissue that covers the inside of eyelids, as well as the white part of the eyeball. Sezen Karakus, M.D., an ophthalmologist from the Wilmer Eye Institute, Johns Hopkins Medicine, shares what you need to know about allergic conjunctivitis.

Allergic conjunctivitis is caused by allergens and irritants, such as pollen, dust and mold. Allergic conjunctivitis can be grouped into two types:

Seasonal allergic conjunctivitis: The seasonal form is associated with seasonal allergies that usually occur during the spring and summer months, and sometimes during the fall. Exposure to pollen, grass and other airborne allergens causes seasonal allergic conjunctivitis.

Perennial allergic conjunctivitis: The perennial form persists throughout the year, and is generally triggered by indoor allergens such as animal dander, dust and mold spores.

Allergic Conjunctivitis Symptoms

Common symptoms of allergic conjunctivitis in the eyes can include:

• Intense itching of eyes and urge to rub eyes.
• Red eyes.
• Watery or white, stringy mucus discharge.
• Swollen eyelids.

These symptoms may be accompanied by nasal symptoms such as a runny or itchy nose, or sneezing.

Allergic Conjunctivitis Diagnosis

Your doctor will diagnose you with allergic conjunctivitis through a review of your symptoms and an eye examination. Specific blood tests or skin tests may be required to diagnose or identify the specific allergen causing your reaction.

Allergic Conjunctivitis Treatment

Treatment for allergic conjunctivitis may include:

• Cold compress. 
• Artificial tears. 
• Anti-allergy eye drops or oral medications (over-the-counter or prescription).
• Allergy immunotherapy.

Some additional measures may be helpful, such as:

• Avoiding allergens.
• Washing your face after exposure to environmental allergens such as dust or pollen.
• Frequent washing of clothes.
• Bathing or showering before bedtime.
• Keeping contact lenses and cases clean and changing contact solution daily.

Pink Eye vs. Allergies

Pink eye, or conjunctivitis, refers to an irritation or infection of the conjunctiva. Allergic conjunctivitis is often confused with pink eye caused by viral infection of conjunctiva due to their similar symptoms.

Similarities

Symptoms of both include:

• Eye redness.
• Watery discharge from the eyes.
• Gritty feeling or foreign body sensation.

Differences

• Intense itching of the eyes is a symptom only associated with eye allergies.
• Pink eye caused by viral conjunctivitis often starts in one eye and spreads to the other, while eye allergies usually affect both eyes at once.
• Viral conjunctivitis can be highly contiguous, which is different from the noncontagious allergic conjunctivitis

Your doctor will be able to distinguish between these two conditions through an eye examination.

Allergic conjunctivitis

Allergic conjunctivitis is an inflammation of the mucous membrane of the eyes when exposed to an allergen. It may result from a reaction to pollen, bacteria, ionizing radiation, drugs, contact lenses, and other irritants.

Allergic conjunctivitis is often combined with a number of diseases: allergic rhinitis, atopic dermatitis, bronchial asthma.

Specificity of the disease

Allergic conjunctivitis is often referred to as “red eye disease”, the reason for this is the presence of certain symptoms: itching or burning sensation, lacrimation, photophobia, swelling and redness of the eyelids. In most cases, such conjunctivitis causes a runny nose and cough. Allergic conjunctivitis almost always affects both eyes.

Forms of allergic conjunctivitis

Allergic conjunctivitis can be year-round and seasonal forms. Accordingly, various substances can be allergens.

The manifestation of the year-round form of allergic conjunctivitis is the presence of symptoms of allergic conjunctivitis constantly, year-round with infrequent deterioration of the condition. Such manifestations of the disease usually occur when a person comes into contact with household allergens, namely: house dust, mold fungi, the epidermis of birds and domestic animals, dust mites.

Seasonal allergic conjunctivitis is characterized by the onset of symptoms at the same time each year. Allergens in this case can be: pollen of flowers, grasses and trees, mushroom spores.

Allergic conjunctivitis occurs mainly in children and urban residents due to unfavorable environmental and working conditions.

