Eye Allergy Overview

Leonard Bielory | 24 February, 2021

            Eye Allergy Overview

Also called allergic conjunctivitis or ocular allergy, eye allergy occurs when something you are allergic to irritates the conjunctiva. This is the delicate membrane covering the eye and the inside of the eyelid.

Like all allergies, allergic conjunctivitis starts when the immune system identifies an otherwise harmless substance as an allergen. This causes your immune system to overreact and produce antibodies called immunoglobulin (ige). These antibodies travel to cells that release chemicals which cause an allergic reaction. In this case, allergic reactions include eyes that water, itch, hurt or become red or swollen.

The most common causes of allergic conjunctivitis are seasonal allergens such as pollen and mold spores. People with seasonal allergic rhinitis (hay fever) normally notice their symptoms worsen when they go outdoors on days with high pollen counts.

Indoor allergens such as dust mites and pet dander can also cause eye allergies year-round. If you suffer from this type of allergy, you may notice your symptoms worsen during certain activities such as cleaning your house or grooming a pet.

Eye allergy symptoms can be very annoying. Yet they pose little threat to eyesight other than temporary blurriness. Unlike conditions such as pink eye, allergic conjunctivitis is not contagious.

However, red, itchy, burning and puffy eyes can be caused also by infections and other conditions that can threaten eyesight.

If your symptoms are related to an eye allergy, chances are you will have problems in both eyes.

Typical symptoms include:
•    watery eyes
•    itchiness
•    sensitivity to light
•    redness
•    grittiness
•    eyelid swelling

These symptoms can occur alone or along with allergic rhinitis nasal symptoms. They typically appear shortly after exposure to the allergen.

Symptoms resulting from seasonal outdoor allergens tend to be worse than if your symptoms are due to indoor allergens such as dust mites or pet dander.

Symptoms may be reduced if you are taking allergy medications such as antihistamines, which suppress the allergic reaction.

The first step toward relief from annoying eye allergy symptoms is a proper diagnosis.

Eye allergy treatment & management

If indoor allergens are causing your eye allergy symptoms, avoidance is the key to relief. Use a vacuum with a hepa filter to reduce dust in your home or try keeping pets out of the bedroom to reduce exposure to their dander.

If pollen and other seasonal allergens are causing your misery, here are a few helpful suggestions:

  • Wear a hat with a wide brim to reduce the amount of allergen that blows into the eyes.
  • Sunglasses can also help reduce the amount of allergen that lands in the eyes.
  • Apply saline eye drops to the eyes after being outdoors to wash away allergens from the ocular lining.

Over-the-counter antihistamine pills and eye drops are often used for short-term treatment of eye allergy symptoms. However, prolonged use of some eye drops may actually make your symptoms worse as they may exacerbate patients having dry eyes along with their ocular allergies.

Your doctor may prescribe stronger medications if your symptoms are long-lasting.

Corticosteroid eye drops are effective, but they often have side effects, even when used only for a short time. Use of this medication should be managed by an ophthalmologist due to the risk of side effects, such as glaucoma (increased ocular pressure), cataracts and infection.

Depending on what is causing your eye allergy symptoms, immunotherapy (allergy shots) can be very effective in providing long-term resistance to the triggering allergens.




Bielory, L. (2000). Allergic And Immunologic Disorders Of The Eye. Part Ii: Ocular Allergy. J Allergy Clin Immunol, 106(6), 1019-1032. DOI:10.1067/MAI.2000.111238

Bielory, L. (2002a). Ocular Allergy Guidelines: A Practical Treatment Algorithm. Drugs, 62(11), 1611-1634. HTTP://WWW.NCBI.NLM.NIH.GOV/PUBMED/12109924

Bielory, L. (2002b). Update On Ocular Allergy Treatment. Expert Opin Pharmacother, 3(5), 541-553. DOI:10.1517/14656566.3.5.541

