I’m a bit unusual, I’m told – I love winter! The clear frosty mornings, clean fresh air, beautiful snow-covered countryside. Well, all good things come to an end and, for me, it has been a great winter so I’m happy. The warmer weather and the blossom on the trees is when (normal) people cheer up a bit with spring underway.
However, every year, at around this time I see a steady stream of clients whose eyes are driving them nuts! First tree, then grass and plant pollens are released into the air. They are completely harmless to us but the unlucky 20% experience a reaction designed to protect the body from attack by harmful things like viruses or bacteria. Unfortunately, sometimes the body gets it a bit wrong!
This can affect the eyes alone or the symptoms can be more widespread. If just the eyes are affected then first we have to ensure it is an ocular allergy and not another cause. The key features are both eyes itching and watering; the conjunctiva (the transparent membrane that covers the white of the eye) may be swollen and it will be pink to some degree. The eyelids may be slightly puffy, too.
Conjunctivitis gives a foreign body sensation like you’ve got something in your eye along with a sticky discharge; the eye will appear redder and the lids may be stuck together on waking. A corneal ulcer is very painful. Blepharitis (inflammation of the eyelids) has inflamed lid margins and dandruff type deposits on the lashes. There are other conditions that I have to rule out but I need the expensive toys that I have littered around the practice to look for them.
If I am satisfied that the problem is an ocular allergy then my advice depends on the severity of the symptoms. First of all, try to avoid exposure to the airborne pollen by staying indoors if possible; wearing close fitting “wrap-around” type sunglasses; fit pollen filters in your car and use the recycle air feature of the car’s aircon. Do not rub the eyes – this encourages the inflammatory cells to break down and increase the irritation.
There are several types of eye drops available without prescription from a chemist. Probably the most common one is called a mast cell stabiliser. Opticrom is one of the most widely used brands but there are others. These work by stopping one of the inflammatory cells from reacting to the pollen. Unfortunately, it takes around a fortnight to build up its action so you need to start taking it before the hayfever season starts and keep taking it throughout the season.
If it’s a bit too late for that and your eyes are streaming already then the only over the counter drops which will help are Otrivine Antistin. These combine an anti-histamine with a vasoconstrictor so they reduce the swelling and block the inflammatory chemicals BUT they can only be used for seven days. Only the mast cell stabilisers can be used throughout the season.
If you need to use drops to calm the symptoms of ocular conjunctivitis, or anything else, for that matter, do follow the advice of the pharmacist and the instructions in the packaging – you don’t want to make an uncomfortable situation much worse.
That’s enough from me, I’m off to clean my skis and look forward to next December!