Necessary information for the doctor

The doctors of the MEDINEF clinic are always ready to help you, but it is especially important to provide our doctors with the necessary information to identify the correct diagnosis and subsequent treatment:

• when symptoms of allergic conjunctivitis appear, at the same time each year or continuously;
• whether the aggravation occurs when going to nature, leaving the house, or, conversely, upon returning home;
• do you see any relationship between the onset of an allergic reaction and contact with the allergen;
• if you have other types of allergies, if so, to which substances;
• whether members of your family were ill with allergic diseases.

Your information about the development of the disease will help to quickly establish the correct diagnosis and identify the allergen that causes allergic conjunctivitis.

Diagnosis of allergic conjunctivitis

In some cases, there is a typical picture of the disease or a clear connection with exposure to an allergen, which leaves little doubt when making a diagnosis. Most often, the diagnosis of allergic conjunctivitis is associated with certain difficulties and in most cases requires the use of specific allergological methods.

Allergic history reveals an allergen in 70% of patients. When diagnosing, elimination and exposure tests are often used. Skin tests used in ophthalmology combine low trauma and high information content. Provocative allergy tests are used only in exceptional cases. Conducting laboratory allergodiagnostics is possible even during an exacerbation of the disease.

Treatment of allergic conjunctivitis

Treatment of allergic conjunctivitis takes about 10-14 days. Properly selected therapy allows you to get rid of all symptoms completely. The determination of the allergen plays a very important role in the treatment, which in some cases makes it possible to exclude contact with it. If this is not possible, then drug treatment is prescribed.

For mild allergic conjunctivitis, cold compresses and “artificial tears” are sometimes sufficient . In more severe cases, the doctor may prescribe anti-inflammatory and anti-allergic drugs.

Allergic conjunctivitis should only be treated by specialists , otherwise self-treatment can be harmful. Complications of allergic conjunctivitis can be various infections that have got into the eyes and the development of purulent inflammation of the eyes.

Prevention of allergic conjunctivitis

To prevent allergic conjunctivitis, contact with allergens should be avoided or reduced to a minimum. If this is not possible, it is necessary to use antiallergic drugs prescribed by the doctor in advance.

We have extensive experience in the treatment of various diseases, including allergic conjunctivitis. Our specialists have all the necessary knowledge to determine the most effective treatment for allergic conjunctivitis.

Timely contact with the doctors of our clinic, adequate treatment and prevention of exacerbations of allergic conjunctivitis prevents the development of complications and helps to quickly forget about the disease.

Allergic conjunctivitis. What is Allergic Conjunctivitis?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Allergic conjunctivitis is a reactive inflammation of the conjunctiva caused by immune reactions in response to contact with an allergen. With allergic conjunctivitis, hyperemia and swelling of the mucous membrane of the eye, itching and swelling of the eyelids, lacrimation, and photophobia develop. Diagnosis is based on the collection of an allergic history, skin tests, provocative allergic tests (conjunctival, nasal, sublingual), laboratory tests. In the treatment of allergic conjunctivitis, antihistamines (by mouth and topically), topical corticosteroids, and specific immunotherapy are used.

ICD-10

h20.1 Acute atopic conjunctivitis

• Causes
• Pathogenesis
• Classification
• Symptoms of allergic conjunctivitis
• Diagnostics
• Treatment of allergic conjunctivitis
• Prognosis and prevention
• Prices for treatment

General

Allergic conjunctivitis occurs in about 15% of the population and is a significant problem in modern ophthalmology and allergology. Allergic damage to the organ of vision in 90% of cases are accompanied by the development of conjunctivitis, less often – allergic blepharitis, eyelid dermatitis, allergic keratitis, uveitis, iritis, retinitis, neuritis. Allergic conjunctivitis occurs in both sexes, mostly young people. Allergic conjunctivitis is often combined with other allergies – allergic rhinitis, bronchial asthma, atopic dermatitis.

allergic conjunctivitis

Causes

Common in the etiology of all forms of allergic conjunctivitis is increased sensitivity to various kinds of environmental factors. Due to the peculiarities of the anatomical structure and location of the eyes, they are most susceptible to contact with exogenous allergens. Depending on the etiology, there are:

