allergic conjunctivitis

Allergic Conjunctivitis : Causes, Symptoms, Treatment and Prevention

Allergic Conjunctivitis: Pink Eye

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People have allergic conjunctivitis when eyes come into contact with an allergen. This is a substance that makes the immune system of the body overreact. Eyes become sore, painful and inflamed. Symptoms take place because histamine is released along with other active substances by mast cells as the immune system overreacts. This leads to dilation of blood vessels which causes blood vessels to expand and widen. This irritates the nerve endings and increases secretion of tears. Allergic conjunctivitis is different from infective versions of this disease.

Causes and Types/Picture

Causes of Allergic Conjunctivitis

Following allergens are associated with allergic conjunctivitis:

  • Pollen (hay fever)
  • Animal fur
  • Eye drops
  • Makeup
  • Dust mites

Types of Allergic Pink Eye- Picture

There are various types of allergic conjunctivitis:

Seasonal Allergic Conjunctivitis

This is also called allergic rhinoconjunctivitis. This is a pollen causing seasonal allergy. It is a common cause of allergic conjunctivitis. Pollen-induced conjunctivitis is more common in colder countries as against tropical nations.

Pollen conjunctivitis is associated with symptoms of hay fever and sneezing, blocked/runny nose, itching in the nose and watery eyes. Hay fever is when conjunctivitis is accompanied by sneezing and blocked nose along with other symptoms

This is the kind of seasonal allergic conjunctivitis/allergic rhinoconjunctivitis which exclusively occurs during spring and summer months when plants are pollinating. Some people even have symptoms during early fall.

Contact Conjunctivitis

Contact dermato-conjunctivitis is its other name. This is caused by cosmetics, eye drop or chemicals which irritate the conjunctiva of sensitive people causing an allergic response. Sensitivity to certain substances causes this disorder. Symptoms usually develop 2-4 days after the substance comes into the eye.

Giant Papillary Conjunctivitis

This is associated with contact lenses. When people with sensitivity put on contact lenses, they experience discomfort which can get worse as the eye becomes red. Giant papillary conjunctivitis may also occur after eye surgery when patients use hard contact lenses. It could be that poor hygiene while handling contact lenses.

Perennial Conjunctivitis

Perennial Conjunctivitis
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This is all year around conjunctivitis and it persists throughout the year. This is caused due to an allergy to house dust mites. What are these? Dust mites are microscopic insect-like creatures living in bedding, furniture and carpets of houses. They want skin cells shed by people and thrive in warm and humid conditions.

Dust mite allergy is an immune system response to specific dust mite protein which causes other problems than conjunctivitis such as asthma. Other reasons for getting this type of conjunctivitis may be exposure to animal dander. These are small scales from animal skins or hairs or bird feathers causing allergies in people.


Many people with this type of conjunctivitis have problems with both eyes. Symptoms appear after the eye comes into contact with the allergen. Symptoms take within two to four days to appear.

Common Signs

Following symptoms are common across patients suffering from allergic conjunctivitis:

  • Red eye
  • Pink eye
  • Eyes become irritates as small blood vessels in conjunctiva widen
  • Pain is there in one or both eyes
  • Photophobia or sensitivity to light
  • Affected vision
  • Itchiness as eyes become irritated
  • Swollen eyelids
  • Soreness
  • While those with seasonal allergic pink eye get symptoms only during certain months of the year, those with perennial conjunctivitis may find certain times of the day are worse than others. and symptoms last throughout the year.

Symptoms accompany sneezing, sniffles or stuffy nose with nasal allergy. Eye allergy symptoms include burning sensation and clear, water discharge.

Eye Allergy Triggers

Outside allergens: like pollens

Indoor allergens: Pet dander, dust mites and mould

Irritants: Cigarette smoke, perfume, diesel exhaust

Outdoor allergens, such as pollens from grass, trees and weeds
Indoor allergens, such as pet dander, dust mites and mould
Irritants, such as cigarette smoke, perfume and diesel exhaust

Symptoms of Different Allergic Conjunctivitis

Primary types of eye allergy include seasonal or perennial allergic conjunctivitis, contact allergic conjunctivitis and giant papillary conjunctivitis . Other types clue vernal keratoconjunctivitis and atopic keratoconjunctivitis.

Seasonal allergic conjunctivitis patients may also have chronic dark circles called allergic shiners under their eyes. Other symptoms of seasonal allergy include puffy eyelids, runny nose, hay fever, while the perennial allergy has milder symptoms which last throughout the year. Symptoms of vernal keratoconjunctivitis include:

  • Itching
  • Significant tearing and production of thick mucus
  • Aversion to light or photophobia
  • A sensation of a foreign object in the eye/foreign body sensation.

If left untreated, this disease which occurs year round with symptoms worsening seasonally occurring mostly in boys and young men can impair vision.

Atopic keratoconjunctivitis affects elderly people- especially men with allergic dermatitis. It occurs year-round and has similar symptoms as vernal keratoconjunctivitis. If left untreated, it scars the cornea and its delicate membrane. Contact allergic conjunctivitis caused by contact lenses or proteins from tears binding to the surface of the lens include mucous discharge, lens discomfort, itching and redness. A more severe form of contact allergic conjunctivitis, giant papillary conjunctivitis is where individual fluid sales/papules form in the upper lining of the inner eyelid.

Symptoms include itchiness, puffiness, tearing, mucous discharge, blurring of vision, sensitivity to contact lenses and foreign body sensation.

Management, Treatment and Prevention

Management and Treating Allergic Conjunctivitis

The first step is generally to avoid allergens triggering symptoms. Outdoor exposure can be detrimental.

Outdoor Allergens

Treatment involves staying indoors when pollen counts are high. Window fans should be avoided and glasses/sunglasses need to be worn when pollen count is at its peak. Keep from rubbing your eyes as this can make things worse.

Indoor Allergens

  • Keep windows closed
  • Use mite proof covers and mattresses
  • Wash bedding frequently using hot water at least 130 degrees F
  • Limit exposure to mould by keeping the humidity in the home low
  • Use a dehumidifier
  • Clean floors with mop or damp rag
  • Wash hands after petting animals
  • Close air ducts to your room


OTC Eyedrops and Oral Medications

OTC Eyedrops and Oral Medications
Photo By: Steve Jurvetson/CC BY

OTC eyedrops and oral medications can provide short-term relief, but the safest and best option is to choose prescription eyedrops and oral medications. Prescription drops provide short and long term relief of eye allergy and treatment can also use artificial tears, antihistamines and cell stabilisers.

What are artificial tears? These are tear substitutes which can wash allergens and moisten the eye and prevent drones. Drops can provide additional soothing and comfort by being cooled in the fridge.

Decongestants are another good bet. These reduce redness of the eye associated with eye allergies by narrowing blood vessels in the eye. Anti-histamines can be used in conjunction. But bear in mind that prolonged use of eye drops can cause rebound leading to increased swelling and redness. Therefore, do not self-medicate. Rely instead on a good eye doctor.

Oral antihistamines can reduce itchiness, redness and swelling. These provide quick relief and can normally be used up to 4 times each day.

Mast cell stabiliser eyedrops can also prevent the release of histamine that causes allergy.

Nonsteroidal anti-inflammatory drugs can relieve itching. Stinging and burning sensation on use is common, but these drops can be used 4 times in a day

Corticosteroid eyedrops: These treat chronic eye allergy and must be used under the supervision of an ophthalmologist

Non-sedating oral antihistamines and allergy shots or immunotherapy also work wonders. While the latter increases immunity to substance or allergen, the former lowers histamine levels.


  • Don’t wear contact lenses till disease leaves
  • Bathe the eyes
  • Do not rub eyes
  • Avoid allergen

Common classes of drugs meant to maintain good eye health and prevent allergies include:

  • Ocular topical decongestants
  • Ocular topical antihistamines
  • Ocular topical lubricants
  • Ocular topical steroids
  • Ocular topical mast cell stabilisers
  • Immunotherapy

Prevention can also be tried through the use of allergy medicines. Never share items like towels and cover your mouth while coughing or sneezing. Don’t share contact lenses with friends and wash hands frequently- use a hand sanitizer if you must. Clean surfaces like desks and countertops and be aware of pollen count in the season if you are allergic.

Follow eye doctor’s instructions for lens care and replacement and when swimming, wear goggles to protect the eye. Don’t share eye makeup and make sure you use fresh pillow cases.


In totality, allergic conjunctivitis has the potential to turn into serious eye impairment. So make sure to tackle this problem at the early stages and save yourself the cost, prolonged time and effort of long-term treatment for chronic conditions.

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