dry eyes caused by allergies?

[Trac]

I have a friend who constantly tells me that my dry eyes are caused by nothing more than allergies. I don't think that could be true. I have had dry eyes for 2 1/2 years now and they are not seasonal. The amount of pain and dryness is not seasonal. If it is related to allergies how long after exposure to the allergen should I expect it to affect my eyes?

[doc k]

It's possible, but what evidence does your friend have that you have allergies? Do you have sinusitis? Any history of allergies? Sounds unlikely in your case.

However, a practical way to tell is to try an antihistamine/mast-cell stabilizer drop for about a week, and see how you respond. Ketotifen (Alaway, Zaditor) is a good 12-hour drop that's OTC. Try 2 drops daily for one week as a therapeutic trial. Should cost you about $12.00.

[Trac]

My friend has no reason to make this statement. I think he is just trying to help out.

The drops would be worth a try if they told me if I had allergies or not. I occasionally use Pataday, but not very often, only when nothing seems to work and my eyes feel very gritty. My doctor says I should not use antihistamines because they will further dry out my eyes.

[doc k]

Right. Pataday (oleopatadine) is a very effective antihistamine/MCS drop, and is probably better than ketotifen. You get 24 hours of effect with it, of course.

If you've tried it for about a week (random number, there: long enough to have the drop take effect, long enough for the tissue to begin to heal, and long enough to average out some of the non-controlled variables of your environment...on second thought, maybe two weeks is better) and no improvement occurs, then I'd rule out chronic allergies (although acute allergies may not be ruled out, but you'd notice them, I'd say).

As to avoidance of antihistamines, I think the advice meant ORAL antihistamines, not topical.

[magoo]

Do your eyes itch? That's a sign of allergy for sure. Does the Pataday give you relief when you do use it? (If you're like me, by the time you use it your eyes are so miserable you can't really tell)
An ophthalmologist told me he could tell if allergy was a component of the problem by looking at the inner eyelid. The allergic eyelid will have bumps, that look kind of like pillows, on the inside.

Here's a photo of that: http://www.treatmentforpinkeye.org/w...unctivitis.jpg
(although in the link it mentions pinkeye, this is a photo of 'allergic pink eye' not the contagious type)

[doc k]

Magoo, I think the appearance of a papillary reaction on the palpebral conjunctiva is reasonably specific to allergic conjunctivitis, but it is not sensitive enough of an indicator. It is not a sine qua non.

In other words, if you have it, then it is likely to be allergic, but if you don't, then you may still have allergic eye issues.

http://www.springer.com/cda/content/...907-p173848471

This link makes a case for a chronic allergic reaction that is mediated by a different inflammatory pathway than acute allergic conjunctivitis.

[magoo]

Thank you Doc K, I have wondered just how accurate that information was from that ophthalmologist. I have long suspected an allergic component to my eye problems but he assured me that was not the case. I will ask my NEW doctor about it.

[Trac]

Thanks both of you. I only use Pataday about once a week. I use about 12-18 times a day. None of these are artificial tears which I was putting in nonstop on some days. I use serum tears 8xday, mucomyst 4xday, restasis 4xday and muro drops. Sometimes I am concerned that I am over treating my eyes, but the only thing I use that is preservative free is the muro drops and then the FML and muro ointment I use at night. IMy eyes are real sensitive to odors.

[doc k]

I'm not trying to contradict your physician, though. It's just that it's easy and safe to do a therapeutic trial, and probably worthwhile.

[doc k]

In the link immediately above, on the last page it says that cyclosporine (Restasis) is effective as an anti-allergy therapy, so you may not need to add anything else to cover the putative allergic etiology, Trac.

[doc k]

Whoops

Trac, I didn't realize that you were the original poster. Now I'm giving contradictory messages!

Let me summarize:
If indeed your friend is right and you have an allergic component (unlikely), your cyclosporine therapy should theoretically be "covering that base".

A therapeutic trial of an antihistamine/MCS like oleopatadine or ketotifen is less likely to be successful.

Sorry for the medical history confusion.

[magoo]

Thanks again from me too, doc k. I am also using Restasis, so that information is very valuable for me. (Sorry Trac for kind of hijacking your thread)

And doc, no problem, that ophthalmologist is long in my past ;o)

[Mewkiss]

Hi Trac, I just wanted to add my two cents about your friend.

Having been sick for many years, I find that when people feel helpless or just don't know what to say or how to help they make suggestions. Whether or not they are valid is another story.

So all you can do is say thank you and look into it to satisfy yourself that either you do have allergies or do not.

Sometimes it can just be maddening when people just don't have a clue how horrible we feel.

Mew

[Trac]

I think that is exactly what it was. My friend felt so bad for me, my eyes were swollen and red. The worse part is he suggested a bunch of OTC allergy drops that my doctor later said were making things worse because they were drying everything up.
Before I started wearing the moisture goggles everyone would ask me if I had bad allergies, it got to the point where I would just agree with them and add that I have dry eyes too. It really irrigates me when people tell me that they have dry eyes too. I feel like saying, yes I can tell that is why you have all 4 tear ducts plugged, and put in eye drops every 15 minutes and still look like a drug user.
Sorry, it must be time for another shot of serum drops.

[Trac]

Doc K

I don't think allergies have a major role to play in my dry eyes. I sure wish someone could figure out what was causing this so I could get it fixed. I do notice that some times I feel worse after eating certain types of sweets, or my diet just isn't very good, and some flowers really bother my eyes. When the flowers start to decompose, they still look fresh enough, but they start to give off an odor and that bothers my eyes. So do fresh marigolds and poppies. We have tomatoes in our backyard and the yellow powder and juices from the tomato plants really bothers my eyes. Some perfumes, colognes and hand sanitizers also chemicals from labs I do in my classroom (I am a high school science teacher) all of these and more cause swelling and burning and foreign body sensation in my eyes.

It seems like my sense of smell is much more acute than it use to be and more acute than most people I am around. It seems like I can smell things and they burn my eyes. Does this sound crazy to anyone but me? Some days it is worse than others. I don't have a clue why