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The list of nonallergenic ocular irritants is long and includes chemical fumes (from paints, carpeting, plastics and perfumes), aerosolized sprays (from cleaning products, hair care products and perfumes) and smoke (from candles, fireplaces, cigarettes and factories). Other irritants include smog, high ozone levels and other pollution; dust (even without allergy); chlorine in swimming pools; ocean salt water; construction debris; and even perspiration, the experts noted.
Although some of the symptoms may resemble those of allergies, sensitivity to these irritants does not represent a true allergic reaction involving IgE and the release of histamine or other chemicals. These nonallergenic irritants can, however, add to the effect of pollens or other allergens, exacerbating the condition, Dr. Raizman noted.
“It is pretty easy to differentiate irritant conjunctivitis from allergic conjunctivitis,” Dr. Friedlaender said, noting that allergic conjunctivitis causes itching, redness and swelling during the allergy season, and nasal symptoms usually are present as well. In contrast, irritant conjunctivitis is not seasonal, lacks itching, has little swelling and does not respond to antihistamines, he said.
The key to avoiding irritant conjunctivitis is to identify the irritant and stay away from it or protect against it with goggles, Dr. Friedlaender said. But this may be easier said than done. “Nonspecific irritants may be hard to pinpoint unless the patients notice that certain environments do precipitate eye irritation,” Dr. Raizman said. Dr. Cohen suggested, “Ask patients to consider the time of day and activities when they notice maximum irritation—and to avoid the environment where they are exposed to the irritant.”
A Pound of Cure
If patients would take preventive measures, dependency on allergy drugs would be greatly reduced, Dr. Raizman pointed out. However, allergen avoidance is not always easy or possible.
Treatment for both allergic and nonallergenic irritants starts with cold compresses, ice packs and preservative-free artificial tears kept in the refrigerator, the experts agreed.
Although some of the symptoms may resemble those of allergies, sensitivity to these irritants does not represent a true allergic reaction involving IgE and the release of histamine or other chemicals. These nonallergenic irritants can, however, add to the effect of pollens or other allergens, exacerbating the condition, Dr. Raizman noted.
“It is pretty easy to differentiate irritant conjunctivitis from allergic conjunctivitis,” Dr. Friedlaender said, noting that allergic conjunctivitis causes itching, redness and swelling during the allergy season, and nasal symptoms usually are present as well. In contrast, irritant conjunctivitis is not seasonal, lacks itching, has little swelling and does not respond to antihistamines, he said.
The key to avoiding irritant conjunctivitis is to identify the irritant and stay away from it or protect against it with goggles, Dr. Friedlaender said. But this may be easier said than done. “Nonspecific irritants may be hard to pinpoint unless the patients notice that certain environments do precipitate eye irritation,” Dr. Raizman said. Dr. Cohen suggested, “Ask patients to consider the time of day and activities when they notice maximum irritation—and to avoid the environment where they are exposed to the irritant.”
A Pound of Cure
If patients would take preventive measures, dependency on allergy drugs would be greatly reduced, Dr. Raizman pointed out. However, allergen avoidance is not always easy or possible.
Treatment for both allergic and nonallergenic irritants starts with cold compresses, ice packs and preservative-free artificial tears kept in the refrigerator, the experts agreed.