What is Allergic Conjunctivitis? Eye allergies account for a number of patient visits each year. The hallmark of allergic conjunctivitis is itching. I tell patients that it’s like the itching they get when bitten by a mosquito. You feel like itching or aggressively rubbing the eyelids will end the agony. It doesn’t. Trust me, I have the same problem. Don’t itch if possible. Try to rub the eyebrow or well below the lower eyelid as this can alleviate some of the sensation. Rubbing only releases more Histamines. The histamines are proteins released by the mast cells. Mast cells are the immune or allergy cells which begin to populate parts of the body susceptible to allergies. Mast cells are attracted by antigens (poller or rag weed, etc.). Mast cells have antibodies coating their outer cell surface. Some of these antibodies are randomly attracted to specific antigens and thus the chain reaction. The antigen, let’s say pollen in this scenario, is floating around, then drops into your eye. Well one the mast cells is there and by random (un)luck, this mast cell has an antibody ready for the pollen. The antibody and antigen bind and this triggers a message to the mast cell to stimulate more antibodies and mast cells. Not just a bunch of randoms though. It’s a very specific message…it calls out the clones. Now you have clones of mast cells specific for the pollen and all ready to go to battle.
What to do? You can try to avoid these allergens. Clean sheets with hypoallergenic detergent, avoid pollen, bark etc. Clean animals or live in an animal free environment (good luck!). This sometimes works. Antihistamine eyedrops are the first line treatment of choice. Sometime steroids may be used. Caution must be used with steroid use in the long term because of cataract risk and glaucoma risk (rare). Another form of treatment is allergy testing and shots. Shots help to move the immune reaction to another part of the body…many times to the stomach or GI system. This works well because the GI system will never see these unprocessed antigens. I typically will have the patient use a antihistamine eye drop.
Come on in! We are happy to see you anytime for an exam. It’s not painful!
Timothy D. McGarity, M.D.
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