Allergic eye disease
Medical treatment
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| Eye drop induced allergic conjunctivitis |
Treatment of allergic eye disease involves:
- Avoiding known causes
- Simple home remedies
- 'Over-the-counter' medicines
- Prescription medicines
- Specialist only medicines
Avoiding known causes
Wherever possible suffers should avoid any known causes of allergy. Simple measures include:
- Changing play areas
- Hand washing after work or play
- Staying indoors when pollen or dust levels are high
- Closing windows
- Delegation of lawn mowing
- Removal of plant species
- Air-conditioning/filtering
- Goggles and wrap-round sunglasses
- Wet-dusting
- Dust covers on pillows and mattresses
- Exposing furniture to sunlight to kill dust mites
- Removal of carpet
- Selling the cat/dog/rabbit/horse
- Moving house
Simple therapies
Two simple treatments can be very effective:
- Irrigating the eyes with artificial tears or solutions such as Optrex.
- Cool compresses can provide excellent relief, particularly in children with acute allergic conjunctivitis. The simplest way to do this is keep a wet flannel in a plastic bag in the fridge.
Over-the-counter (OTC) treatments
There are several types of treatments available without prescription from a pharmacy. Note that oral (tablet form) antihistamines are almost always ineffective.
The most effective OTC medicines are:
- Topical antihistamines
- 'Whitening' agents
Topical antihistamines
These are useful if symptoms occur infrequently or in a predictable way; for example when mowing the lawns. These drops can be used either when symptoms develop or before starting the activity associated with allergy.
Commonly used agents include:
- Livostin (levocabastin)
- Lomide (lodoxamide)
Whitening agents
This type of drug constricts the blood vessels of the conjunctiva. The main effect is to whiten the eye and there is some relief of itch and watering.
Examples include:
- Albalon
- Visine
- Zincfrin
Prescription medicines
More potent eyedrops are available on prescription. The two most effective medicines are:
- Cromolux (sodium chromoglycate)
- Patanol (olopatanol)
Cromolux
This is a very effective drug that often fails because treatment is stopped before it gets a chance to work. The drug takes three weeks to take effect and must be used continuously for ongoing relief.
Patanol
Patanol is simple to use and very effective in some patients. It is expensive but free trial packs are available.
Specialist only medicines
Patients with severe allergy usually require treatment with steroid eyedrops. Wherever possible these are used intensively for short periods and other drugs such as Cromolux are used at the same time to reduce the amount of steroid therapy required.
Steroids are very effective but have the potential to cause significant side effects such as glaucoma and cataract. For this reason steroid eyedrops are available only under the supervision of eye specialists and patients taking steroids need to be reviewed regularly by an ophthalmologist.