Allergy eye drops are a type of liquid medication that is used for people who experience allergies in their eyes. Often, the symptoms of eye allergies are triggered by those things that trigger hay fever, including pet dander, dust, or pollen. As a result, people experience tearing, swollen eyelids, bloodshot or red eyes, itchy eyes, feeling like something is inside the eye, or burning feelings in the eye. Sometimes, allergies can also be triggered by contact lenses or certain medications.
A Diagnosis of Eye Allergies
Eye allergies happen when the immune system becomes too sensitive to certain environmental factors, causing it to overreact. These factors are not a problem for people without allergies. When someone with an allergy comes into contact with one of those factors, called allergens, the mast cells’ antibodies respond by sending histamines and other chemicals and substances to the eyes. This causes leakages in the tiny blood vessels of the eyes, causing them to become watery, red, and itchy.
An eye allergy can present with the exact same symptoms as certain eye diseases. This is why it is important not to self-diagnose, but to actually seek medical attention. The way people respond to allergies ranges from a mild discomfort and redness, to a severity that actually impairs vision. Usually, over the counter remedies can provide sufficient help. If not, an appointment with an allergist may be required. He or she will look at your symptoms and medical history to determine what is going on and how it can be treated.
Some of the tests you will be given include a microscopic eye examination, in which the swollen vessels can be seen. Furthermore, you may have to have a white blood cell count, which shows whether there is an allergic reaction. In order to do this, a piece of the eyelid’s inner lining, the conjunctiva, will gently be scraped.
Types of Eye Allergies and Symptoms
There are various types of eye allergies, as the table below demonstrates.
| Type | Symptoms | Details |
| Seasonal allergic conjunctivitis | · Redness
· Itching · Clear, watery discharge · Chronic dark circles or allergic shiners · Puffy eyelids · Photophobia (sensitivity to bright light) · Cold-like symptoms (sneezing, congestion, runny nose). |
· Also known as SAC.
· It is the most common type of eye allergy, with symptoms only existing in one of the four seasons, depending on the pollen types. · Most people with SAC also suffer from hay fever. |
| Perennial allergic conjunctivitis | · Redness
· Itching · Clear, watery discharge · Burning sensation · Chronic dark circles or allergic shiners · Puffy eyelids · Photophobia (sensitivity to bright light) · Cold-like symptoms (sneezing, congestion, runny nose). |
· Also known as PAC
· Happens all year round. · Is usually milder than SAC. · Generally caused by reactions to allergens that are present all year, including dust mite, pet dander, and mold. |
| Atopic keratoconjunctivitis | · Burning sensation
· Severe itching · Thick mucus, sticking the eyelids together after sleep · Redness |
· Most common in older men with allergic dermatitis.
· Can happen all year long. · Can lead to corneal scratching. |
| Vernal keratoconjunctivitis | · Photophobia
· Foreign body sensation · Tearing · Thick mucus and discharge · Itching |
· More serious than PAC or SAC.
· Can happen all year, but usually becomes worse in certain seasons. · Most common in young men and boys. · 75% of cases also have asthma and/or eczema. · Can impair vision if left untreated. |
| Giant papillary conjunctivitis | · Puffiness
· Itching · Mucous discharge · Tearing · Poor tolerance of contact lenses · Blurred vision · Foreign body sensation |
· Often happens in people who wear contacts.
· Severe form of contact allergy. · Papules, or fluid sacs, form in the eyelid’s upper lining. |
| Contact allergic conjunctivitis | · Itching
· Redness · Lens discomfort · Mucous discharge |
Happens following contact lens irritation, or proteins binding to the lens’ surface. |
Different Allergy Eye Drops
Generally, an ophthalmologist or physician will recommend that you try artificial tears first, and placing cold compresses over your eyes. Avoiding your allergens is also important. You may prescribed with over-the-counter allergy eye drops. The type will depend on:
- Your type of allergy
- The allergens
- Your symptoms
- The effect of your allergy on daily activities
Allergy eye drops come in many shapes and forms. Most of them, however, only treat one of the symptoms. For instance, it can address itching but it won’t provide relief for redness. Some eye drops are over-the-counter remedies; others are only available on prescription. Some provide long-term relief and are slow acting; others act quickly but are not long lasting. The main types of eye allergy drops are highlighted in the table below.
| Type | Detail | Brands |
| Antihistamine | · Usually offered as first type of treatment.