• Seasonal allergic conjunctivitis. Pollinous conjunctivitis (hay fever, pollen allergy), caused by pollen allergens during the flowering of grasses, trees, cereals. Exacerbation of pollinous conjunctivitis is associated with the flowering period of plants in a particular region. Seasonal allergic conjunctivitis in 7% of patients worsens in the spring (late April – late May), in 75% – in the summer (early June – late July), in 6. 3% – in the off-season (late July – mid-September), which correspondingly coincides with the pollination of trees, meadow grasses and weeds.
• Spring conjunctivitis. The etiology of spring conjunctivitis has been little studied. The disease worsens in spring – early summer and regresses in autumn. This form of allergic conjunctivitis usually resolves spontaneously during puberty, which suggests a certain role of the endocrine factor in its development.
• Large papillary conjunctivitis. The main development factor is considered to be the wearing of contact lenses and eye prostheses, prolonged contact of the mucous membrane with a foreign body of the eye, the presence of sutures that irritate the conjunctiva after cataract extraction or keratoplasty, calcium deposits in the cornea, etc. In this form of allergic conjunctivitis, the inflammatory reaction is accompanied by the formation of upper centuries of large flattened papillae.
• Drug conjunctivitis develops as a local allergic reaction in response to topical (90. 1%), less often systemic (9.9%) use of drugs. The occurrence of drug allergic conjunctivitis is promoted by self-medication, individual intolerance to the components of the drug, polytherapy – a combination of several drugs without taking into account their interaction. Most often, the use of antibacterial and antiviral eye drops and ointments leads to drug allergic conjunctivitis.
• Chronic allergic conjunctivitis. It accounts for more than 23% of cases of all allergic eye diseases. With minimal clinical manifestations, the course of chronic allergic conjunctivitis is persistent. Direct allergens in this case are usually house dust, animal hair, dry fish food, feathers, down, food products, perfumes, cosmetics and household chemicals. Chronic allergic conjunctivitis is often associated with eczema and bronchial asthma.
• Atopic keratoconjunctivitis. It is an allergic disease of multifactorial etiology. It usually develops with systemic immunological reactions, therefore it often occurs against the background of atopic dermatitis, asthma, hay fever, and urticaria.

Pathogenesis

The pathogenesis of allergic conjunctivitis is based on IgE-mediated hypersensitivity reaction. The starting factor of allergic conjunctivitis is the direct contact of the allergen with the conjunctiva, leading to degranulation of mast cells, activation of lymphocytes and eosinophils and a clinical response followed by an inflammatory-allergic reaction. Mediators released by mast cells (histamine, serotonin, leukotrienes, etc.) cause the development of characteristic symptoms of allergic conjunctivitis.

The severity of allergic conjunctivitis depends on the concentration of the allergen and the reactivity of the body. The rate of development of a hypersensitivity reaction in allergic conjunctivitis can be immediate (within 30 minutes from the moment of contact with the allergen) and delayed (after 24-48 hours or more). This classification of allergic conjunctivitis is practically significant for the choice of drug therapy.

Classification

Allergic eye lesions can occur in the form of pollinous conjunctivitis, spring keratoconjunctivitis, large papillary conjunctivitis, drug conjunctivitis, chronic allergic conjunctivitis, atopic keratoconjunctivitis. Along the course, allergic conjunctivitis can be acute, subacute, or chronic; according to the time of occurrence – seasonal or year-round.

Symptoms of allergic conjunctivitis

Allergies usually affect both eyes. Symptoms develop within a few minutes to 1-2 days from the moment of exposure to the allergen. Allergic conjunctivitis is characterized by severe itching of the eyes, burning under the eyelids, lacrimation, swelling and hyperemia of the conjunctiva; in severe cases – the development of photophobia, blepharospasm, ptosis.

Itching in allergic conjunctivitis is so intense that it forces the patient to constantly rub his eyes, which, in turn, further enhances the rest of the clinical manifestations. Small papillae or follicles may form on the mucosa. Discharge from the eyes is usually mucous, transparent, sometimes viscous, thread-like. When the infection is layered in the corners of the eyes, a purulent secret appears.

