Finding relief from allergy-induced red eyes

If trees and plants are blooming, pollen is in the air — and too often, in people’s eyes. For allergy sufferers, this fine powder released by plants can wreak havoc on their eyes (and nose and throat, too). Other airborne allergens, such as dust mites, mold and pet dander, can cause similar distress, leaving eyes itchy and watery.

But it’s important to consider that there are different red eye causes, and how to treat them is going to depends on the cause. It’s important to make sure itchy eyes are allergy-induced before using allergy relief treatments.

In this article:

What can cause red eyes?

Red eyes happen when tiny blood vessels in the eyes widen and become swollen, causing that classic bloodshot look, according to board-certified allergist John James, MD, a medical specialist and spokesperson for the Asthma and Allergy Foundation of America (AAFA).

Redness, swelling and itching can occur when the tissue that lines the inside of the eyelid and the outside of the eyeball (the conjunctiva) becomes inflamed. This reaction to allergens is referred to as allergic conjunctivitis. If allergies are the cause, typically both eyes are involved, not just one.

There are many other possible causes of red eyes, including:

• A scratched eye (corneal abrasion)
• Blepharitis (inflammation of the eyelids)
• Broken blood vessels from a big sneeze, heavy lifting or rubbing the eyes too hard
• Other forms of conjunctivitis
• Dry eye (the body doesn’t make enough tears to properly lubricate eyes)
• Eye infections
• Glaucoma (a group of eye conditions that affect the optic nerve, usually due to increased pressure within the eyeball)
• Irritation from contact lenses, chlorine, dust, perfume, smoke or other irritants
• Uveitis (inflammation in the middle layer of tissue of the eye)

These conditions require diagnosis by a medical professional.

Differences between allergic conjunctivitis and viral or bacterial conjunctivitis

It’s not always easy to know what’s affecting eyes, says Dr. James. Both allergic red eyes and red eyes due to viral bacterial infection of the conjunctival lining of the eye are called conjunctivitis. There are actually several forms of conjunctivitis, each one named after its causative agent: allergic conjunctivitis, infectious conjunctivitis, chemical (or irritant) conjunctivitis and nonspecific conjunctivitis — the last being a catch-all term for causes not laid out in the first three categories.

If allergic conjunctivitis symptoms don’t resolve within a few days, contact a health care provider. People who experience eye pain or vision issues should seek immediate medical attention.

Common features of allergic conjunctivitis include allergic red eyes:

• Affect both eyes
• Are not contagious
• Are sometimes accompanied by sneezing and runny nose
• Most likely occur during allergy season (for those with pollen allergies)
• Often last for several weeks
• Usually cause eyes to itch

Potential signs of something more serious may include:

• Blurry vision
• Feeling a foreign object in the eye
• Inability to open the eye
• Light sensitivity
• Red eye is caused by an object or chemical splashed in the eye
• Red eye occurs with a bad headache, eye pain, fever or if light starts to hurt the eyes
• Seeing circles around lights.
• Significant eye pain
• Significant swelling and redness of the eyelids
• Sudden eyesight changes
• Swelling in or around the eye
• Thick discharge from eyes
• Upset stomach or nausea

Someone experiencing these symptoms should seek medical attention immediately.

How to help prevent red eyes from allergies

Avoiding triggers can be key. For those who suffer from seasonal allergies, experts recommend staying indoors during high-pollen times, like early morning and early evening. They also recommend keeping windows closed and using air conditioning or central heating when possible so that the air at home and in the car is filtered.

“Sunglasses can also help keep pollen out of the eyes,” says Mitchell Grayson, MD, chair of the Asthma and Allergy Foundation of America’s (AAFA) Medical Scientific Council.

Indoor allergy sufferers may want to opt for hard floors. Use only low-pile carpets and try to stick to small area rugs that can be thrown in the wash. Vacuum regularly, use allergy-proof covers on mattresses and pillows, keep pets out of the bedroom and consider an air filtration system like a Crane HEPA air purifier.

If someone is currently experiencing the symptoms of allergy-induced red eyes, cool compresses can be soothing.

If someone’s allergic conjunctivitis is flaring, they may need to avoid wearing contact lenses. They can ask their optometrist or ophthalmologist when they can resume wearing contacts.

How to help get rid of allergy-induced red eyes

If someone has conjunctivitis symptoms, it’s best not to guess. Contact a health care provider to get treatment. When it comes to management of allergic conjunctivitis, there are several over-the-counter (OTC) medications that may help to provide relief, says Dr. James.

Some of the best eye drops for red eyes include antihistamine eye drops, like Pataday Once Daily Relief extra-strength eye drops, Zaditor antihistamine itch relief eye drops and CVS Health eye itch relief eye drops, which work by blocking the effects of histamine, the chemical released by the body that causes allergy symptoms, such as red, itchy and watery eyes.

Antihistamine-and-vasoconstrictor combination eye drops for allergic conjunctivitis, like Bausch and Lomb Opcon-A eye drops, can also help relieve redness by both blocking histamine effects and narrowing or constricting the blood vessels in the eyes.

But Dr. James advises using these eye drops with caution and only for short-term relief. That’s because vasoconstrictors — ingredients like naphazoline that shrink blood vessels to reduce redness — can actually make things worse if overused, leading to more redness and irritation. Make sure to read the package directions to determine how long a product can be used.

Eye drops are the mainstay of therapy for allergic conjunctivitis, but for people who experience other allergy symptoms associated with red eyes, OTC nonsedating oral antihistamines may help. These medications include fexofenadine, loratadine, cetirizine, and levocetirizine. Ask a health care professional before starting an allergy treatment regimen.

If these management options or prescription medications don’t give relief, allergen immunotherapy (allergy shots) could be considered after consultation with a board-certified allergy specialist, says Dr. James. This is a long-term management option.