Ophthalmic allergies: what treatments?

Ophthalmic allergies

Ophthalmic allergies are a frequent cause of visits to ophthalmologists. Often disabling to the patient, they should not be taken lightly.

There are severe forms, which can lead to local complications. Explanations with Dr. Serge Doan, ophthalmologist.

Ophthalmic allergies

Photo Christina Morillo in Pexels

Definition: What is an eye allergy?

Eye allergy is an inflammation of the eye caused by allergens such as pollen, mold, dust mites (a component of household dust) or animal hair (cat, dog, horse, etc.).

In contact with the allergen, the allergic cells produce histamine, which causes itching, redness and swelling,” explains ophthalmologist Dr. Serge Doan. The allergy can therefore manifest itself as eye damage, rhinitis, asthma, eczema, hives or food allergy.

Eye allergies often take the form of conjunctivitis, which is often associated with rhinitis, i.e., rhinoconjunctivitis. When associated with spring pollen, it is hay fever.

Eyelid eczema is another form of eye allergy. It occurs either as part of a contact allergy to makeup, jewelry or eye ointments, or in connection with more diffuse eczema in atopic dermatitis,” the physician adds.

Very rarely, the cornea (the clear porthole of the eye) can be affected during an eye allergy, which is called keratoconjunctivitis, a severe form of eye allergy. In this case, vision can be affected.

Symptoms

The symptoms are varied. The most common are itching (pruritus), tingling, sandy or burning sensation in the eyes, redness of the eyes, tearing, secretions (impurities) with the eyes stuck in the morning or swelling of the eyelids. Both eyes are usually affected.

In case of keratitis (eye pain), there may be light glare and decreased vision.

Also in associated rhinitis, the nose runs, gets blocked, itches and sneezes.

In a pollen allergy, the symptoms are repeated every year in the same season. They will be more chronic in the case of dust mite allergy or other household allergens.

Who to consult?

The diagnosis of allergic conjunctivitis is usually easy. The pharmacist or general practitioner is used to treating uncomplicated, non-severe forms.

But only the ophthalmologist can diagnose and treat a severe form of keratitis,the specialist insists.

You will have to be consulted if an initial treatment fails or if there are signs of keratitis (pain, glare in the light, loss of vision)“.

The allergist can determine which specific allergen is responsible for the eye allergy. He or she can also manage other non-eye allergies and prescribe desensitization.

Treatments: how to treat an eye allergy?

Treatment of allergies includes measures to avoid them when possible.

They are the first step in treatment to avoid contact with the allergen and/or reduce the appearance of symptoms. This is particularly important in the case of dust mite allergy.

Eye drops

We distinguish antihistamine eye drops from anti-degradant eye drops. “The anti-histamine eye drops represent the treatment of the allergic crisis because they act quickly neutralizing the effect of histamine,” assures our contact person.

Theoretically, anti-mastoid eye drops have a rather preventive effect because they take longer to work.

They prevent the release of histamine from the allergic cells and must be prescribed before the allergy occurs.

However, in practice they can be effective for moderate allergies. Some eye drops combine an antihistamine and anti-degradation effect.

It should be noted that preservative-free eye drops are preferable for allergy sufferers.

In some bottles, preservatives such as benzalkonium chloride are used to prevent microbial contamination. They can induce an eye allergy and have a toxic effect on the eye surface.

The duration of treatment depends on the duration of symptoms, but these eye drops can be taken chronically if they do not contain preservatives.

  • Antihistamine eye drops such as allergodil®, Levophta® or Levofree® (preservative-free) are part of the therapeutic arsenal for allergic conjunctivitis.
  • Mast cell anti-slippers, including sodium cromoglycate, are prescribed for the prevention of allergic conjunctivitis for several weeks or months. Among the most commonly used are opticron®, Naabak®, multicrom®, cromedil®, and cromabak®.
  • Often eye drops are prescribed that combine the properties of antiH1 and anti-degrading eye drops such as zalerg (no preservatives) or monoketo.

Local corticosteroids

“Corticosteroid eye drops or eye ointments are very effective for eye allergies, but carry the risk of developing a complication in case of abuse or misdiagnosis.

They can cause herpes, glaucoma or cataracts,our specialist concludes. That is why they are reserved for severe forms and can only be prescribed by an ophthalmologist for a short period of time.

Desensitization

Still called specific immunotherapy or allergy vaccination, desensitization is the only treatment to date that can cure certain allergies such as those related to dust mites, pollen and hymenoptera.

This method consists of gradually accustoming the body to the allergen in question by administering increasing doses of an allergenic vaccine until the effective dose is reached.

Antihistamine medications can help improve allergic eye symptoms.

Preventive measures

Wearing sunglasses to protect the eyes, applying cold compresses and rinsing the eyes with saline or instilling artificial tears are simple gestures that can alleviate early symptoms.

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