Eye Allergies and Dry Eye
Listen to your patient’s primary complaint. Then, ask about their signs and symptoms commonly associated with the issue. Experienced ophthalmologists often have a difficult time differentiating between dry eyes, contact lens issues, allergies or a combination of these issues.
Because of the numerous problems that can affect the eyes, it can be difficult to determine the problem causing the issues. For example, a patient may be experiencing dry eyes, allergies and a deficiency caused by an autoimmune disorder.
Because of the multifaceted issues, determining the cause of the eye issue can be extremely difficult. For this reason, it may be best to look at the patient as a whole to help determine the causes of the eye issue. Additionally, having a patient who is willing to allow you to treat them systemically to help relieve their eye problems.
Where to Start
Dr. Solomon begins by offering simple homeopathic remedies. Then, as needed, he moves on to other medications. Dr. Solomon not only focuses on the patient’s chief complaint, he also gets a detailed medical history of the patient.
Then, he will take into account the time of year when the symptoms are the worst, where the patient works, any recent travel and the patient’s home. Finally, Dr. Solomon will look for any other comorbidities and want to know any medication that the patient is currently taking.
This information can help Dr. Solomon find the cause of inflammation and irritation on the surface of the eye. Dr. Solomon uses point of care test, a diagnostic tool. The Doctor’s Allergy Formula was acquired by Bausch and Lomb. This tool uses 60 specific allergens to help determine the cause of the eye irritation and inflammation. The test checks for seasonal allergens, indoor allergens and outdoor allergens.
Dr. Solomon is proactive. He encourages patients who suffer from allergies to make an appointment before spring and fall. These seasons are when allergens are at their peak. Patients should be screened for any hypersensitivities as they can exacerbate the patient’s condition.
The doctor often recommends this screening for patients suffering from aqueous dry eye and are being treated with Restasis or Allegan (cyclosporine ophthalmic emulsion 0.05 percent) or those who have a meibomian gland dysfunction (MGD).
Dr. Solomon believes those suffering from ocular surface diseases are more prone to season exacerbations. Patients and ophthalmologists can no longer assume that only one disease is causing the issues. It may be caused by a number of additional co-contributors, such as allergies, autoimmune disorders and the like.
During the exam, ophthalmologists should look for clues during the eye exam, such as head congestion, headaches accompanied by eye tearing and itchiness, runny nose and swelling of the eyelids. Additionally, ophthalmologists should look for a papillary response, conjunctival chemosis and hyperemia.
These symptoms are consistent with conjunctivitis caused by allergies, states Dr. Solomon. However, this condition is also combined with other symptoms. Patients may also experience symptoms due to contact lens wear. The cornea of the patient may be dry due to the wearing contact lens for extended periods of time.
Because of this, ophthalmologists must be willing to think outside the box when patients complain of eye irritation, inflammation and dry eyes. Oftentimes, the doctor must use interpretation to get to the root cause of the problem.
Because there are so many factors to consider when determining the underlying issues surrounding the patient’s symptoms, there are numerous things to consider. First, the ophthalmologist must understand that allergic reactions may be temporary; however, the symptoms may continue for quite some time.
For example, those with eye inflammation caused by MGD or posterior blepharitis may not have healthy lipid layers. This can make it difficult for the eye to naturally clear allergens from the eye.
Dr. Solomon states that a lid and lash cleanser containing a hypochlorous acid-based formula, such as NovaBay Pharmaceuticals or Avenova, may be required. This formula helps improve the quality of the patient’s tears, which can help remove debris from the ocular surface. Additionally, the formulas activate the oil glands along the lash line. This can help with the productions of the patient’s natural tears and improve the quality of the patient’s tears.
Artificial tears are a great choice for those suffering from ocular surface disorders; however, many formulas have a dilutional effect on the eyes. Therefore, a lubricant drop may be recommended. Dr. Solomon sends each of his patients home with a sample bottle of lubricant drops, regardless of the patient’s diagnosis. A patient who needs to use these lubricant drops more than twice daily may have an underlying disorder of the aqueous layer of the eye and may need to be treated with cyclosporine.
Combining two products that treat both the water and oil components of the patient’s tears can improve the ocular environment, making it more resistant to allergens that may trigger dry eye. Medications may be required to help relieve the symptoms of ocular allergies and dry eye.
Cold compresses can also help remove debris and allergens from the eyelids and eyelashes and help alleviate swelling. If debris accumulates in the eyes overnight, a warm washcloth can help safely remove the debris in the morning.
The patients should follow the doctor’s recommendations to help improve eye health while relieving dry eyes and allergies. Ophthalmologists should make their patient’s understand the importance of maintaining their eye health throughout the year. As the allergy seasons approach, patients should utilize a variety of tips to help minimize eye irritation caused by allergens.