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Those who suffer eye allergy should keep their environment as clean as possible, writes Dr Tan Niap Ming
LITTLE Tommy had been blinking a lot this past two months and his mum had tried telling him to stop doing this. She also noticed that his eyes were occasionally wet and a little red in appearance in the morning. Sometimes Tommy, 4, rubbed them.
One morning, there was sticky mucus in the corner of his left eye and his mum brought him to the doctor. Tommy was diagnosed with allergic conjunctivitis. His mother was assured that it was not infectious and that the blinking would not become a habit.
With treatment, Tommy stopped blinking and rubbing his eyes. His eyes were no longer sticky or red when he woke up in the morning.
Tommy’s treatment included giving his beloved teddy bear and blanket a hot bath and drying in the sun.
What Tommy had is a fairly common condition. It affects all ages and sufferers may have good and bad times. For some, it is worse during puberty and growth period.
Allergic reaction is usually overreaction to a substance perceived as harmful, even if it is actually not so. These substances are called allergens.
Patients who have allergic rhinitis, eczema or asthma may also suffer from allergic conjunctivitis as their bodies tend to be more sensitive to allergens.
Allergens that cause an allergic reaction in the eye is typically airborne such as dust, dust mites, mould, pollen and animal dander.
Eye drops, cosmetics, skin care and sun block may also be causal factors. Protein deposits on reusable contact lens and the cleaning or soaking solution are fairly common causes as well.
Food that typically causes skin allergy or asthma is usually not the culprit. In an allergic reaction, our cells produce a substance called histamine which gives rise to all the signs and symptoms.
Signs and symptoms of eye allergy include tearing, itchiness, discomfort, blurring of vision, redness and swelling of the eyes.
One may even notice a ballooning of the conjunctiva (white area of the eye). Clear stringy mucus occurs in moderate to severe cases.
Although it is not always possible to live in a perfectly clean environment, efforts should still be taken to reduce the amount of allergens as well as one’s exposure to it.
Dust mites that feed on dead skin that we shed are found deep in the mattress, pillow, duvet, soft toys, sofa, cushion and carpet.
If one sweats during sleep, the sweat will carry the dead skin deeper into the mattress and pillows and these become ideal habitats for dust mites to proliferate.
Regular vacuuming as well as steam or hot wash will help to reduce its population. Placing the mattresses in the sun is also an effective method.
The old granny method of giving the mattress a good beating in the hot sun is actually good. Unfortunately, mattresses these days are too heavy for such a task! One should consider an anti-dust mite cover for beddings.
Medical treatment in the form of eye drops and oral medications are useful in controlling the symptoms. If we can’t remove the allergen, then we need to modulate our bodies’ reaction to it.
There are medications that, when taken over long periods, can dull the tissue reaction to the allergens.
It is important to resist the temptation to rub your eyes when you experience itchiness as this actually stimulates the production of more histamine from cells on the undersurface of the eyelid.
This will lead to more itchiness and cause a vicious cycle of events. Histamines are less active in cold temperatures so flushing the eyes with cold, preservative free eye drops will reduce the redness and itchiness. It will also wash out the allergen and dilute the histamine circulation.
Anti-histamines are available in the form of eye drops as well as oral medication and it usually gives quick relief.
Steroid eye drops is sometimes prescribed in acute cases and is generally effective but it should be used strictly under the supervision of an eye doctor. Unsupervised self-medication may result in permanent damage to the eye.
Contact lens users who experience allergic symptoms should first consult an eye specialist and avoid wearing contact lens until all symptoms are resolved. Daily disposable contact lens is usually recommended when restarting usage of contact lens.
Allergic conditions in the eye are seldom blinding but severe or neglected cases may have long-term consequences. So it is important to recognise and treat the condition early and adequately.
The author is consultant ophthalmologist at Prince Court Medical Centre