Allergic conjunctivitis is inflammation of the white part of your eye and the inside lining of your eyelids due to allergies.
On this page, you can find the following information:
- What are the symptoms of allergic conjunctivitis?
- What can I do if I have allergic conjunctivitis?
- How is allergic conjunctivitis diagnosed?
- What are the cases of allergic conjunctivitis?
- How can I prevent allergic conjunctivitis?
Key points about allergic conjunctivitis
- Conjunctivitis caused by allergies can be seasonal, occurring at certain times of the year (when due to pollen or grasses) or ongoing (when caused by dust mite or pets).
- Unlike bacterial or viral conjunctivitis, allergic conjunctivitis can't be spread from person to person.
- Allergic conjunctivitis usually affects both eyes.
- Symptoms can include red, itchy, watery, gritty eyes, puffy eyelids and a sore or burning sensation in your eyes.
- Treatment includes avoiding allergens and taking medicines to relieve your symptoms.
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Allergic conjunctivitis usually affects both eyes. Symptoms can include:
- itchy, watery eyes
- puffy eyelids and swelling of your eyelids
- the white of your eyes looking red or pink
- sore or burning, gritty, irritated eyes
- other allergic symptoms such as the suddenly getting a blocked or runny nose
- in severe cases, your conjunctiva (the tissue that covers the surface of your eyeball) may swell, which is known as chemosis.
Your vision isn't usually affected by allergic conjunctivitis. However, if you are constantly exposed to an allergen and have long-term allergic conjunctivitis, your vision may become reduced. You may also develop large red bumps in the inner lining of your upper eyelid, known as papillae, and your cornea may be damaged by long-term inflammation.
There are several things you can do to improve your symptoms, including:
- not rubbing your eyes
- washing your eyes with cold water
- using cold packs or cold compresses on your eyes to soothe symptoms
- not wearing contact lens until your symptoms have cleared up
- using eye drops
- consider taking antihistamines if you have hay fever.
Identify and remove the cause
If you have worked out what allergen or irritant is causing your symptoms, you need to minimise your risk of exposure to it, and where possible, remove it. For example, removing carpet, using barrier encasing of your pillows and mattress, or washing bedding in hot water to remove house dust mites. Read more about how to prevent allergic reactions?
Bathe your eyes with cold water, or apply cold-water compress
Mild symptoms can be managed with bathing your eyes with cold water, or applying cold-water compress to the eye. The cold restricts circulation and will help calm down the inflammation that is associated with eye allergies.
- You can make a cold compress by dipping a flannel (face towel) in cold water, gently squeezing out some of the water and applying the cool flannel over your eyes. Repeatedly re-soak the towel to keep it cool or cold, until you get relief (10 to 20 minutes).
- If you apply a homemade compress using as a bag of ice, wrap the ice in a small towel or cloth. Don’t apply ice directly to the skin. It can cause frostbite.
How to wash your eyes
- Before touching your eyes, wash your hands with soap and warm water.
- Dry hands with a clean or disposable towel.
- Clean away any crusting or discharge with a disposable cotton swab and cooled boiled water. Don't use cotton wool balls because they can unravel, leaving cotton in your eye. Surgical swabs from your chemist or disposable eye make-up removal pads are best.
Use eye drops
There's a range of different types of eye drops used for eye allergies such as antihistamines and mast cell stabilisers. Some offer immediate relief, while others take a few weeks to be effective. Read more about eye drops for eye allergies.
Antihistamine tablets or capsules
Antihistamine tablets or capsules are best used to relieve itching and allergy symptoms associated with the nose. While they can be mildly effective in relieving the itching associated with eye allergies, they may cause dry eyes and potentially worsen eye allergy symptoms. Read more about antihistamines.
See your doctor or go to the nearest emergency department immediately if you or someone you care for experiences any of the following symptoms:
Your doctor will ask you questions about your symptoms, including when you experience them and whether you have any allergies, asthma or eczema. Your doctor will also examine your eyes and check your vision. No tests are usually needed to diagnose allergic conjunctivitis. If you have chronic allergic conjunctivitis, your doctor may refer you for further eye tests to check your vision.
Allergic conjunctivitis can be caused by several things.
- Allergens in the air, such as pollen and moulds, are the most common cause of allergic conjunctivitis and are usually seasonal, eg, during the hay fever season of each year.
- Dust mites, animal dander and feathers usually cause ongoing allergic conjunctivitis when there is exposure to them.
- Direct eye contact with allergic triggers, such as cosmetics and preservatives in some eye drops and contact lens solutions, can cause allergic conjunctivitis when used.
The best thing to do to prevent allergic conjunctivitis is to prevent exposure to allergen.
- Don't rub or touch your eyes. If you touch anything you are allergic to and then touch your eyes, this can trigger allergic conjunctivitis.
- Wash your hands well before touching your eyes for any reason.
- Change to low allergy eye products if your symptoms seem to come on after using eye make-up. Discuss options with your pharmacist.
- Use your own flannel, towels, pillowcases and bed linen and change these regularly.
The following links provide further information about allergic conjunctivitis. Be aware that websites from other countries may have information that differs from New Zealand recommendations.
- Allergic conjunctivitis Auckland Regional HealthPathways, NZ, 2018
- Allergic conjunctivitis DermNet NZ, 2015
- Specific allergen immunotherapy (AIT) for environmental (inhaled) allergies Paediatric Society of NZ and NZ Child & Youth Clinical Network, NZ, 2020
- Allergic conjunctivitis Patient Info, UK
- Castillo M, Scott NW, Mustafa MZ, Mustafa MS, Azuara-Blanco A. Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis Cochrane Database of Systematic Reviews. 2015; 6: CD009566.
- Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S. Sublingual immunotherapy for treating allergic conjunctivitis Cochrane Database of Systematic Reviews. 2011; 7:CD007685.
Information for healthcare providers
Information for health professionals The Australasian Society of Clinical Immunology and Allergy
Specific allergen immunotherapy (AIT) for environmental (inhaled) allergies Paediatric Society of NZ and NZ Child and Youth Clinical Network, NZ, 2020
Red eye Eye Emergency Manual, Australia
Causes, complications and treatment of a red-eye BPAC, NZ, 2013
Eye infections Starship Clinical Guidelines, NZ, 2009
Eye infections OphthoBook
Anti-inflammatory and allergy eye drops NZ Formulary
Anti-infective eye preparations NZ Formulary
Castillo M, Scott NW, Mustafa MZ, Mustafa MS, Azuara-Blanco A. Topical antihistamines and mast cell stabilisers for treating seasonal and perennial allergic conjunctivitis Cochrane Database of Systematic Reviews 2015;6:CD009566.
Calderon MA, Penagos M, Sheikh A, Canonica GW, Durham S. Sublingual immunotherapy for treating allergic conjunctivitis Cochrane Database of Systematic Reviews 2011;7:CD007685.
Dr Divya Perumal works at the Eye Institute and Auckland Public Hospital. She has expertise in performing eye surgery, including advanced glaucoma surgery and cataract surgery. She is a senior lecturer at the University of Auckland and is actively involved in teaching junior doctors and research, as well as conducting public lectures.