eye diseases are common disorders where the conjunctiva
is affected and the red eye is a distinguishing
feature. But in most cases, allergic rhinitis and
less frequently asthma and eczema are present.
However, initially, the eye-related symptoms are
The eye is probably most vulnerable to allergic
attacks as it lacks a mechanical barrier to the
entry of allergens. The practice of treating
allergic eye diseases as nuisance is misguided,
since the quality of life is profoundly affected.
Seasonal eye allergies may cause headache, fatigue,
loss of sleep and generally reduce the efficiency
of the patient.
The incidence of allergy is as high as 30% to
50% in the U.S. and is higher in industrialized
countries because of resulting pollution, urbanization
and hygiene issues.
The most common allergic eye diseases affect
people of all age groups and are:
Seasonal allergic conjunctivitis: It is often
associated with hay fever and is triggered by
the same allergens that cause allergic rhinitis
- pollens of trees, grass or weeds. In U.S. ragweed
pollen has been identified as the most common
cause of seasonal allergies.
Perennial allergic conjunctivitis: It occurs
throughout the year because of allergens, which
are present at all times of the year. These commonly
are house dust mites, molds or animal dander.
The symptoms for the above two eye allergies
are itching watering and redness of the eye.
Allergic rhinitis is usually present.
The rarer and more serious types of allergic
eye diseases are:
Atopic keratoconjunctivitis or AKC: This is
a chronic, inflammation of conjunctiva and eyelids.
AKC affects both eyes and is commonly associated
with a family history of atopy like, eczema and
asthma. Approximately, 25% of the elderly eczema
patients develop some symptoms of AKC. Although
the disease generally affects people in their
50s, in some cases onset of AKC may be as early
as late teens. In some ways it is a life long
disease. Corneal involvement may lead to blindness.
About 10% of AKC patients also report cataract
with severe types of atopic dermatitis. Young
adults are more prone to developing AKC, 10 years
after the onset of atopic dermatitis. Uniquely,
AKC affects the anterior part of the lens, making
it opaque in 6 months.
The symptoms are continuous itching, soreness,
loss of vision and a feeling of dryness. It is
associated with eczema. Some of its symptoms
are similar to those of eczema, like swollen
Vernal keratoconjunctivitis or VKC: VKC is a
rare chronic disease, affecting both eyes, and
occurs in children with a history of atopy. Before
puberty, it occurs more in males. After puberty,
males and females are equally affected. VKC recurs
in spring with symptoms that are triggered by
wind, dust, and hot weather or sweating caused
by physical exertion. In 5% cases, VKC may lead
to blindness, with one eye affected more than
The symptoms are watering of the eyes, stickiness,
itchiness and stuck eyelids after sleep. Corneal
involvement may cause pain, loss of vision and
sensitivity to light.
Giant papillary conjunctivitis or GPC: GPC is
not a true eye allergy but a mimicking of eye
allergy symptoms. This disease is the result
of damage caused to the eye by a foreign body,
such as, contact lens. Cobbles develop inside
the upper eyelid, along the line of contact with
the foreign body, for example, the edges of the
contacts. In fact, the incidence of GPC has shown
an increase with the increased use of contacts.
GPC often completely resolves on removal of the
foreign body or contact lens.
Common symptoms include intense itching, blurred
vision, increased mucus discharge and reduced
tolerance to contact lens wear.
The diagnosis is based mainly on the medical
history of the patient and ophthalmologic findings.
Allergy skin tests and allergy blood tests may
be done to confirm the diagnosis or to detect
the offending allergen.
Contacts, if worn, must be removed. If there
is inflammation, cool compresses and artificial
tears can be very soothing. For the seasonal
or perennial allergies a dust free, less polluted
area can improve things. Further change your
towels and bed linen.
However medication is necessary. Drugs recommended
are topical antihistamines and mast cell stabilizers.
Oral histamines provide relief, especially, when
allergic rhinitis is present.
In severe cases, topical steroids are used but
only after a thorough diagnosis. Generally steroids
are avoided because they may lead to further
complications like, cataracts, glaucoma and other
A severe allergic reaction, though rare, can
lead to corneal ulceration, affecting the patient’s