Allergic Conjunctivitis, Op-ed

The prevalence of ocular allergies has been increasing worldwide for the past several decades. Estimates suggest that ocular allergies affect 15 to 20% of the worldwide population.

Allergic conjunctivitis usually happens when a person’s eyes come into contact with an allergen, a substance that makes the body’s immune system overreacting. The eye becomes sore and inflamed.

Smoking has been linked to an increase in disorders of the eye’s ocular surface which result in symptoms such as itchiness, redness, and irritation of the eyes. Changes to the eye’s ocular surface associated with smoking include changes to the lipid layer of the tear film, reduced tear secretion, and reduced corneal and conjunctival sensitivity. Passive smoking can also increase the risk of these disorders. Ocular surface disorders include atopic keratoconjunctivitis and allergic conjunctivitis. A number of studies of allergic reactions in children have reported that the risk of developing allergic conjunctivitis increased by about 20% in children who are exposed to environmental tobacco smoke.

Symptoms

Most people with allergic conjunctivitis have problems with both eyes. Symptoms occur because the overreacting immune system makes the body release histamine and other active substances through mast cells. The blood vessels dilate or expand, and this irritates the nerve endings. The result is an increased secretion of tears. Allergic conjunctivitis is different from infective conjunctivitis. There are different types of allergic conjunctivitis.

Symptoms may appear quickly, soon after the eyes come into contact with the allergen. Symptoms of allergic conjunctivitis include red or pink eyes, pain may affect one or both eyes. As the eyes are irritated, they may itch. Rubbing can make the itchiness worse. Swollen eyelids, the eyelids may puff up when the conjunctiva becomes inflamed, or if the person has been rubbing them a lot.

People with seasonal allergic conjunctivitis will experience symptoms at certain times during the year, usually from early spring into summer, and sometimes into fall. Those with perennial allergic conjunctivitis are susceptible at any time of year. They may find symptoms are worse at certain times of the day than at others.

If the eyelids are red, cracked, or dry, this may indicate contact conjunctivitis. Contact conjunctivitis and giant papillary conjunctivitis are not seasonal, and symptoms may occur at any time of year.

Seasonal Allergic Conjunctivitis

Pollen is the most common allergen to cause conjunctivitis in countries that have cold winters. If conjunctivitis results from pollen, there will likely be other symptoms, including sneezing, an itchy, blocked, or runny nose, and itchy and watery eyes. Seasonal allergic conjunctivitis or allergic rhinoconjunctivitis is also known as hay fever. It usually happens during the spring and summer months. At this time, plants, and especially grass, trees, and flowers, are in pollen. Some people have symptoms during early fall.

Symptoms of seasonal allergic conjunctivitis are red eye, itching of eye (main symptom), watering of eye. It may be associated with sneezing and watery nasal discharge.

Contact Conjunctivitis

Symptoms of contact conjunctivitis are usually caused by cosmetics, eye-drops, or other chemicals that irritate the conjunctiva in those who are susceptible. Contact with these substances leads to an allergic response. Some people are sensitive to specific substances. Symptoms usually develop 2 to 4 days after the substance comes into contact with the eyes.

Contact Lens Allergy

Contact lens allergies are a bit more complicated than other allergies. Contacts are actually made from medical grade, hypoallergenic materials. So, in most cases, the contact materials do not cause an allergic reaction. Rather, the ‘allergy’ is caused by a build-up of contaminants.

However, in rare cases, people can develop an allergy to the actual lenses. This happens when proteins that naturally build up on contacts enter the bloodstream via the eyelids. This protein breaks down naturally when contacts are removed and stored in contact solution. If and when these proteins end up being absorbed by the body, the immune system identifies the proteins as foreign invaders and attacks them, resulting in a reaction.

