Itchy, Red eyes?  You could suffer from eye allergies.

By Jessica Lemons, OD

Reviewed by Tomy Starck, MD

About one in five Americans suffer from allergies.  Half of these people suffer from eye allergies.  Eye allergies are also called ocular allergies and can cause a condition known as allergic conjunctivitis.  Allergic conjunctivitis is an immune reaction of the conjunctiva, the white part of the eye, to an allergen.  When an allergen comes into contact with the eye, the eye deems it as foreign which triggers the mast cells in the eye to release histamine.  This is known as an allergic reaction.  The most common indoor eye allergens are dust, mold, and pet dander.  Outdoor allergens include pollen, grass, and weeds.  Some people are allergic to the preservatives in artificial tears, so they are forced to switch to a preservative free lubricant in order to alleviate symptoms.

Itchy, red eyes, a runny nose, sneezing, coughing, and headaches from sinus congestion are all signs of allergies, but how does one know if he or she has ocular allergies? The signs and symptoms of eye allergies include redness, itching, tearing, burning, and slightly blurred vision.  An individual can experience one or all of these symptoms with the most common being red, itchy eyes. Contact lenses may also become uncomfortable when ocular allergies are present because allergens can cause a coating on the lenses.  A person that has a mucous discharge coming from the eyes should contact his or her eye doctor immediately because this could potentially be an eye infection.

There are several different treatment options for eye allergies.  The foremost is to try to eliminate the allergen. Examples of this include wearing sunglasses outside to prevent pollen in the air from entering the eyes, cleaning the bed sheets to rid of dust mites, using a mop with a moist towelette instead of a broom to decrease the amount of dust in the air, and limiting contact with pets.  If the allergen is unidentifiable, then there are other treatment recommendations.  The first is to not rub the eyes even though they itch.  Mechanical rubbing of the lids can actually increase the release of mast cells making the allergic reaction worse.  Cold compresses can be used on the eyes to help with overall comfort.  Artificial tears can be used to flush out allergens.  If these options do not work, topical anti-histamine or mast cell stabilizer drops can be prescribed by an eye doctor.  Topical anti-histamine drops are fast acting while mast cell stabilizer drops provide longer lasting effects.  Topical decongestants are sometimes purchased over the counter to decrease the redness of the eye.  Decongestants vasoconstrict, or shrink the blood vessels making the eye look less red.  This makes the eye look better but does not treat the underlying cause of the red eye.  In addition, topical decongestants can have a rebound effect, which makes the eye look even redder after the drop wears off.  These drops are not typically recommended.  Topical steroids can be used; however, they are limited to severe cases and for short durations of use due to potential side effects like increased intraocular pressure and an increased formation of cataracts.  Oral anti-histamines may also help relieve symptoms but are usually not as successful as drops due to the heavy concentration of the medication on the ocular surface.  In addition they may aggravate or cause dry eye. Immunotherapy also known as allergy shots has proven to be very efficacious.  A small amount of the symptom causing allergen is injected into the body so that one can build up immunity to it.  Allergy specialists can aid with immunotherapy.  Contact lens wearers that also suffer from eye allergies will need to remove their lenses before applying a prescription medication to the eyes.  If the contact lenses are coating due to allergies it might be best to switch to a daily disposable lens during the allergy season.

It is best to seek medical help from your eye doctor if you cannot eliminate the cause of the allergy or if the methods of relief you are using are not working.  Dry eyes can be mistaken for eyes under the influence of allergies. Usually with dry eye syndrome people complain of red, watery, burning eyes which are also symptoms of ocular allergies.  Your optometrist or ophthalmologist should be able to decipher between the two and come up with an appropriate treatment regimen for you.  For relief of your eye allergies please visit us at UltraVision, for an appointment call 210-308-5550.

Options for Presbyopia

By Jessica Lemons, OD

Reviewed by Tomy Starck, MD

Presbyopia is a condition in which the crystalline lens of the eye loses its ability to focus, making it difficult to see near objects clearly.  This condition is a natural part of aging, usually begins between age 40 and 45 and steadily worsens until age 60.  It is not a disease and cannot be prevented.  Many people start to notice they have to hold things at arm’s length to read and may also experience eye strain and headaches.  Individuals that are nearsighted may realize it is easier to read with their glasses off.  Although there is no cure for presbyopia, there are several different treatment options.

If you experience any of the symptoms mentioned above, the first thing you need to do is have a comprehensive eye exam by your eye care provider.  Then, your eye doctor can discuss which of the following treatment options is best for you.  Each individual is unique and has different needs so one form of treatment may be better for one person over another.

The treatment options can be broken down into three main categories including glasses, contact lenses, and refractive surgery.  If a person chooses to wear glasses, there are three different options.  One can wear reading glasses that they will put on only to read and will remove to see at a distance.  Some people do not like the hassle of putting the glasses on and taking them off all day so a pair of bifocal glasses would be more appropriate for them.  There are two types of bifocal lenses:  one with a line and one without a line.  A no line bifocal is also called a progressive addition lens (PAL).  A lined bifocal has an actual line on the lens where the upper portion of the lens is used to see at a distance and the lower portion of the lens is for near work.  A progressive lens has no line and there is a gradual change from distance to near as you go from the top to the bottom of the lens.  Many times a person’s lifestyle determines which type of bifocal is better suited for them.  With both types of bifocals there is an adaptation period to get used to the glasses.

When it comes to contact lenses, there are also three different options.  A person can wear contact lenses to correct his or her distance vision which will still require the use of reading glasses for up close.  If the goal is to get rid of glasses all together, then monovision or multifocal contact lenses are the better choice.  Monovision correction is when one eye is used to see far and the other is used to see near.  The brain learns to use the better eye for the task at hand, whether one is driving or reading.  Sometimes an individual’s depth perception is slightly diminished with monovision contact lenses since he or she is only using one eye at a time.  If good depth perception is a key component to one’s lifestyle, then multifocal contact lenses may be a better option since both eyes are seeing at distance and near.  With either contact lens option there is an adjustment period to the lenses and the vision may not be as crisp as with glasses.

If someone is ready to get rid of glasses or contact lenses or cannot tolerate contact lenses due to lens awareness or dry eyes, a surgical option is superb for them.  There are two different surgical opportunities.  The first involves monovision correction through a laser procedure known as LASIK.  As reviewed above, monovision is when one eye sees for distance and the other for near.  LASIK can even be performed on one eye of individuals that only require reading glasses to rid them of glasses all together.  The second surgical option is to replace the crystalline lens of the eye with a multifocal lens implant.  This lens implant sees at both distance and near.  The surgical procedure is the same as a cataract extraction; however, the lens of the eye has not fully developed a cataract and is not cloudy.  Therefore, the surgery is referred to as a refractive lens exchange.  In closing, there are several different options to aid with the onset of presbyopia.  With all options an increase in the amount of focal lighting at near is the key to clear and crisp vision.  To find out what option is best for you, visit us at UltraVision for all your presbyopic needs.  Please call 210-308-5550 for an appointment.