Ocular Allergies

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The main components in an allergic reaction are:

  • Allergen: This is the microscopic thing you are allergic to. Pollen, dust, cat hair, etc.
  • Mast Cell: These are cells lining the surface of your eye and inside your eyelids. Think of this as a glass jar filled with marbles. When the allergen attaches to the wall of the mast cell it will “break this jar and release the marbles”.
  • Histamine: Think of these as the marbles inside the jar. When histamine is released it will attach to the surface of the eye and cause your symptoms of swelling, redness and itching.

There are number of places in the allergic reaction that you can deal with your symptoms. And there are different products that will do this for you. Here is a list of solutions you can try.

  1. Avoid the Allergen. With seasonal allergies this is probably not possible but it can work for other allergens like pets.
  2. SYSTANE ULTRA: Dilute and wash away allergens before they attach to the mast cell. You do this with artificial tears. You will need to use artificial tears regularly (4-8x/day or more) to do this.   Artificial Tears can be used throughout the day and long-term without any risk of problems, but beware there are many different drops to choose from. Our recommendation is Systane Ultra. It is available over-the-counter and we sell it a little less than drug stores for your convenience.
  3. OPTICROM®: Opticrom blocks the allergen from attaching and breaking the mast cell. This is an effective way to deal with seasonal allergies. Opticrom is available over-the-counter and is used 3-4x per day for the allergy season- it can be used for months at a time. It works reasonably well but it can take up to a week to start to work – just think, if you already have allergy symptoms that means that some mast cells have already been broken. Opticrom will prevent new mast cells from being broken but you will have to wait out the current symptoms you have. This is a good solution for seasonal allergy relief.
  4. Naphcon-A: Naphcon-A is an antihistamine eye drop (the A in most eye drops stands for this). It is useful for immediate and short term allergies like pet allergies. After the histamines have been released it blocks them from attaching to the surface of they eye and reduces your symptoms. They are intended to be used 3-4x per day for 1-2 days but not long-term – just like you wouldn’t think of taking Reactine/Clariton every day for weeks.  The problem with most antihistamine eye drops, in particular Visine brands, is that they have a vasoconstrictor in them which makes your eyes less red but used over time these can have a rebound effect and actually make your eyes more red.
  5. PATANOL or ZADITOR: These are prescription eye drops which are available from your family doctor. They will effectively stabilize the mast cells and block histamines and are safe to use long-term. These are excellent options for seasonal allergy relief.

Michael D. Nelson, OD FAAO