Written By: Dr. Stephanie Mulick, O.D.

For most people, itchy eyes are a sign of allergies. Some people experience allergies during certain seasons. Springtime brings new blooms, fallen leaves occur during the fall which can stir up allergens in the air and other people have allergies year-round, no matter what time of year. Itchy eyes can cause us to rub our eyes, which just exacerbates the symptoms of allergies. 

Do not rub your eyes!

Yes, I realize that this is easier said than done, but eye rubbing can come with a price. 

When you rub your eyes it can cause inflammation, redness and even more itchiness. There have been several studies that have shown that excessive eye rubbing can also lead to thinning of the ocular surface and put someone at risk for developing keratoconus. 

Keratoconus is a cone-shaped bulging of the cornea. Think about a tire with a thin spot that eventually bulges out due to tire pressure and lack of support from the thin area of rubber.  

Keratoconus does have a hereditary component and is usually diagnosed in patients between the ages of 10-25 and can progress for about 10 years. 

Keratoconus Symptoms:

• Frequent need for glasses change
• Excessive eye rubbing
• Blurred or distorted vision
• Glare or light sensitivity

So, how can you relieve itchy eyes without rubbing them?

• Cold is very beneficial when it comes to itchy eyes. Just applying a cold compress on your closed eyelids can help relieve the itch. 
• Artificial tears can help by washing out the allergen but can be even more beneficial if you keep them in the refrigerator. Cold preservative-free Artificial tears can do wonders for itchy eyes. 
• If all else fails, itch relief eye drops or anti-allergy (anti-histamine) drops can be very soothing for itchy eyes. Do keep in mind that anti-histamines do come with a side-effect of dry eyes. 
• Prescription allergy drops can also be an option (again they may exacerbate symptoms of dry eyes. 
• Oral anti-histamines like benedryl or zyrtec can also help, but again with side effects, such as dry eyes and mouth and sleepiness. 

Over the counter anti-itch eye drops: 

So you are in the eye drop aisle and the options are endless. How do you choose which drop to use? If you are looking for artificial tears (click here). For itch relief eye drops, here is a list of some of my favorites. (Keep in mind itch relief eye drops can cause dry eye symptoms, so if possible start with cold artificial tears and use itch relief drops sparingly). 

• Pataday (just recently released over the counter, once a day dosing works well)
• Zaditor (one drop, twice a day)
• Alaway (one drop, twice a day)

Avoid whitening or redness-relief eye drops: 

Most redness-relief eye drops contain decongestants that cause vasoconstriction (constriction of the blood vessels) leading to a lack of oxygen. This lack of oxygen triggers a signal to the brain leading to neovascularization (growth of new blood vessels). Neovascularization causes our eyes to become redder with time, which is the opposite effect of what we want with redness-relief.

The medication in redness relief drops also cause rebound vasodilation (increased diameter of blood vessels) leading to an increase in redness of the eyes usually to a degree stronger than initially present. This cycle of vasoconstriction, neovascularization and vasodilation leads to dependence and overuse of redness relief drops with a decrease in effect over time.

Keep in mind that a diagnosis of ocular allergies can only be done by an eye doctor during an eye exam. It is important to have a thorough health exam annually, including the health of your eyes.

Bottom Line:

The hallmark sign of ocular allergies is itchy eyes. Since allergies can be caused by many factors. Environmental allergies from pollen, dust, mold, grass, etc, food allergies or even contact allergies from soaps, detergents, cleaning agents, makeup, lotions, etc. The best way to determine the exact cause of an allergy is to have allergy testing.  

As far as combating itchy eyes cold compresses, cold artificial tears, anti-itch eye drops, or oral antihistamines can be helpful. 

And remember to avoid redness relief eye drops and do not rub your eyes, this only makes your symptoms worse.