Allergies

Allergies affecting the eye are fairly common. The most common allergies are those related to pollen, particularly when the weather is warm and dry. Symptoms can include redness, itching, tearing, burning, stinging, and watery discharge, although they are not usually severe enough to require medical attention. Antihistamine decongestant eyedrops can effectively reduce these symptoms, as does rain and cooler weather, which decreases the amount of pollen in the air.

An increasing number of eye allergy cases are related to medications and contact lens wear. Also, animal hair and certain cosmetics, such as mascara, face creams, and eyebrow pencil, can cause allergies that affect the eye. Touching or rubbing eyes after handling nail polish, soaps, or chemicals may cause an allergic reaction. Some people have sensitivity to lip gloss and eye makeup. Allergy symptoms are temporary and can by eliminated by avoiding contact with the offending cosmetic or detergent.

Blepharitis and Conjunctivitis

Blepharitis is a chronic inflammation of the eyelids and is one of the most common disorders of the eye. Oils and other secretions build up on the eyelid surface and eyelashes, resulting in red, flaking or crusting of the eyelids. Other symptoms can include a sandy, gritty sensation, with burning, itching and/or redness. Although blepharitis is a chronic problem, applying warm compresses and lid scrubs can help control it. In some cases, it may be necessary to prescribe an antibiotic ointment.

• Warm compresses – soak a clean washcloth in very warm water, squeeze out the excess water, and then press it against your closed eyelids for approximately five minutes. You may need to rewarm the cloth several times. This will help to soften and loosen the debris on the eyelids.
• Lid scrubs – following the warm compresses, pull your eyelid away from your eye and gently clean the eyelid margin (at the base of your lashes) with the edge of the washcloth using a side-to-side motion. You may use solution with a small amount of baby shampoo mixed with an equal amount of water to cleanse your eyelids or a pre-packaged eyelid scrub solution.

The above treatment should be repeated two to four times daily for the first two or three weeks. As your symptoms improve, you can decrease the frequency as necessary to maintain your comfort level. Remember this is a chronic condition and stopping treatment altogether may result in a recurrence of symptoms.

Conjunctivitis is the term used to describe inflammation of the conjunctiva. Many refer to it as “pink” eye. A thin, membrane called the conjunctiva covers the white part of the eye. The conjunctiva has fine blood vessels, but when it becomes irritated or inflamed, the blood vessels enlarge and become more prominent and the eye turns red.

There are many different sources of eye irritation that can cause conjunctivitis. The most common are:

• Infections
• Allergies
• Environmental Irritants

Infectious conjunctivitis can be caused by a bacteria or virus. Bacterial infections, such as staphylococcus or streptococcus, cause a red eye that is associated with considerable amounts of discharge. Some bacterial infections are more chronic and may produce little or no discharge, except for mild crusting of the eyelashes in the morning.

Viruses are also common causes of conjunctivitis. Some viruses produce the familiar red eyes, sore throat, and runny nose of a common cold. Others may infect only one eye. Viral conjunctivitis usually produces a watery discharge and lasts from one to two weeks. Infectious conjunctivitis, whether bacterial or viral, can be very contagious. Frequent hand washing is recommended to help to prevent spread of the infection.

Some allergies, like hay fever, may produce a chronic redness and itching. Any type of conjunctivitis is aggravated by dryness of the eyes or environmental irritants, such as smoke.

The above treatment should be repeated two to four times daily for the first two or three weeks. As your symptoms improve, you can decrease the frequency as necessary to maintain your comfort level. Remember this is a chronic condition and stopping treatment altogether may result in a recurrence of symptoms.

Corneal Infections

Sometimes the cornea is damaged after a foreign object has penetrated the tissue, such as from a poke in the eye. At other times, bacteria or fungi from a contaminated contact lens can pass into the cornea. Situations like these can cause painful inflammation and corneal infections called keratitis. These infections can reduce visual clarity, produce corneal discharges, and perhaps erode the cornea. Corneal infections can also lead to corneal scarring, which can impair vision and may require a corneal transplant.

As a general rule, the deeper the corneal infection, the more severe the symptoms and complications. It should be noted that corneal infections, although relatively infrequent, are the most serious complication of contact lens wear.

Minor corneal infections are commonly treated with anti-bacterial eye drops. If the problem is severe, it may require more intensive antibiotic or anti-fungal treatment to eliminate the infection, as well as steroid eye drops to reduce inflammation. Frequent visits to an eye care professional may be necessary for several months to eliminate the problem.

Dry Eye Disease

What is dry eye?

The continuous production and drainage of tears is important to the eye's health. Tears keep the eye moist, help wounds heal, and protect against eye infection. In people with dry eye, the eye produces fewer or less quality tears and is unable to keep its surface lubricated and comfortable.

The tear film consists of three layers--an outer, oily (lipid) layer that keeps tears from evaporating too quickly and helps tears remain on the eye; a middle (aqueous) layer that nourishes the cornea and conjunctiva; and a bottom (mucin) layer that helps to spread the aqueous layer across the eye to ensure that the eye remains wet. As we age, the eyes usually produce fewer tears. Also, in some cases, the lipid and mucin layers produced by the eye are of such poor quality that tears cannot remain in the eye long enough to keep the eye sufficiently lubricated.

What are the symptoms of dry eye disease?

The main symptom of dry eye is usually a scratchy or sandy feeling as if something is in the eye. Other symptoms may include stinging or burning of the eye; episodes of excess tearing that follow periods of very dry sensation; a stringy discharge from the eye; and pain and redness of the eye. Sometimes people with dry eye experience heaviness of the eyelids or blurred, changing, or decreased vision, although loss of vision is uncommon.

Surprisingly, some people with dry eye may have tears that run down their cheeks. This is because the eye may be producing less of the lipid and mucin layers of the tear film, which help keep tears in the eye. When this happens, tears do not stay in the eye long enough to thoroughly moisten it.

What causes dry eye disease?

Dry eye can occur in climates with dry air, as well as with the use of some drugs, including antihistamines, nasal decongestants, tranquilizers, and anti-depressant drugs. Dry eye is more common in women, especially after menopause. People with dry eye should let their health care providers know all the medications they are taking, since some of them may intensify dry eye symptoms.

People with connective tissue diseases, such as rheumatoid arthritis, can also develop dry eye. It is important to note that dry eye is sometimes a symptom of Sjögren's syndrome, a disease that attacks the body's lubricating glands, such as the tear and salivary glands. A complete physical examination may diagnose any underlying diseases.

How is dry eye disease treated?

Artificial tears, which lubricate the eye, are the principal treatment for dry eye. They are available over-the-counter without a prescription. Sterile ointments are sometimes used at night to help prevent the eye from drying. Using humidifiers, wearing wrap-around glasses when outdoors, and avoiding windy and dry conditions may bring relief. For people with severe cases of dry eye, temporary or permanent closure of the tear drain (small openings at the inner corner of the eyelids where tears drain from the eye) may be helpful.

Some people may find relief by supplementing their diets with omega-3 fatty acids, which are found naturally in foods like oily fish (salmon, sardines, anchovies) and flax seeds. Ask your ophthalmologist before you incorporate oral supplements of omega-3 fatty acids into your dry eye treatment regimen.

If these methods fail your ophthalmologist may suggest use of a prescription medication. One such medication, cyclosporine (Restasis®) works by stimulating tear production and reducing inflammation. Steroid eye drops may also be used, but are generally not recommended for long-term treatment.