itchy eyes – Ask Eye Doc

Written by: Dr. Stephanie Mulick, O.D. Kids love to touch things, they love to get messy and they hate to wash their hands. Why is that? Honestly, I don’t know why kids don’t like washing their hands. I think it has to do with power. When we, as parents tell our child to do something, like “wash your hands,” and they don’t do it or they put up a fight, well, they are now in control and they get a little attention from Mom or Dad. I am not a psychologist, sometimes I wish I was when it comes to raising my daughter, but I do know that the struggle is real. So, not only do children love to get dirty and not wash their hands, but they also seem to love touching their face and eyes--Eww! As an eye doctor, it is not uncommon to see children with ocular allergies, styes (chalazion) or pink eye. “Doctor, why is my son constantly rubbing his eyes?” This is a very common question that I get from parents. There are several reasons why children rub their eyes. Some children rub their eyes out of nervousness or a way to release energy, like biting fingernails. Others rub their eyes due to fatigue. It is not uncommon to see a sleepy child rub their eyes. Visual fatigue or blurry vision can also be a culprit. Eye allergies can cause itchy eyes which can lead to eye rubbing as well. So, what’s the problem with eye rubbing? The problem with eye rubbing is that it can cause infection, inflammation and has also been linked to a progressive eye condition called keratoconus, in which the front surface of the eye (cornea) becomes thin and starts to bulge forward causing visual distortion. How can I get my child to stop rubbing his/her eyes? First off, it is important to know the cause of eye rubbing. As stated above there are several causes for eye rubbing. If the eye rubbing is a nervous habit here are 4 tips: Gently remind your child about the habitHave your child get involved in creating ways that can help him/her break the habit. Sit down with your child and create a list of some things that they can do that would help them. (my daughter used to bite her nails and we wrote a list for her that seemed to help, she suggested playing with dolls, painting her nails and drawing. This helped her think about the nail-biting and realize she was doing it and that she could do something fun on her list).Distract your child from the habitYou can suggest fun activities or craftsTry to find out why your child is rubbing his/her eyes. Are they tired, mad, are their eyes itchy, or is his/her vision blurry? (click here for a free printable children’s eye chart) Itchy eyes If itchy eyes are the reason for the eye rubbing, then there are some things you can do to help your child. Cold compress: holding a cold compress on your child’s eyes can help to relieve itchy eyesCold Artificial tears: I prefer preservative-free artificial tears (preservatives can cause allergies for some people). Keep the artificial tears in the refrigerator and use as needed even up to every hour. (I provided a table of my favorite preservative-free artificial tears from my post on eye drops).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. (see below for my recommendations).Prescription allergy drops can also be an option (again they may exacerbate symptoms of dry eyes. If all else fails, oral anti-histamines like children’s Benedryl can also help, but again with side effects, such as dry eyes and mouth and sleepiness. (This would only be recommended if nothing else helps). Recommended Over-the-counter preservative-free artificial tears ManufacturerDay-time artificial tearsAllerganRefresh Relieva (Preservative Free bottle)AlconSystane Ultra (preservative-free vials)AkornThera tears (preservative-free vials)Bausch & LombSoothe XP (preservative-free vials)OcuSoftRetain MGD (preservative-free vials)Eyevance pharmaceuticalsFreshkote (preservative-free bottle) Recommended over-the-counter itch-relief eye drops 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) The Bottom Line Kids will be kids, but rubbing their eyes can come with a price, including eyelid swelling, redness, infection and worst-case scenario can lead to a progressive eye disease called keratoconus (thinning to the front surface of the eye). Using cold artificial tears or a cold compress can bring relief to itchy eyes. But, finding out the cause of the eye rubbing can help to pinpoint the problem to find a solution. If the eye rubbing becomes chronic bring your little one to see an eye doctor.