Eye Allergies in Children
It is estimated that allergies (and asthma) may affect up to 25% of the population. While allergies can be manifest at any time of the year, spring and early summer are the seasons during which symptoms are most often experienced. Symptoms include coughing, sneezing, runny nose, scratchy throat or, more severely, rashes, hives and difficulty breathing. The delicate tissues of the eye frequently are the first to be affected by allergies, quickly becoming red and itchy, with watery discharge. In some cases, eye irritation is the only symptom of allergy.
Many children are affected by chronic allergies, which may become severe enough to affect their daily activities. However children cannot always recognize what is wrong or explain their discomfort to family members or caregivers. The observation of specific behaviours and/or eye signs is useful in identifying eye allergies in children.
Children often rub their eyes, blink forcefully and repeatedly, or make rolling eye movements in response to the itchy sensation caused by allergies. They may complain that their eyes hurt, or that they can’t see well. Their eyes may appear red and watery, similar to pink eye. Mild swelling of the eyelids and a darkened discoloration of the skin under the eye also may occur.
It is important to differentiate eye allergies from other forms of pink eye and eye inflammation. Severe eyelid swelling (causing the eye to remain closed) and/or a yellow or green discharge may signal a potentially serious eye infection and warrants more urgent attention.
It may be difficult to identify the cause of the allergy. As allergies tend to run in families, children are more likely to suffer allergy symptoms if they have a parent with allergies or asthma. Exposure to certain allergens can trigger a reaction in susceptible individuals. These allergens commonly include tree, grass and weed pollen; mold spores; dust mites; and cat, dog and rodent dander. Contact with plants (poison ivy, oak, sumac); certain foods (peanuts, milk); and insects also may trigger allergic reaction of the skin, including the eyelids. Allergies may be manifest at the first encounter with a specific trigger, or may develop after several exposures.
Minimizing or eliminating contact with the offending trigger, if it is known, is the most effective way to treat allergies. Make sure your child washes his/her hands and face frequently, and resists touching or rubbing the eyes. Wash bed linen in hot water, replace bed pillows and consider an air purifier, especially if symptoms persist indoors.
While oral allergy medications are effective in treating the systemic symptoms of allergies, relief from eye irritation is best achieved with specific eye treatments. A cold compress, held against the eyes for 5-10 minutes, will reduce itchiness. Non-prescription artificial tear eye drops also will provide relief, especially if they are stored in the refrigerator to keep them cold. Repeating these simple procedures two to three times per day is recommended.
Symptoms that persist despite these simple approaches warrant further evaluation by an optometrist. Professional examination of the eye with a bio-microscope provides a magnified view of eye tissues and structures, allowing identification of the signs of allergy and ruling out other causes of eye irritation such as bacterial or viral infections.
Once the eye allergy is confirmed, your optometrist can recommend and prescribe specific allergy eye medications depending on the child’s age and the severity of the eye irritation. Non-prescription decongestant and antihistamine eye drops can provide temporary relief from redness and itching in older children, but often cause a rebound reaction and worsening of symptoms if used longer than a few days. The use of these non-prescription allergy eye drops in children is not recommended unless professionally advised. Prescription allergy eye drops are more effective at reducing inflammation of eye tissues, and may be prescribed for more severe eye allergies, even in young children. An optometrist also can advise you when it is useful to see an allergist for formal allergy tests.
To find an optometrist in your community, contact the Ontario Association of Optometrist at www.eyeseeeyelearn.com or call 855-424-3735 .
Article by: Dr Catherine Chiarelli