What you can do when spring brings discomfort
it’s spring. Time to lose the layers and pack away the snow shovels for another year. For some of us, though, the milder months come with their own challenge — allergies. The American College of Allergy, Asthma & Immunology estimates that each year 50 million people in the United States experience symptoms from allergies, many of them related to seasonal allergens such as pollen. Pollen-packed days can do a number on our breathing, leaving noses dripping, sinuses congested and lungs begging for mercy. But eyes can also feel the discomfort, with symptoms that include redness, itchiness, swelling and watery discharge.
Making things worse: the trend toward warmer temperatures year-round. That means pollen seasons start sooner and last longer. A 2014 Rutgers University study found that between 2001 and 2010, pollen season in the contiguous U.S. started, on average, three days earlier than it did in the 1990s.
We’re also seeing more plant growth and pollen production — whether from trees in the spring, grass in the summer or ragweed in the fall. According to the Rutgers study, annual totals of airborne pollen have increased by a whopping 40 percent.
But there are ways to fight back.
What to know about how allergies affect your eyes
Ocular allergies (also known as allergic conjunctivitis) happen when an overeager immune system mistakes harmless triggers (such as pollen and weeds) for a threat and goes into overdrive. The mast cells (responsible for your immune system's inflammatory responses) on your eye’s surface become activated, releasing histamines and other chemicals to help get rid of the allergens; this leaves eyes itchy, red, swollen and watery. “You’ll be tempted to rub your eyes, but don’t,” cautions Andrea Thau, a New York City–based optometrist. “This will only release more histamine and make symptoms worse.”
How to outsmart allergens
Avoid exposure Obviously, sealing yourself off from the outside world 24/7 isn’t an option. But try to stay inside as much as possible during pollen-heavy days. The American Academy of Allergy, Asthma & Immunology and Pollen.com offer interactive maps that let you check out current pollen levels in your area. If you’re determined to get in a round of golf or putter around in your garden, try to schedule those activities during the time of day when pollen counts are lowest — generally, in the later afternoon.
Wear sunglasses Any style of shades will help keep lids and lashes pollen-free, but your best bet are those with large or wraparound-style lenses, which keep the wind — and pollen particles that come with it — out of your eyes on breezy days. Airborne allergens can also latch on to the surface of contact lenses, so be sure to clean them daily or consider switching to the disposable kind. While you’re at it, consider wearing a broad-brimmed hat to shield your face and hair.
Keep windows closed, particularly when the pollen count is high. On sultry days click on an air conditioner equipped with a HEPA (high-efficiency particulate air) filter to trap outside allergens. Or consider getting an air purifier.
Don't bring the outside in If you’ve been spending a lot of time outdoors, “leave your jacket or hat in the garage when you come into the house, so you’re not introducing allergens into your home space,” says Michelle Andreoli, M.D., clinical spokeswoman for the American Academy of Ophthalmology. Ditch your clothes and toss them into the washing machine or hamper. Hot temperatures are best for killing pollen, but if your garments can’t take the heat, suds them up in a warmer temp, followed by two quick rinses with cold water. Then, to remove pollen, give yourself a quick rinse in the shower or towel off with a damp cloth.
Wash your eyes and eyelashes twice a day, using a mild face soap, in the morning and right before bed. “Your lashes serve a function,” Andreoli explains. “They’re essentially overhang for the eyes and are actually quite sticky. Pollen sticks to your lashes, and if you don’t scrub that away, it can chronically irritate your eyes. Go to sleep and smash your face into a pillow and you’re grinding pollen into the surface of your eye.” Double down by changing your pillowcases and bedding frequently.
And don’t forget the dog — another magnet for pollen. Give your pets a good brushing, and wipe off their paws before they bring the bad stuff into the house. And, yes, frequent baths are a must.
Treatment
If those annoying symptoms still stick around, you may want to first try basic over-the-counter lubricating drops. For mild symptoms, these should do the trick. “Artificial tears help wash away allergens and keep eyes moist,” says Michele Pham, an allergist and immunologist and assistant professor of medicine at University of California, San Francisco. You can use them multiple times a day, Pham adds, but look for products that are preservative-free.
Antihistamine drops, available over the counter or by prescription, are another option. They work by blocking the effects of histamine made by your body’s immune system, to temporarily relieve itchy, watery eyes. Cool compresses can also provide relief and help with swelling.
If your symptoms persist, consider making an appointment with an allergist or eye doctor for allergy testing, to confirm that your symptoms are allergic reactions. There are a lot of eye conditions that can mimic ocular allergies, including infections, irritant exposures and the common cold. “Dry eye, in particular, shares some of the same features as seasonal eye allergies — dryness, itching, irritation and a sensation that there’s something in the eye,” says Andreoli. (Note that dry eye can increase your risk of having allergic conjunctivitis or make symptoms worse, because you don't have the tears needed to rinse away allergens.)
The treatment of choice for chronic seasonal eye allergies is a dual-acting antihistamine/mast-cell stabilizer. These drops contain both an antihistamine, to relieve itchiness, and a mast-cell stabilizer, which prevents mast cells from responding to allergens and releasing histamine and other chemicals during an allergic reaction. (Put another way: They help prevent, rather than treat, the reaction process.) Because it may take several weeks for mast-cell stabilizers to work, if you're someone who gets eye allergies every year, it’s best to start using this medication two to four weeks before allergy season begins, says Thau. “The whole idea is to get ahead of your allergies.”
Corticosteroid eye drops are reserved for those with severe symptoms. Because of possible side effects, such as elevated eye pressure (which can lead to serious eye conditions like cataracts and glaucoma), corticosteroid eye drops aren’t designed for long-term use and should be prescribed only when absolutely necessary, when milder therapies have failed, says Andreoli. What’s more, they require close monitoring from an ophthalmologist on the lookout for potential complications.
If eye drops aren’t giving you relief, immunotherapy or allergy shots may be an option. An allergist injects you with small amounts of allergens over time, to help build up your tolerance. “Other treatments try to prevent your allergy cells from becoming activated,” says Pham. “Allergy shots can actually change your immune system into not thinking that an allergen is an allergen.” These shots usually take three to five years to reach peak effectiveness, though the results can be long lasting and impressive. After being treated, people can be exposed to large amounts of allergens before experiencing a reaction.
