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Should Your Child See a Doctor?

Eye Allergy

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Definition

  • An allergic reaction of the eyes
  • The eyes are itchy and watery

Symptoms 

  • Itchy eyes with frequent rubbing
  • Increased tearing (watery eyes)
  • Red or pink eyes
  • Mild swelling of the eyelids
  • No discharge or a minimal sticky, stringy, mucus discharge
  • No pain or fever

Causes 

  • Pollens - grass, trees, weeds, molds. Pollens travel in the air.
  • Pets - cats, dogs, rabbits, horses. Animal allergens may be transferred to the eyes by the hands, but can also be airborne.

When to Call Your Doctor for Eye - Allergy

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • You think your child needs to be seen
  • Sacs of clear fluid (blisters) on whites of eyes or inner lids
  • Eyelids are swollen shut (or almost)
  • Discharge on eyelids that's not cleared after taking allergy medicines for 2 days
 

Call Your Doctor During Weekday Office Hours If

  • You have other questions or concerns
  • Eyes are very itchy after taking allergy medicines for 2 days
  • Diagnosis of eye allergies never confirmed by your doctor
 

Parent Care at Home If

  • Mild eye allergy and you don't think your child needs to be seen
 

Home Advice for Eye Allergy

  1. Wash Allergens Off the Face:
    • Use a wet washcloth to clean off the eyelids and surrounding face.
    • Rinse the eyes with a small amount of warm water (tears will do the rest).
    • Then apply a cold wet washcloth to the itchy eye.
    • Wash the hair every night because it collects lots of pollen.
     
  2. Oral Antihistamines:
    • If the nose is also itchy and runny, your child probably has hay fever (i.e., allergic symptoms of the nose AND eyes).
    • Give your child an oral antihistamine, which should relieve the nose and the eye symptoms.
    • Oral antihistamines usually control the eye symptoms and avoid the need for eyedrops.
    • Benadryl or chlorpheniramine (CTM) products are very effective (no prescription needed). They need to be given every 6 to 8 hours (see dosage table). The bedtime dosage is especially important for healing the lining of the nose.
    • Continue oral antihistamines every day until pollen season is over (usually 2 months for each pollen).
     
  3. New Antihistamine Eyedrops (Ketotifen) for Pollen Allergies — First Choice:
    • Usually an oral antihistamine will adequately control the allergic symptoms of the eye.
    • If the eyes remain itchy and poorly controlled, buy some Ketotifen eyedrops (no prescription needed).
    • Dosage: 1 drop every 12 hours
    • Ask your pharmacist to recommend a brand (e.g. Zaditor or Alaway)
    • For severe allergies, the continuous use of ketotifen eye drops on a daily basis during pollen season will give the best control.
     
  4. Older Antihistamine/Vasoconstrictor Eye Drops — Second Choice:
    • Usually the eyes will feel much better after the allergic substance is washed out and cold compresses are applied.
    • If not, this type of eyedrop can be used for intermittent eye allergy symptoms (no prescription needed).
    • Ask your pharmacist to recommend a brand. Examples are Naphcon A, Opcon A or Visine A.
    • Avoid vasoconstrictor eyedrops without an antihistamine (without an A in the name). Reason: they only treat the redness, not the cause.
    • Dosage: 1 drop every 8 hours as necessary.
    • Avoid continuous use for over 5 days. (Reason: rebound red eyes)
    • Disadvantage: less effective than Ketotifen eye drops.
     
  5. Contacts: Some children with contact lenses may need to switch to glasses temporarily (Reason: to permit faster healing).
  6. Expected Course: If the allergic substance can be identified and avoided (e.g., a cat), the symptoms will not recur. Most eye allergies continue through the pollen season (4 to 8 weeks).
  7. Call Your Doctor If:
    • Itchy eyes aren't controlled in 2 days with continuous allergy treatment
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. Meltzer EO. Treatment options for the child with allergic rhinitis. Clin Pediatr. 1998; 37:1-10.
  2. Nash DR. Allergic rhinitis. Pediatr Ann. 1998;27:799-808.
  3. Solomon WR. Nasal allergy: More than sneezing and a runny nose. Contemp Pediatr. 1999;16(8):115-137.
  4. Spector SL, Raizman MB. Conjunctivitis medicamentosa. J Allergy Clin Immunol. 1994;94(1):134-6.

Disclaimer

This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/14/2010 1:24:10 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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