written by Dr. William McSwain

Allergic conjunctivitis is an overreaction of the ocular surface to an allergen in the environment. The most common cause is an allergy to pollen. Other common causes include dust, pet dandruff, cosmetics, or certain eye drops. Symptoms of allergic conjunctivitis usually occur in both eyes and include itching, redness, tearing, and swelling or redness of the eyelids.

Avoidance of the offending allergen is the first step. This may sound easy, but it can be really difficult to identify the cause of your allergy. If you are using eye drops you may need to try a trial off of your eye drop or switch to a different drop that you are not allergic to. Some people develop an allergy to one of the preservatives used in eye drops. If this is the case, you may only be able to tolerate preservative-free eye drops.

Cold compresses may temporarily relieve itching and burning, but will not fix the underlying cause of your allergy.

Oral antihistamines such as Claritin, Zyrtec, or Allegra may be helpful.

Steroid Nasal sprays such as Flonase or Nasonex may be helpful in relieving the sinus congestion that is often associated with allergic conjunctivitis.

Anti-allergy eye drops such as Pataday (antihistamine), Zaditor (antihistamine), or Elestat (antihistamine) are over the counter and do not require a prescription. If these do not work, then prescription drops such as Bepreve (antihistamine), Pazeo (antihistamine), or Alocril (mast cell stabilizer) are available. Bepreve and Alocril are taken 1-2 x daily while Pataday and Pazeo are taken 1 x daily on an as needed basis. Many of the prescription drops are expensive and not covered by insurance. Do not use VISINE or any drops that say “GET THE RED OUT.” Visine may temporarily improve your symptoms, but may cause dependency and make your symptoms worse over time.

Steroid eye drops may be used for a short course if your allergies are severe. These require a prescription and are usually not used long-term for allergies because they can cause other problems in the eyes such as glaucoma or cataracts.

ADDITIONAL READING: https://patient.info/eye-care/eye-problems/allergic-conjunctivitis