By Dr. Richard Norden
Special to CNN
Editor’s note: Dr. Richard A. Norden is an ophthalmologist in the New York metropolitan area who specializes in LASIK and other procedures. He treats patients for a variety of eye ailments including allergies.
(CNN) — Between one-fourth and one-third of the U.S. population has allergic eye disease, experts say; a good percentage of that is seasonal.
We’re quickly off to one of the worst allergy seasons this year because of the relatively mild winter that has allowed trees and plants to blossom and flower early and with a vengeance. As a result, maple, elm and cedar trees, as well as grass and flowers, have released huge amounts of airborne pollen.
Pollen is an otherwise harmless substance, but if your immune system identifies it as an enemy that it needs to react to, it is then called an allergen and certain reactions occur in your body.
Most importantly, your cells will release an antibody known as IgE (Immunoglobulin E), which causes your cells to release substances like histamine. That creates the constellation of symptoms known as allergic conjunctivitis (pink itchy eye) and allergic rhinitis (runny nose).
Doctors are usually inundated with questions related to allergies this time of the year. Here are some of the most common:
Q: How can I have allergies if I’ve never had them before?
A: This is a result of your immune system building up a response after cumulative years of exposure to similar allergens. So, even if you’re 50 and never had allergies, you certainly can develop them now.
Q: Why does someone experience itching of the eye seasonally?
A: As discussed, pollen can trigger the immune response, which releases histamine that causes itching, but so can dust, pet dander and mold. A double whammy is a pet that gets coated with pollen during the spring and early summer, causing extra allergens to be present in your home.
Q: How can I tell if I have seasonal allergies affecting my eyes?
A: Seasonal allergic conjunctivitis. or SAC, flares in the spring and in the fall because of different allergens that are released into the air during those times, as opposed to perennial allergic conjunctivitis, called PAC, which is year-round. PAC is usually triggered by animal dander, feathers and dust mites and is usually not as severe as SAC. Symptoms of SAC include watery, itchy, red, sore, swollen and stinging eyes. Many times, it will be accompanied by allergic rhinitis.
Q: Are there any foods that have natural antihistamine properties?
A: There are three categories of foods that combat allergic reactions:
— Foods with Vitamin C (eaten fresh) including citrus fruits, juices and most other fruits and vegetables.
— Foods with quercetin (a bioflavonoid) that stabilizes mast cells — cells that mediate inflammatory responses — and prevent release of histamine. Examples include citrus fruits, onions, garlic, apples, parsley, tea, tomato, broccoli, lettuce, legumes, berries and wine.
— Foods high in omega-3 fatty acids. These foods combat the inflammation associated with allergic reactions. They include salmon, albacore tuna and mackerel, and walnuts, flaxseed oil and canola oil.
Q: Are there any “common sense” things I can do to reduce the severity of my allergies?
A: The best thing, although not completely practical, is to get skin-tested by an allergist to determine what you’re allergic to, and then avoid that allergen.
Pollen counts are low first thing in the morning, but rise quickly and stay high until the evening. If possible, try to stay indoors during those times as much as you can. If you’re in a car, keep the windows closed and the air conditioner on.
If you have to be outside for any period of time, wear wraparound sunglasses to reduce the amount of pollen that will come to rest on the surface of your eyes. You might consider a wide-brimmed hat for that same purpose. When you go inside, use artificial tears to flush any pollen that may have accumulated on the surface of your eyes. If you have pets that have been outside during the day, you should consider cleaning them with a vacuum that has a HEPA filter.
Q: I’ve done everything that you suggested, but I’m still itching and uncomfortable. How can we treat this?
A: Cold compresses can help with the swelling and may provide a little anesthesia if cold enough, but eye drops are the mainstay of treatment.
Oral antihistamines were among the first systemic drugs to treat allergies and can still be used successfully. Newer antihistamines such as Claritin or Zyrtec are effective and won’t cause drowsiness.
“Older” eye drops include antihistamine/decongestant combinations. There are also mast cell stabilizers that prevent release of histamine, and also dual action antihistamines and mast cell stabilizers.
If you’re still suffering, an ophthalmologist may carefully prescribe low doses of topical steroids for short periods of time. Steroid use needs to be monitored since prolonged use can cause glaucoma and cataracts.
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