· Helps with watery, itchy eyes. · Blocks the body’s histamines, which is what causes your symptoms when you contact an allergen. · Very fast acting, but provides short relief. · Generally has to be used several times per day. |
· Optivar, a type of azelastine hydrochloride.
· Emadine, a type of emedastine difumarate. · Livostin, a type of levocabastine. These are all prescription eye drops. |
| Anti-inflammatory | · Either corticosteroids or NSAIDs (nonsteroidal anti-inflammatory drugs).
· NSAIDs affect the nerve endings, stopping you from feeling itchy. · NSAIDs work in about one hour. · NSAIDs often cause burning or stinging sensations. · Corticosteroids should not be used long term due to side effects. · Corticosteroids require frequent physician check-ups to monitor side effects, which include increased pressure in eye, glaucoma, eye infections, and cataracts. |
· Acular and Acuvail, two types of ketorolac drugs, which are the only approved NSAIDs on the market today.
· Alrex and Lotemax are prescription steroid eye drops. |
| Decongestant | · Brightens the whites of the eye.
· Reduces redness. · Short acting. · Narrows down the eye’s blood vessels. · Available over the counter. · Not recommended for eye allergies by physicians. · If used for too long, they can cause “rebound redness” meaning symptoms actually get worse. This swelling and redness can continue even after you no longer use the drops. · Never suitable for people with glaucoma. |
· Clear Eyes, using naphazoline HCL.
· Refresh, using phenylephrine HCL. · Visine, using tetrahydrozoline HCL and oxymetazoline HCL. These are all over-the-counter remedies. |
| Mast cell stabilizer | · The newest form of eye drop.
· Stops the release of histamines and other chemicals common with allergic reactions. · Prevents symptoms. · Can be used for a long time without noticing side effects. · Can help for those who wear contact lenses. · Available over the counter. |
· Claritin Eye, which is a ketotifen fumarate.
· Refresh Eye Itch Relief, which is a ketotifen fumarate. These are both over the counter remedies. Prescription mast cell stabilizers include: · Cyrolom, a type of cromolyn. · Alomide, a type of lodoxamide. · Alocril, a type of nedocromil. · Alamast, a type of pemirolast potassium. |
| Multiple action | · Offers relief for different symptoms.
· Often combines decongestant with antihistamine. · Can address redness, watery eyes, and eye itching. · Prevents burning, tearing, redness. |
· Vasocon-A, a type of antazoline phosphate/naphazoline HCL.
· Opcon-A and Naphcon-A, types of pheniramine maleat/naphazoline HCL. Certain drops have been created specifically for people with allergic conjunctivitis. These include: · Elestat, a type of epinastine. · Alaway and Zaditor, types of ketotifens. · Pataday and Patanol, types of olopatadine hydrochlorides. |
Side Effects and Risks of Allergy Eye Drops
All medications have certain risks. It is vital, therefore, that you follow the instructions written on the label. You should never use an over-the-counter remedy more than three times per day. If you use them more frequently, they can actually worsen your symptoms. If you have a glaucoma or an eye infection, you should never use any type of eye drop. Rather, you need to speak to your physician about other solutions.
It is very common for eye drops to burn or sting when they are first applied. Keep eye drops stored in the fridge to stop them from going off.
Often, it is not possible to use eye drops while wearing contact lenses. You may be told, therefore, to remove them before applying the drops. Generally, you can put them back in around 15 minutes after you have applied the drops. With some drops, you cannot wear contact lenses at all. Thus, make sure to check the label.
In almost all cases, you will require drops more than once per day, even if they are long lasting.
Resources and References:
- American College of Allergy, Asthma & Immunology – Types of Allergies (ACAAI.org)
- Mayo Clinic – Allergy Medications: Know Your Options (MayoClinic.org)
