Eye Care Tips for Dealing with Allergies and Contact Lenses
Seasonal allergies affect around 40 million Americans and about 30 million people wear contact lenses. If you fall into both categories, you know the itchy, watery misery of seasonal allergies is made worse by the plastic on your corneas.
Dr. Steven Stetson, medical director of Diamond Vision, a laser-vision and eye care center in Manhattan, has eye care tips for those of you who suffer seasonal allergies and wear contacts.
1. Cease Rubbing
It may feel better in the short term, but “rubbing actually instigates more release of histamine,” Dr. Stetson said. Histamines are the chemicals immune cells produce to fight invaders like germs and bacteria.
Histamines are what cause your allergy symptoms in the first place, so rubbing your eyes is summoning more troops to the bleary battleground—i.e. creating more inflammation.
2. Protect Yourself
“If you know you are someone who suffers from pollen allergies, go out as little as possible during pollen season,” Dr. Stetson said. Of course many of us can’t afford to become hermits for weeks on end, so the right glasses and eye drops can help you survive outside.
3. Wear Wraparound Sunglasses
No, you don’t need to start sporting the enormous side-shield glasses your grandma likes, Gucci and Ray-Ban make posher versions. In addition to blocking UV radiation, the extra side protection will help screen your eyes from airborne irritants. Make wraparounds your allergy season accessory that you don’t leave home without.
4. Clean House
While you’re stuck inside waiting for your new sunglasses to arrive, thoroughly clean house, recommends Dr. Stetson. Include damp mopping the floor to eradicate allergy-causing pet dander, mold, and dust mites—the biggest allergy threats in your home.
Make sure you clean high-up horizontal surfaces like the top of bookshelves and door jambs, which breed dust colonies. If your allergy symptoms are worse in the morning, you could have a dust mite problem, Dr. Stetson said. Consider chucking out your pillow and getting a new one every year and or an allergen impermeable cover for it. If your house is humid consider investing in a dehumidifier, which removes the moisture that mold thrives on.
5. Refrigerate Your Artificial Tears
The cooler temperature will help soothe your eyes, Dr. Stetson said. If you take oral allergy medications like Zyrtec, Allegra, or Claritin—which are all antihistamines—they may dry out your eyes. As part of your allergy treatment plan, he recommends keeping artificial tears with you at all times—which may mean that you can’t always refrigerate them. Using the tears 3–4 times a day can really help counteract the medication-induced dryness.
6. Use Artificial Tears Sans Preservatives
Dr. Stetson prefers preservative-free artificial tears because a small percentage of patients have adverse reactions to preservatives—especially detergent-based ones like benzalkonium chloride (BAK).
“Chronic use of BAK-based teardrops and other eye medications (such as glaucoma drops) has been associated with damage to the corneal epithelium [layer of surface cells] and increased inflammation,” Dr. Stetson wrote in an email.
He recommends over-the-counter brand Blink Tears, which makes eye drops both without preservatives and with a safer preservative.
Safer preserved artificial tears include oxidation-based preservatives (purite and sodium perborate) that become inactive when exposed to the surface of the eye. Blink Tears, Genteal, and Refresh Optive brands, have oxidation-based preservatives.
For more information on benzalkonium see the article: “Preservatives in Topical Ophthalmic Medications: Historical and Clinical Perspectives”
7. Go-To Prescription Medications
If your eyes are extremely irritated by allergies you may require prescription medication. Your optometrist or ophthalmologist will probably tell you to remove your contacts until symptoms improve. Dr. Stetson said the best and most common go-to anti-allergy drops on the market are Lastacaft and Pataday.
These two drops provide allergy symptom relief all day generally with just one dose, and have both an antihistamine as well as a mast cell stabilizer. Mast cells are trigger response cells, which when your body senses an antigen, are the cells that release the histamine forces.
“Having a drop that not only controls histamine but also reduces or stabilizes the mast cell so that it doesn’t go ahead and release the histamine in the first place, is very effective,” Dr. Stetson said.
