Soothing relief for those itchy eyes due to allergies

Ask Dr. Louise

Q:When my allergies kick up, my eyes get red and itch like crazy. Visine® eye drops don’t really help me. Is there anything else I can try?

Years ago, I bought my “dream” car, a classic jet-black 1985 Jeep CJ7 hardtop. I could hardly wait to take it cruising the back roads, so we took the top off and spent the following Saturday afternoon driving through the gently rolling hills of central Ohio. Moist earth warmed by the day’s mid-August heat greeted us as we crested each hill, its rows of tall stalks of corn alternating with lush fields of bushy soybeans.

Saturday afternoon was magic, but Sunday morning was a nightmare as I woke up with a completely stuffed up nose and eyes that itched like fire.

I moaned to my husband, Charlie, “What could have set off my allergies? The only thing I’m allergic to is ragweed, and we drove past corn and soybeans.”

“I hate to tell you, honey, but we definitely drove past ragweed yesterday. I saw TONS of it growing thick in the ditches by the sides of the road.”

“Aaargh!”

Do you need to soothe the discomfort of itchy eyes from allergies gone wild? You’ll find several types of eye drops available without a prescription. How do you choose the best one?

Lubricating eye drops can ease burning and help relieve dryness. Systane®, GenTeal® or Refresh® help reduce the “sand in your eyes” feeling by flushing pesky pollens away, but can’t shut down your allergic reaction once it starts.

Decongestant eye drops help your eyes look less red or “bloodshot” by shrinking the blood vessels in the whites of your eyes. They can help reduce puffiness around your eyelids but don’t help reduce allergic reactions.

Naphazoline is the only decongestant eye drop available without a prescription. It’s sold both as Naphcon® and combined with an antihistamine as Visine-A® and Naphcon-A® (the “A” stands for antihistamine). Eye drops containing naphazoline can cause trigger dry eyes and aggravate certain types of glaucoma, threatening your vision. Because of this risk, naphazoline eye drops are only for short-term use; avoid using them for more than 3 days at a time, and if you have glaucoma you should avoid naphazoline entirely.

Antihistamine eye drops help reverse eye itching and swelling from allergies. Pheniramine maleate is an antihistamine available in both Visine-A® and Naphcon-A® eye drops, but they also contain the decongestant naphazoline, which limits their safe use to only 3 days at a time.

The most effective eye drops to use when allergies strike is ketotifen. Ketotifen works both by helping prevent an allergic reaction and by calming it down once it starts.

When you come in contact with something you are allergic to, it triggers a chain reaction leading to redness, swelling and itching. This reaction is triggered by a chemical called histamine. Your body stores histamine in special cells called mast cells, and when it recognizes pollen or cat dander as something you are allergic to, these mast cells open up and release histamine into your bloodstream, creating the misery of an allergic reaction.  

Medicines called mast cell stabilizers BLOCK this chain reaction from starting by keeping histamine safely locked up inside your mast cells. Ketotifen is a mast cell stabilizer. Using ketotifen eye drops, I could drive past ditches full of blooming ragweed without suffering the next day because it keeps histamine safely inside my mast cells.  

But ketotifen is not just a mast cell stabilizer, it works as an antihistamine, too, able to both prevent and relieve allergic reactions. Once sold as the prescription drug Zatidor®, ketotifen is sold both as a generic and Alaway® brand eye drops.

Here are 4 Tips on Using Eye Drops for Allergies:
1.Avoid naphazoline eye drops.
Decongestant eye drops don’t address the allergic reaction, and only reduce redness. Limit naphazoline eye drops use to three days at a time, and avoid it completely if you have glaucoma.

2.Ketotifen is the best non-prescription eye drop for allergies.
Ketotifen works both as an antihistamine and mast cell stabilizer. It is available as an inexpensive generic and very safe to use, even in children as young as 3 years old.

3.Use only one drop in each eye.
Any more than one drop at a time will just run out and be wasted. Wait a bit before giving yourself another dose.

4.Keep it clean.
Always wash your hands first and avoid touching the tip of the dropper directly to your eye or to any other surface.

Dr. Louise Achey, Doctor of Pharmacy is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Your questions and comments are always welcome at www.AskDrLouise.com. ®2019 Louise Achey
 

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