Bielory, L. (2007). Differential Diagnoses Of Conjunctivitis For Clinical Allergist-Immunologists. Ann Allergy Asthma Immunol, 98(2), 105-114; QUIZ 114-107, 152. DOI:10.1016/S1081-1206(10)60681-3

Bielory, L. (2008). Ocular Allergy Overview. Immunol Allergy Clin North Am, 28(1), 1-23, V. DOI:10.1016/J.IAC.2007.12.011

Bielory, L. (2010). Allergic Conjunctivitis And The Impact Of Allergic Rhinitis. Curr Allergy Asthma Rep, 10(2), 122-134. DOI:10.1007/S11882-010-0087-1

Bielory, L. (2020). Allergic Inflammation Of The Anterior Surface Of The Eye. Allergy Asthma Proc, 41(6), 449-453. DOI:10.2500/AAP.2020.41.200068

Bielory, L., Delgado, L., Katelaris, C. H., Leonardi, A., Rosario, N., & Vichyanoud, P. (2020). ICON: Diagnosis And Management Of Allergic Conjunctivitis. Ann Allergy Asthma Immunol, 124(2), 118-134. DOI:10.1016/J.ANAI.2019.11.014

Bielory, L., & Friedlaender, M. H. (2008). Allergic Conjunctivitis. Immunol Allergy Clin North Am, 28(1), 43-58, VI. DOI:10.1016/J.IAC.2007.12.005

Bielory, L., Katelaris, C. H., Lightman, S., & Naclerio, R. M. (2007). Treating The Ocular Component Of Allergic Rhinoconjunctivitis And Related Eye Disorders. Medgenmed, 9(3), 35.HTTPS://WWW.NCBI.NLM.NIH.GOV/PUBMED/18092041

Bielory, L., Lien, K. W., & Bigelsen, S. (2005). Efficacy And Tolerability Of Newer Antihistamines In The Treatment Of Allergic Conjunctivitis. Drugs, 65(2), 215-228. HTTP://WWW.NCBI.NLM.NIH.GOV/PUBMED/15631542

Bielory, L., Meltzer, E. O., Nichols, K. K., Melton, R., Thomas, R. K., & Bartlett, J. D. (2013). An Algorithm For The Management Of Allergic Conjunctivitis. Allergy Asthma Proc, 34(5), 408-420. DOI:10.2500/AAP.2013.34.3695

Bielory, L., & Mongia, A. (2002). Current Opinion of Immunotherapy for Ocular Allergy. Curr Opin Allergy Clin Immunol, 2(5), 447-452. HTTP://WWW.NCBI.NLM.NIH.GOV/PUBMED/12582330

Bielory, L., & Schoenberg, D. (2019). Emerging Therapeutics for Ocular Surface Disease. Curr Allergy Asthma Rep, 19(3), 16. DOI:10.1007/S11882-019-0844-8

Bielory, L., & Schoenberg, D. (2019). Ocular Allergy: Update On Clinical Trials. Curr Opin Allergy Clin Immunol, Publish Ahead Of Print. DOI:10.1097/ACI.0000000000000564

Elieh Ali Komi, D., Rambasek, T., & Bielory, L. (2018). Clinical Implications of Mast Cell Involvement in Allergic Conjunctivitis. Allergy, 73(3), 528-539. DOI:10.1111/ALL.13334

Groneberg, D. A., Bielory, L., Fischer, A., Bonini, S., & Wahn, U. (2003). Animal Models of Allergic And Inflammatory Conjunctivitis. ALLERGY, 58(11), 1101-1113. HTTP://WWW.NCBI.NLM.NIH.GOV/PUBMED/14616119


Nye, M., Rudner, S., & Bielory, L. (2013). Emerging Therapies In Allergic Conjunctivitis And Dry Eye Syndrome. Expert Opin Pharmacother, 14(11), 1449-1465. DOI:10.1517/14656566.2013.802773

Rosario, N., & Bielory, L. (2011). Epidemiology Of Allergic Conjunctivitis. Curr Opin Allergy Clin Immunol, 11(5), 471-476. DOI:10.1097/ACI.0B013E32834A9676