8. More Powerful Prescription Meds
If you are having a particularly bad allergic reaction that requires a strong, fast-acting anti-inflammatory, your eye doctor may prescribe either a steroid drop or a non-steroidal anti inflammatory drop (Ibuprofen in eye drop form).
“A steroid drop will often be prescribed for a severe allergy issue, but will not be given for a long period of time in order to avoid potential harmful side effects such as increased intraocular pressure (fluid pressure inside the eyes) as well as a potential for cataract formation if used for long periods,” Dr. Stetson said.
“Non-steroidal anti-inflammatories can be used safely for moderate to severe allergic symptoms without the above side effects.” Prolensa and Ketorolac are two non-steroidal anti-inflammatory drops.
9. When to Consider LASIK Surgery
If your contacts are really a problem during allergy season, or you develop an allergy to them, you may consider permanent corrective eye surgery such as LASIK. While these surgeries won’t have any effect on seasonal allergies, they can help your eyes a great deal by eliminating the need to wear the contacts that traps antigens close to your eye.
10. Eat Local Honey
A mild allergy sufferer and pet owner, Dr. Stetson said his holistic tip for reducing the overall severity of seasonal allergies is to eat honey, preferably raw and unfiltered, from a nearby apiary. Local bees make honey from the same pollen that irritates your system—but if all year long you expose yourself to small doses of it, your body will become accustomed to the pollen and stop seeing it as a threat worthy of deploying the histamine troops.
Diamond Vision Manhattan Location
15 West 44th St. (between 5th and 6th avenues)
When You Become Allergic to Your Lenses
You can wear contact lenses for 10 to 15 years without any problem, then suddenly your body reaches a threshold and the plastic sitting on your eye becomes an irritant.
The body will then produce a histamine response, leading to “a cascade of inflammatory events, which cause blood vessel growth in the eyelid,” Dr. Stetson said. These swollen blood vessels are known as Giant Papillary Conjunctivitis (GPC), and this condition will happen to about 5 to 10 percent of contact lens wearers, Dr. Stetson estimates.
“It’s a scary thing for patients,” he said, adding that patients usually don’t understand why they are having a problem all of a sudden.
In addition to the bumpy eyelid, symptoms of GPC include swollen, itchy eyelids, oftentimes accompanied by ropy, milky discharge, and blurred vision.
“What cures the problem is cessation of using the contact,” Dr. Stetson said.
Doctors usually also prescribe a steroid drop and sometimes also a nonsteroidal anti-inflammatory eyedrop for GPC, he said.
Some patients are able to wear different contact lenses (ones with increased oxygen diffusion) after having GPC, however the eyes remain more sensitive and often people can’t wear their contacts for as long.
Sutures in the eye, and lint trapped there long-term can cause also GPC, but the soft contact lenses, popular nowadays for their comfort factor, are perhaps the biggest culprit.
Soft lenses are larger than the hard lenses worn 30 years ago, measuring around 14 millimeters in diameter compared with the around 9 millimeter wide hard lenses. Because they were smaller, hard contact lenses didn’t cover the whole cornea, “moved around the eye more, [and] they allowed oxygenation and more flow of tears,” Dr. Stetson said.
The greater coverage of the cornea with the soft lenses, means tears are less able to get underneath the contact, keeping it flushed and healthy.
Refractive surgeries like LASIK, which eliminate the need for contacts, also greatly limit the risk of GPC. “By taking a piece of plastic off the eye, we’re doing it a huge service,” Dr. Stetson said.
“The reality is, long-term, soft contact lenses do do damage to the eye.”
Allergies are the sixth leading cause of chronic illness in the U.S., according to the Centers for Disease Control and Prevention.
Pollen, grasses, dust, mold, smoke, perfume, food, and pet dander can send your immune system into overdrive, resulting in uncomfortable allergic reactions.
Some allergies, like peanut allergies, tend to be lifelong, while many people grow out of other childhood allergies. People of any age can develop allergies.
Alternative treatments for allergies include acupuncture and Chinese herbs, which can help resolve the underlying immune system imbalances.