Eye allergies are the eyes’ physiological reaction to the presence of certain irritants, also called allergens. This reaction is stressful because, even though most allergens are harmless, the eyes treat them as invasive. Eye allergies often occur in combination with nasal and other upper respiratory allergy symptoms.

Approximately 22 million people in the U.S. suffer from itchy, swollen, and red eyes. Seasonal allergic conjunctivitis (hay fever) is the most common allergic eye problem. In 2021, an estimated 81 million Americans were diagnosed with seasonal allergic rhinitis, which can include symptoms of itchy, swollen, or red eyes.

With proper identification and treatment, allergy sufferers can control their symptoms and avoid future reactions. Specialists at Baptist Health can assist you in managing your allergies.

What Are Eye Allergies?

Eye allergies are a special case of conjunctivitis, caused by allergens rather than a bacterial or viral infection. The conjunctiva is the clear tissue that covers your eyeball and the inside of your eyelid. Unlike other forms of conjunctivitis, allergies of the eye are not contagious.

Types of Allergic Conjunctivitis

There are several types of allergic conjunctivitis. These include:

• Seasonal allergic conjunctivitis (SAC) - Also called hay fever conjunctivitis, SAC is the most common type. It typically occurs during the spring, summer, or fall when pollen from trees, grasses, and weeds is present. This condition is sometimes referred to as acute allergic conjunctivitis due to its rapid onset.
• Perennial allergic conjunctivitis (PAC) - Also known as year-round allergic conjunctivitis, PAC is a chronic condition often triggered by indoor allergens such as dust mites, pet dander, or mold. Symptoms tend to be milder than SAC but may persist throughout the year.
• Vernal keratoconjunctivitis - This is a more serious, chronic type of allergic conjunctivitis that typically affects boys or young men. It may worsen seasonally and is often associated with other allergic conditions like eczema or asthma. Symptoms include intense itching, excessive tearing, thick mucus discharge, a sensation of something in the eye, and light sensitivity.
• Atopic keratoconjunctivitis - This chronic condition usually affects older men with a history of allergic dermatitis. Symptoms can include severe itching, burning, redness, and thick mucus discharge, especially upon waking. If not managed properly, this condition may lead to complications, including scarring of the cornea.
• Contact allergic conjunctivitis - This type can occur due to irritation from contact lenses or from proteins in your tears that bind to the lenses. Symptoms may include itching, redness, mucus discharge, and discomfort when wearing contacts.
• Giant papillary conjunctivitis - A more severe form of contact allergic conjunctivitis, this condition is often related to prolonged contact lens use. It causes large papules (fluid-filled sacs) to develop on the upper inner eyelid, leading to discomfort and lens intolerance.

What Are the Symptoms of an Eye Allergy?

Eye allergy symptoms can vary from person to person and depend on the type of allergic conjunctivitis. Symptoms may range from mild to severe. While many types share common symptoms, some individuals may also experience more intense or persistent reactions.

Common Eye Allergy Signs and Symptoms

Allergies can impact all the visible parts of the eye. Common symptoms of allergic conjunctivitis include:

• Itchiness, redness, or burning
• Swollen eyelids
• Watery tear ducts
• Light sensitivity

Eye allergies are usually just one aspect of a broader physiological reaction to an allergen, which may also include an itchy or runny nose, headache, sore throat, and coughing.

Anaphylaxis

In rare cases, contact with allergens can cause anaphylaxis, an extreme and possibly fatal allergic reaction. Anaphylaxis is marked by:

• Swollen throat, lips, or tongue
• Impaired breathing
• Skin rashes or hives
• Rapid pulse
• Dizziness, lightheadedness, or fainting
• Change of color in the face or body (turning pale or red)
• Gastrointestinal pain
• Vomiting or diarrhea
• Uterine cramps

When to See a Doctor

If you are experiencing common allergy symptoms, see your physician for a professional diagnosis. In more severe cases, call 911 or go to the nearest emergency medical facility. Should the need arise, allergy sufferers with epinephrine auto-injectors can self-administer a medication to counter an anaphylactic reaction. 

What Triggers Eye Allergies?

The root cause of eye allergies is similar to that of other types of allergies: the hypersensitivity of the body’s immune system to certain “invading” or “foreign” elements. This overreaction results in antibody production, leading to repeat episodes in future contact with the allergen.

There are numerous allergens in both indoor and outdoor environments. Major allergic conjunctivitis cause examples include:

• Plant pollen, especially from ragweed, grasses, and trees
• Pet dander
• Mold
• Smoke
• Dust
• Perfumes

Another leading contributor is irritation from wearing contact lenses. Wearing contact lenses can increase the risk of eye allergies. Proteins from your tears may bind to the surface of the lenses, and allergens like dust or pollen can become trapped on or beneath them, potentially triggering an allergic reaction.

How Do I Know If I Have an Eye Allergy?