Giant Papillary Conjunctivitis

This often results from wearing contact lenses. In some people, contact lenses cause discomfort. This can get progressively worse and increasingly uncomfortable, causing the eyes to become red. Giant papillary conjunctivitis (GPC) may also occur when a person uses hard contact lenses after eye surgery or exposed stitches rubbing against the eyelid. Poor hygiene when handling contact lenses, solutions, and cases may contribute to infections of the eye.

GPC seems to be caused by an allergy, either to contact lenses or the chemicals used to clean them. Contact lens wearers with asthma, hay fever, or other allergies are more likely to get GPC.

GPC may be due to an allergy to deposits of proteins or other substances on the contact lenses, a contact lens, artificial eye, or chronic eye allergies

Perennial Conjunctivitis

Perennial conjunctivitis lasts all year. It mainly results from an allergy to house dust mites. These are microscopic insect-like creatures that live mainly in bedding, upholstered furniture, and carpets. Dust mites eat skin cells shed by people, and they love warm, humid environments. Dust-mite allergy is an immune-system response to a specific dust mite protein. This causes a range of problems, including conjunctivitis, a blocked or runny nose, sneezing, and contraction of the airways, as in asthma.

Dust mites are the most common cause of allergy from house dust. Dust mites live and multiply easily in warm, humid places. They prefer temperatures at or above 21.11 °C with humidity of 75 to 80 percent. They die when the humidity falls below 50 percent. They are not usually found in dry climates. Dust mite particles are often found in pillows, mattresses, carpeting, and upholstered furniture. They float into the air when anyone vacuums, walks on a carpet, or disturbs bedding and they settle once the disturbance is over. Dust mites are a common cause of asthma in children. A house does not need to be visibly dirty to trigger a dust mite allergy reaction. The particles are too tiny to be seen and often cannot be removed using normal cleaning procedures. In fact, a vigorous cleaning can make an allergic person’s symptoms worse.

Other causes include animal dander, the small scales from animal skins or hair or bird feathers. These can cause an allergic reaction in some people.

Allergic Conjunctivitis and Dry Eye

While an eye allergy and dry eye are two separate conditions, clinical studies have shown that it’s possible for chronic allergy symptoms in the eyes to lead to dry eye disease. Antihistamines may also dry out your eyes.

Allergic conjunctivitis and dry eye syndrome are 2 of the most common anterior inflammatory disorders of the eye. These disorders have been regarded to be the epidemics of the 21st century. The prevalence of dry eyes has been reported to range from 5% to 35% of the population.

When measured with questionnaires reflecting the quality of life, dry eye disease and allergic rhinoconjunctivitis can have the same effect on the quality of life as moderate angina. Approximately 46% of patients with allergic conjunctivitis display significant impairment of their overall quality of life during an acute episode.

Dry eye syndrome is often misdiagnosed as an eye allergy, especially if you’re trying to diagnose yourself at home. Some cases may be related to underlying health conditions, such as thyroid disease, and rheumatoid arthritis.

Other possible causes of dry eye include smoking, dehydration, low humidity, hormone fluctuations during menopause, or taking oral contraceptives.

Dry eye may be brought on by excessive screen time, whether it’s related to your job on the computer, watching television, or using your smartphone. In some cases, cutting down on time spent in front of the screen may help alleviate dry eye symptoms.

Prevention

The best way to prevent allergic rhinitis is to find out what is causing it and to avoid the allergen.

Common allergens are pet fur and pollen. If the allergy is caused by pets, try keeping pets out of the bedroom, brushing them regularly and washing them every 2 weeks, washing their bedding regularly. If you are visiting a house where there is a pet, taking an antihistamine medicine one hour before may help reduce symptoms.

If pollen causes a reaction, stay inside and keep doors and windows closed, avoid areas with a lot of grass, flowers, or trees, use wraparound sunglasses to protect your eyes, bathe and change your clothes after being outside.

If house dust mites cause a reaction, avoid soft furnishings, such as carpets and drapes, use a vacuum cleaner, choose anti-allergenic mattresses and bedding, vacuum often, and dust with a clean and damp cloth.