Allergy season is coming!

Eye allergy, dry eye disease, virus or bacteria - which one is bothering my eyes?

It is a scene that happens every day at our Vancouver eye clinic.  A child comes in with dry eyes.  Simple, right?  Not at all! Here is a window on how doctors distinguish between dry eye disease, bacterial infections, viral infections and eye allergies.

If a child has dry eyes, doctors have to find the cause.  Dry eyes in kids can be caused by allergies, viruses, bacteria or systemic diseases.  A good doctor will correctly determine the cause of the dryness in order to treat the problem effectively.

Doctors distinguish between bacterial and viral infections on the one hand and allergies on the other using many techniques.  One of them is by noting the duration of the episode.   Viral and bacterial infections are usually not chronic.  By contrast, a chronic problem can point to an eye allergy.

Only about 1.5% of healthy children have dry eye disease symptoms and for most children dry eye is the symptom of an eye allergy.  However, parents of children with dry eyes need to take them to the optometrist for evaluation because some symptoms point to potentially serious problems. 

For example, dry eyes with the presence of a symptom such as burning is an indication of possible systemic disease.  In certain children with dry eyes, certain things point to dry eye syndrome such as a history of systemic disease like rheumatoid juvenile arthritis or Sjögren’s syndrome.  Conversely, other things point to allergies such as a history of asthma or atopic dermatitis. Bacteria or a virus may be the cause of dry eyes if the child has a history of recent upper respiratory infection,  or a recent eye infection in a sibling.

Doctors pay close attention to patient symptoms because these help to distinguish between dry eye disease (aka dry eye syndrome) and eye allergy.  Here are some symptoms and the cause that they point to:

• itching is strongly associated with eye allergy; 
• burning and foreign body sensation are associated with dry eye disease;
• complaints of lids matted together, along with irritation and soreness suggest a bacterial infection
• irritation and pain suggest a virus;
• sensitivity to light is also usually associated with a virus;
• tearing eyes are usually a sign of dry eye;

To learn more about eye allergies in kids, click here.

Allergy season will be a month longer than normal this year - what to do about itchy and watery eyes

I'm seeing more patients with complaints of itchy, watery eyes.  And my husband is complaining like crazy and begging for a prescription!  That means it's spring and allergies are here.  In fact, in the northern part of North America (which includes most of Canada), allergy season is expected to last as much 27 days longer than normal according to a study published by the Proceedings of the National Academy of Sciences. 

Eye allergies are a reaction allergens such as pollen, mold, dust mites and pet dander.  They get in the eyes and cause inflammation of the tissue that lines the inner eyelid. 

There are a number things you can do.

 If you wear contact lenses, consider switching to daily disposable lenses.  They are by far the most comfortable lenses on the market. Allergy season can make contact lenses more uncomfortable and comfort declines significant in weeks three and four for a monthly lens.  You can avoid most of these problems by switching to a daily lens.  Although daily lenses are more expensive, you don't need to buy solutions and they are super-convenient because you don't need to clean and care for them.  They are unbeatable for traveling.

Allergy medication is an another option.  Oral, all purpose allergy medication like Claritin should be used with caution, especially if your main complaint is itchy and watery eyes.  These pills can dry out the eye and replace one problem with another.

There are a number of prescription eye drops designed to eliminate itchy watery eyes that your eye doctor can tell you about and prescribe if appropriate.  Many of these are very effective, now come in "once-a-day" formulation, are pregnancy safe and can be used in children as young as two years old.  For a child, who needs a parent to apply the drops, the once-a-day option is convenient because you can give the child one drop in the morning and he is good for the next 16 hours of summer camps, sports, hikes and everything else than makes summer fun!