Allergy or allergy-like symptoms, especially those of the eyes and upper respiratory system, are common, and may result from a number of medical conditions. You will need to see your physician for a proper evaluation. He or she may take the following steps to diagnose your case:

• Conduct a physical examination
• Document your symptoms and family medical history

Your provider may also conduct allergy testing as part of their evaluation. These may include:

• Radioallergosorbent, or RAST - This test is used to identify your allergen or allergens.
• Skin-prick test - This test involves injecting tiny amounts of potential irritants under your skin to look for evidence of an allergic response (e.g., swelling, itching, or redness).
• IgE antibody test - This test indicates past contact with an allergen.

How Do I Know if I Have Allergic Conjunctivitis or Bacterial Conjunctivitis?

Differentiating between allergic conjunctivitis and bacterial conjunctivitis can be difficult. Itchy and watery eyes tend to be more common in allergic conjunctivitis and symptoms will be present in both eyes. In bacterial conjunctivitis, symptoms tend to only occur in one eye. Allergic conjunctivitis also tends to last much longer than bacterial conjunctivitis. If you are unsure of which type of conjunctivitis you have, it is important to contact your healthcare provider.

Eye Allergy Treatments

Allergies are managed rather than cured. Mild symptoms can be controlled with over-the-counter medications, such as antihistamines and decongestants. Other treatment options for allergic conjunctivitis include:

• Artificial tears - Eye drops provide temporary relief by flushing allergens from the eye.
• Mast-cell stabilizers - Mast-cell stabilizers limit the production of histamines, the body’s symptom-causing response to the presence of allergens.
• Corticosteroids - Steroidal eyedrops can reduce itching, swelling, and redness of the conjunctiva.
• Subcutaneous immunotherapy (allergy shots) - Immunotherapy offers long-term relief of allergies and allergy symptoms.

Anaphylaxis is treated with epinephrine (also called adrenaline). Pre-loaded epinephrine auto-injectors are available by prescription. At-risk allergy sufferers should be aware of the early signs of anaphylaxis and carry one or more epinephrine auto-injectors at all times.

Can Benadryl Help with Allergic Conjunctivitis?

Benadryl can be an effective form of treatment for people with allergic conjunctivitis. Sleepiness is a common side effect of taking Benadryl, so it is often recommended to take before going to sleep.

How Long After Eye Allergy Treatment Until I Feel Relief?

How long it usually takes to experience relief from your symptoms depends on the type of treatment and the severity of your symptoms.

• Antihistamines - These medications typically start working 30 minutes after taking them.
• Allergy eye drops - Generally, eye drops start working after about an hour.
• Allergy shots - Typically, allergy shots start working within a few weeks but can take up to 6 months or longer to notice a significant difference or decrease in symptoms.

How to Prevent Allergic Reactions in the Eye

Of course, the best way to cope with eye allergies is to avoid allergens altogether. Here are some steps you can take to prevent an allergic reaction. If you are:

• Allergic to pollen - Avoid going outside when pollen counts are high. Close your windows and run the air conditioner. Make sure you change your HVAC filters regularly. If you do go outside, wearing eyeglasses or sunglasses can reduce the amount of pollen that gets into your eyes.
• Allergic to pets - Keep your pets out of your bedroom to the extent you can. To reduce the buildup of pet dander, eliminate carpet from floors where possible. Wash your hands after contact with animals, and ensure proper filters are in place throughout your HVAC system.
• Allergic to mold - Maintain humidity levels of 30 to 50 percent throughout your home. This can be accomplished by placing dehumidifiers in high-humidity zones such as the basement and in stairwells.
• Allergic to smoke - Maintain a strict no-smoking policy in your home.
• Allergic to dust - Avoid contact with dust mites. Wash sheets and pillow cases regularly in hot water and use allergen-reducing covers for bedding, where possible.
• Allergic to perfume - Avoid contact with perfumes, colognes, and items that contain them. Purchase only scent-free washing and cleaning products.

FAQ

How Long Do Eye Allergies Last?

How long eye allergies last depend on what is causing them, how severe they are, and what treatment is being used. Some allergies may resolve 30 minutes after taking an antihistamine, allergy eye drops may start working after about an hour, and allergy shots usually take several weeks or 6 months to start making a significant difference. If your allergies are more severe, treatments may reduce but not resolve all symptoms.

Can Allergic Conjunctivitis Affect One Eye?

Allergic conjunctivitis typically affects both eyes. If only one eye is affected, that is usually a sign that you have bacterial conjunctivitis.

What Does an Eye Allergy Look Like?

Eye allergies may look like itchy, watery, burning, red, or swollen eyes. People may also experience light sensitivity or blurred vision.

Can You Relieve Allergic Conjunctivitis at Home?

Home remedies for allergic conjunctivitis may include:

• Regularly flushing your eyes with water.
• Applying a cold compress to your eyes.
• Using over-the-counter or prescription medications.

Is Allergic Conjunctivitis Contagious?

No. Allergic conjunctivitis is not contagious.