Glaucoma & Cataract, Prof. Eytan Blumenthal | Allergy affecting the eyes

Allergy

Allergies are a very common problem. Some people respond in an exaggerated manner to substances, chemicals, or biological materials that most other people do not respond or react to.

Allergies can develop to the pollen of certain plants, to particular foods, to animal fur, to the house dust mite (a microscopic organism that lives in dust, carpets, linens, mattresses and pillows, and to which many people develop allergies), and to a wide variety of chemicals and substances.

Most allergies develop to substances that originate from animal or plant sources. Our eyes are probably the most sensitive organ in the body. Is there any other organ or surface in the body that will be so negatively affected by a grain of sand or an eyelash that touches it? When it comes to our eyes, we are all “princesses” (if you are familiar with the story of the princess and the pea). Hence, allergies that affect our eyes can become very annoying, perhaps more so than allergies in other parts of our bodies.

Allergies are connected to immunological processes of the body that are mediated by antibodies and specific cells belonging to the immune system. For some reason or other, these immune cells are activated at times when they are meant to remain dormant (inactive). This means that they “wake up” and develop a strong immune response to “allergens”, substances that the body is supposed to remain inert towards. Essentially, an allergy is an immune response against a substance that in most other people does not trigger an immune, allergic response.

Allergies are a very unpleasant, yet extremely common phenomenon in the human species and many people suffer from them in different forms. In general, allergies can be manifested as a skin-rash, an asthma attack, severe and chronic rhinitis, itching, and more. The part of the eye which most strongly responds in allergies is the conjunctiva, a thin, translucent membrane which covers the white areas of the eyeball and the inside of the eyelids. The conjunctiva of allergy sufferers becomes red, irritated, very itchy, and may also become teary. Allergies are often characterized by their seasonal nature or their appearance in association with specific substances. For example, a person who is allergic to grass will develop allergic symptoms when he is in close proximity with grass, particularly if the grass if freshly cut, and more so if the grass is blooming. A person who is allergic to pine blossoms will manifest his allergies every year in roughly the same months, which is the season when that pine blossoms.

A person who is allergic to flowers and pollen, will also find his allergies “blooming” during the spring; whereas a person who is allergic to the house dust mite will be allergic when exposed to this environment, perhaps all year round. It is important for those who know that they are allergic to dust to realize that it is not the dust itself they are allergic to, but the small animal that lives on dust, called the “house dust mite”.

Today, many medications for allergies are available in the form of pills as well as eye-drops and nasal sprays. People whose allergies manifest primarily as eye allergies would be wise to rely primarily on medication in the form of eye-drops.

If a person who knows that he/she suffers from eye allergies has not seen an ophthalmologist for this reason in the past 3-4 years, it is recommended to schedule an eye appointment. This is because it is very likely that the eye-drops that he/she uses are not as potent or effective as some of the drops that have appeared on the market in the past few years. These new drops, which are topical anti-histamines, have a very good efficacy-safety profile, and have revolutionized the field.

It is recommended that a person who has more general allergies, i.e. allergies that include allergic rhinitis, sinusitis, cough and even asthma attacks, should, in addition to eye-drops, be treated with pills particularly during their allergic attacks. This treatment should, of course, be conducted under the auspices and the recommendations of an allergist, general physician or ophthalmologist. Here, too, anti-histamines in the form of pills exist, with the newer prescriptions having the benefit that they cause only minimal drowsiness, as opposed to the previous generation of anti-histamines that caused significant drowsiness and sleep.

If you know to which substances you are allergic, it is recommended to try to distance yourself from these substances (allergens) as much as possible. It is not logical to be allergic to a specific food or pet and to insist on being exposed to it on a daily basis. It is important to remember that with repeat exposure to the allergen there is a good chance that the allergy will become stronger and stronger. On the other hand, sometimes one does not know to what he/she is allergic to, or it may not be possible to completely distance oneself from the allergen. To help identify to which substances a person is allergic to, it is possible to undergo skin tests to a battery of common allergens, and identify which ones cause an allergic skin reaction.

In summary: Allergies can be very unpleasant and may in certain instances significantly affect a person’s quality of life both as a result of complaints related to the eye such as redness, tearing, a strong and consistent itch, as well as due to complaints related to the rest of the body such as chronic rhinitis, sinusitis, cough and in extreme cases, asthma attacks.

It is worthwhile and recommended to be under the care of a doctor and to return for a check-up if you have not updated your medicines, in the past few years, to the newest generation of medications available for allergies. For those people who take pills for their allergies such as: anti-histamines, it is beneficial to know that there are new-generation pills which cause much less drowsiness and thus have a much smaller (almost negligible) effect on everyday life. The same is true for eye-drops that treat allergies which in the last 3-4 years have become significantly more effective. Currently, there are several types of very effective eye-drops which successfully prevent symptoms of eye allergies, drops that one can take during an attack, or preferably, shortly before an attack (if one knows that he might be exposed to an allergen, prior to the actual exposure). For example, a person who is allergic to the seasonal blossoming of flowers in the springtime will be well advised to instill anti-allergy eye-drops before departing on a nature hike. Likewise, if your friend has a cat to which you are allergic to, you would be wise to instill eye-drops, and perhaps take a tablet prior to visiting that friend.

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