In some forms of allergic conjunctivitis (spring and atopic keratoconjunctivitis), the cornea is affected. With drug allergies, lesions of the skin of the eyelids, cornea, retina, choroid, and optic nerve can be observed. Acute drug conjunctivitis is sometimes aggravated by anaphylactic shock, Quincke’s edema, acute urticaria, systemic capillary toxicosis.

In chronic allergic conjunctivitis, the symptoms are poorly expressed: complaints of periodic itching of the eyelids, burning eyes, redness of the eyelids, lacrimation, and a moderate amount of discharge are characteristic. They say about chronic allergic conjunctivitis if the disease lasts 6-12 months.

Diagnostics

In the diagnosis and treatment of allergic conjunctivitis, it is important to coordinate the interaction of the attending ophthalmologist and the allergist-immunologist. If there is a clear association of conjunctivitis with exposure to an external allergen in the anamnesis, the diagnosis is usually beyond doubt. To confirm the diagnosis is carried out:

• Ophthalmic examination. Detects changes in the conjunctiva (edema, hyperemia, papillary hyperplasia, etc.). Microscopic examination of conjunctival scrapings in allergic conjunctivitis can detect eosinophils (10% or more). In the blood, an increase in IgE of more than 100-150 IU is typical.
• Allergological examination. To determine the cause of allergic conjunctivitis, tests are carried out: elimination, when, against the background of clinical manifestations, contact with the alleged allergen is excluded, and exposure, which consists in repeated exposure to this allergen after the symptoms subside. After subsiding of acute allergic manifestations of conjunctivitis, skin-allergic tests (application, scarification, electrophoresis, prick test) are performed. During the period of remission, they resort to conducting provocative tests – conjunctival, sublingual and nasal.
• Laboratory examination. In chronic allergic conjunctivitis, a study of eyelashes for demodex is indicated. If an infectious lesion of the eyes is suspected, a bacteriological examination of a smear from the conjunctiva for microflora is performed.

Treatment of allergic conjunctivitis

The main principles of the treatment of allergic conjunctivitis include: elimination (exclusion) of the allergen, local and systemic desensitizing therapy, symptomatic drug therapy, specific immunotherapy, prevention of secondary infections and complications. With large papillary conjunctivitis, it is necessary to stop wearing contact lenses, eye prostheses, remove postoperative sutures or remove a foreign body.

In allergic conjunctivitis, oral antihistamines (claritin, ketotifen, etc.) and antiallergic eye drops (levocabastine, azelastine, olopatadine) are prescribed 2-4 times a day. Also shown is the local use in the form of drops of cromoglycic acid derivatives (mast cell stabilizers). With the development of dry eye syndrome, tear substitutes are prescribed; with damage to the cornea – eye drops with dexpanthenol and vitamins.

Severe forms of allergic conjunctivitis may require topical corticosteroids (eye drops or ointments with dexamethasone, hydrocortisone), topical NSAIDs (eye drops with diclofenac). Persistently recurrent allergic conjunctivitis is the basis for specific immunotherapy.

Prognosis and prevention

In most cases, with the establishment and elimination of the allergen, the prognosis of allergic conjunctivitis is favorable. If left untreated, an infection may be added with the development of secondary herpetic or bacterial keratitis, a decrease in visual acuity. In order to prevent allergic conjunctivitis, contact with known allergens should be avoided whenever possible. In seasonal forms of allergic conjunctivitis, it is necessary to conduct preventive courses of desensitizing therapy. Patients suffering from allergic conjunctivitis should be observed by an ophthalmologist and an allergist.

You can share your medical history, what helped you in the treatment of allergic conjunctivitis.

You can get advice from an ophthalmologist and an allergist-immunologist in Volgograd, Volzhsky and Mikhailovka at DIALINE clinics. We offer a wide range of services, including laboratory tests and examinations on advanced equipment. To make an appointment with a specialist, simply call or leave a request on the website.

Sources

1. Allergic conjunctivitis / Maychuk Yu.F.// Clinical Ophthalmology. – 2002 – No. 1.
2. Allergic rhinoconjunctivitis: (clinical recommendations) / ed. A. S. Lopatina – 2015.
3. Allergic conjunctivitis / Pugachev A.I. / / Attending physician. – 1999.
4. This article was prepared based on the materials of the site: https://www.krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment.