Eye Allergies: Causes, Symptoms, & Treatments
Allergies can cause a range of physical reactions across your body, and the human eye is no exception. Some allergy sufferers ignore eye symptoms, choosing instead to focus on other effects like skin rashes and scratchy throats.
But overlooking the health impact of eye allergies can increase your risk of chronic complications like dry eye disease and vision loss.
Thanks to a range of eye drops and medications, you can manage the symptoms of eye allergies. Recognizing and addressing symptoms can be the key to reclaiming your quality of life.
Below, we’ll explain how to spot eye allergy symptoms, and share some methods for treating them and avoiding eye allergy flare-ups.
Eye allergy symptoms: Do allergies make your eyes hurt?
You might find that your eyes hurt from allergies, but pain isn’t the only issue. Other eye symptoms commonly include:
- Itchy eyes from allergies
- Redness
- Increased tear production, even though your tears don’t seem to provide relief
- Swollen eyes
- A burning sensation
- Heightened sensitivity to light
- Discharge from the eye
However, different eye allergy types can cause flare-ups and slightly different physical effects.
Eye allergy types
There are four main subtypes of eye allergies. Each one can create different symptoms.
In an allergic reaction in the eyes, your immune system produces antibodies after you come into contact with a particular substance. During diagnosis, your specific eye allergy antibodies will give your allergist a clue about what’s causing your reaction to help guide your treatment plan.
Simple allergic conjunctivitis
This type of eye allergy generally causes a clear, watery discharge in both eyes that may not lead to crusting when you wake from sleep. You may also notice swelling and water retention in your eyelids.
It’s rare to feel pain or have vision difficulties due to simple allergic conjunctivitis. If you do experience these symptoms, it’s worth asking your doctor about other potential diagnoses.
Vernal keratoconjunctivitis
Symptoms for this type of eye allergy usually flare up most severely around springtime. These include:
- Thick discharge of mucus from the eyes
- Pain
- Blurry vision
- Extreme sensitivity to light
- A feeling like something is in your eye, even when there isn’t
A doctor might also find ulcers on your cornea and bumps on the underside of your eyelid, known as giant papillae.
Atopic keratoconjunctivitis
The symptoms of atopic keratoconjunctivitis may last much longer than with other eye allergies.
These include:
- Pain
- Blurred vision
- Extreme light sensitivity
- The feeling of a foreign body in your eye
Because this variety of eye allergy can cause chronic inflammation, the eyelids and surfaces may go through changes. These can include new blood vessel growth and scarring of the cornea — the transparent outer layer of the eye.
You might also notice changes to the skin around the eyes.
Giant papillary conjunctivitis
This type of eye allergy starts similarly to simple allergic conjunctivitis before progressing to more severe symptoms, including:
- An itch that gets worse
- Thick discharge of mucus from the eye
- Pain that becomes more severe over time
- Vision that becomes increasingly blurry as symptoms progress
- Papillae on the lining of the eyelids
Eye allergy complications
If you divert from a prescribed treatment plan or avoid treatment altogether, your eye allergy may progress into a more severe condition that risks further health problems.
The common complications of an eye allergy include:
- Dry eye disease. This chronic condition affects tear production and quality, causing ongoing dryness, redness, and irritation.
- Infection. Bacteria can enter the surface of your eye through scratches. In a healthy eye, tears wash away debris and form a defense against infection. But allergies can affect how your tears work and increase your risk for infection.
- Corneal scar. Repeated flare-ups of atopic keratoconjunctivitis can cause scarring on your cornea.
- Limbal stem cell deficiency (LSCD). If too much corneal damage occurs, the eye’s conjunctiva cells can grow over the cornea. This can cause increased blood vessel growth and a loss of clarity in the eye's outer layer. LSCD can cause extreme light sensitivity, eye pain, and vision loss.
- Secondary keratoconus. The cornea may change shape and become less effective due to an underlying condition like an eye allergy. If keratoconus becomes too severe, even eyeglasses are unlikely to correct the resulting vision problems.
- Cataract. These form cloudy areas in the eye lens, leading to blurry vision and muted colors.
- Increased intraocular pressure. High eye pressure, or intraocular hypertension, can damage the optical nerve. Leaving eye allergies to progress without treatment can increase pressure in the eye.
- Irreversible vision loss. Without prompt and effective treatment, eye allergy complications can cause partial or complete vision loss.
It’s vital for your eye health that you seek swift treatment for both eye allergy symptoms and the complications of eye allergies.
What causes eye allergies?
Eye allergies are caused by an oversensitivity in your immune system. Contact with a particular substance might trigger an inflammatory response in you that it typically doesn’t cause in others. If a substance irritates your eyes, structures around the eye called mast cells produce histamine, which causes characteristic itching.
Allergens that can cause eye allergies
Specific airborne substances can trigger the immune reaction that causes eye allergy symptoms, including:
- Pollen
- Pet fur and dander
- Dust
- Smoke
- Mold
Certain perfumes or cosmetics can also cause allergic reactions in the eyes. Eye drops that contain preservatives may trigger a similar response. The safest option is always choosing preservative and allergen-free eye drops.
Eye allergy risk factors
Several lifestyle, environmental, and genetic factors can make you more likely to experience the effects of eye allergies.
Risk factors for eye allergies vary depending on their type:
- Simple allergic conjunctivitis. You’re more likely to develop this type of allergy if you’re under 20 years of age and/or prone to asthma, allergic rhinitis, and atopic dermatitis.
- Vernal conjunctivitis. Males and those who live in dry, hot climates have a higher risk of vernal conjunctivitis. People with this type of eye allergy are often younger than age 10 and live with asthma.
- Atopic keratoconjunctivitis. This type of eye allergy most regularly affects people with atopic dermatitis — a type of eczema. Older males also have a higher risk of atopic keratoconjunctivitis.
- Giant papillary conjunctivitis. Those who wear soft contact lenses regularly for at least 1–2 years are more likely to develop this eye allergy. The onset time may vary if other causes are to blame.
Eye allergy diagnosis
If you notice symptoms of any type of eye allergy, seeking diagnosis and treatment is an essential step to avoid complications and preserve your vision. Other eye conditions can have symptoms similar to eye allergies, so it’s important to pursue an accurate diagnosis.
Eye allergies symptoms checklist
This checklist may help you distinguish between eye allergies and other conditions to get the most appropriate treatment:
🔲 I experience itchy, red eyes whenever my hay fever flares up.
🔲 I always feel eye allergy symptoms when I’m around specific triggers, like pets.
🔲 My eyes are sometimes or often swollen.
🔲 I’m constantly wiping discharge away from my eyes.
🔲 I feel these symptoms at certain times of year but not others.
🔲 My eye drops to treat dry eye disease contain preservatives and/or seem to worsen symptoms
🔲 My eyes experience pain or extreme light sensitivity after using a particular fragrance or brand of cosmetics.
If three or more of the above statements apply to you and over-the-counter (OTC) eye drops don’t seem to help, consider working with an allergist or other doctor to rule out other health problems.
Eye allergy quiz
It’s important to treat eye allergies as soon as possible. Quick action can help prevent severe complications like dry eye or corneal ulcers. Dry eye disease that causes scarring and tissue changes in your eye may even lead to irreversible vision loss.
Find out if you have an eye allergy by taking our helpful quiz.
What to expect during doctor’s visits about eye allergy
For most doctor visits related to eye problems, you’d expect to see an eye specialist. But for eye allergies, it’s critical to manage the immune response and avoid triggers. For that reason, seeing an allergist is often a smart choice.
The allergist or ophthalmologist will ask about your medical history as well as exposure to potential allergens.
An allergist can also provide physical testing to create a precise picture of your allergy status, including:
- Examination using a slit-lamp microscope to check for swollen blood vessels on the eye’s surface.
- Gently scraping the conjunctiva under the eyelid to check for a particular type of white blood cell that contributes to the allergic response.
Eye allergy treatments: Drops and more
Some eye allergies resolve without treatment when patients avoid or clean away the substance that triggers the immune response. Other allergies require ongoing care, especially in the case of seasonal eye allergies.
Medications: How can eye drops help people with eye allergies?
Several medications can help alleviate the symptoms of eye allergies, including artificial tears, decongestants, and oral antihistamines. See how these treatments can help below:
Artificial tears
Eye allergies can contribute to symptoms of dry eye disease. OTC artificial tears can counter the irritating, disruptive effects of dry eye on your day-to-day life. They work by improving the quality and volume of the tears your eyes produce. Once you’ve restored tear production, your risk for redness, itching, and further infections significantly reduces.
For extra relief, you can refrigerate the drops. There’s no maximum dose for artificial tears — you can use them as much or as little as you need. But it’s crucial to choose a product that’s free of preservatives, as additional allergens found in some drops can make your reaction worse.
If OTC drops don’t reduce your symptoms at first, your physician, allergist, or ophthalmologist can prescribe more potent eye drops. As an alternative, a saline eye wash for allergies can have a soothing effect.
Decongestants
Decongestants help by narrowing the expanded blood vessels in your eye, which can reduce redness across the eye’s surface. This medication is available by itself or with a dose of antihistamines to manage the allergic reaction.
Decongestant eye drops are generally low-dose, so you’ll need to apply them four to six times a day for a maximum of two to three days. Using them longer can lead to a “rebound effect” that worsens symptoms, even if you stop using the drops.
People with glaucoma should avoid using decongestant eye drops.
Oral antihistamines
Some people take oral antihistamines to reduce allergic reactions. However, for eye symptoms, they might not be the kindest option for your eyes. Oral antihistamines can worsen symptoms of dry eye and eye allergy. They can also interfere with your energy levels and coordination.
If your physician recommends oral antihistamine medication for your eye allergies, ask about side effects and possible alternatives.
Prescribed eye drops for eye allergies
If your symptoms don’t respond to OTC interventions, a physician, eye specialist, or allergist may prescribe stronger treatments for your eye allergies.
These include:
- Prescription drops for dry eye symptoms. Doctors can prescribe treatments with active ingredients like cyclosporine that help lubricate the eye and improve tear production.
- Mast cell stabilizer eye drops. These drops soothe your body’s response to allergens by blocking histamine production in the mast cells around the eye. However, they’re only effective if you take them before experiencing symptoms.
- Combination mast cell and antihistamine drops. Newer allergy-relief eye drops contain medications that reduce mast cell activity and decrease the circulation of symptom-triggering histamines. This reduces itchiness, tearing, and burning sensations around the eye.
- Non-steroidal anti-inflammatory drug (NSAID) eye drops. These can help reduce swelling and inflammation in the eye. However, they can sting or burn during application, and must be given in four doses every day.
- Corticosteroid eye drops. These can be more effective than other eye drops but can also trigger severe side effects like glaucoma, cataracts, and infections. Doctors will usually prescribe corticosteroid drops only for patients with prolonged eye allergy symptoms that don’t respond to other treatments.
Other prescribed medications for eye allergy
Your healthcare professional might also prescribe the following to address the possible causes of your allergic reaction:
- Non-sedating oral antihistamines. Non-drowsy alternatives to standard antihistamines can be effective and are safe for long-term use. But they can trigger other side effects and lead to dry eye disease.
- Immunotherapy, or allergy shots. These shots boost your defense against wayward immune responses by providing tiny amounts of the allergen via injection. Allergy shots may take months to start working. You may need to take other medications to resolve symptoms in the meantime.
Eye allergy home remedies
Eye allergies depend on contact with a triggering substance or foreign material. So — limiting exposure can help reduce the risk of a flare-up.
It’s not always possible to avoid airborne allergens. Even if you do your best, you may still experience symptoms and need eye drops or the assistance of a healthcare professional.
Outdoor allergens
There are a few ways you can avoid coming into contact with outdoor allergens:
- Try to stay inside when outdoor allergens are high, especially during the mid-morning and early evening, periods of high winds. You can check your region’s outdoor pollen count here if you’re unsure about possible allergic reactions.
- Avoid using window fans, which can introduce outside allergens to your indoor environment.
- Use eyewear outdoors to help reduce contact between pollen and your eyes.
- Do your best not to rub your eyes despite irritation, since this can make your symptoms worse.
Indoor allergens
Allergens can also enter your home. You can reduce exposure in the following ways:
- Keep windows closed and use air conditioning units for temperature control. Be sure to keep your AC clean, because a contaminated AC can circulate allergens.
- Limit your exposure to potentially allergenic dust mites by using mite-proof covers on bedding and mattresses. When you wash the covers, use water at a temperature of at least 130º Fahrenheit (54º Celcius).
- Keep a dehumidifier running to reduce your risk for mold exposure, especially in places that are often damp, such as a basement. Ideal humidity is 30% to 50%. If you notice mold patches, clean them with a solution of 95% detergent and 5% bleach.
- Wet-mop floors and wet-dust countertops instead of sweeping, vacuuming, or dry dusting.
Pet dander
If pet dander irritates your eyes, try the following to keep it at bay:
- Wash your hands and clothes after contact with a household pet.
- Try to keep pets out of your home or at least your most-used rooms as much as possible.
- Those with central heating or forced-air systems should keep all vents closed.
- Carpeting collects pet dander. If you can, replace the carpets in your house with linoleum, tiles, or hardwood.
Eye allergies - in summary
Eye allergies can be persistent, uncomfortable, and life-altering. Different types of allergies cause a range of symptoms, and you might find that some OTC treatments and home remedies don’t entirely reduce how your body responds to allergens.
However, help is available to reduce symptoms and manage your immune response over time. It might be time to consider using prescription eye drops that can help you soothe burning, itching, and grittiness.
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Article resources
-
Aljeaidi M, et al. (2020). Dry eyes, ocular lubricants, and use of systemic medications known or suspected to cause dry eyes in residents of aged
care services.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432788/ - Allergy facts and figures. (2021). https://www.aafa.org/allergy-facts/
-
Baab S, et al. (2021). Allergic conjunctivitis.
https://www.ncbi.nlm.nih.gov/books/NBK448118/ - Cataracts. (2019). https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts
-
Dry eye. (n.d.).
https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/dry-eye?sso=y - Dudeja L, et al. (2020). Are we treating the effect and neglecting the cause of keratoconus? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7727957/
-
Dupuis P, et al. (2020). A contemporary look at allergic conjunctivitis.
https://pubmed.ncbi.nlm.nih.gov/31993069/ -
Haagdorens M, et al. (2016). Limbal stem cell deficiency: Current treatment options and emerging therapies.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691643/ - High eye pressure and glaucoma. (2021). https://www.glaucoma.org/gleams/high-eye-pressure-and-glaucoma.php
-
Hosten LO, et al. (2020). Over-the-counter ocular decongestants in the United States – Mechanisms of action and clinical utility for
management of ocular redness.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399465/ -
Randall KL, et al. (2021). Antihistamines and allergy.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5895478/ - Rathi VM, et al. (2017). Allergic conjunctivitis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968423/
-
Today’s national allergy map. (n.d.).
https://www.pollen.com/map