How to Treat Hay Fever and its Effect on the Eyes

With spring firmly waiting around the corner, we are all looking forward to some warmth and sunshine. However, if you are a hay fever sufferer (an allergy to trees, grasses ,weeds and pollen) it could be a nightmare for you as billions of particles are about to be released by flowering trees and grasses. Plus, added to this, research shows that the pollen season is getting longer, by up to 30 days over the year! So instead of starting mid to late March and ending in early September, it is now starting in late February and continuing well into October!

In a typical year, the tree pollen season begins first, starting in February and lasting until June. The grass pollen season starts in May and finishes in July. Weeds such as stinging nettles release pollen from June to September. It used to be that there were good allergy years and bad allergy years but now they all tend to be bad. This could possibly be down to climate change and warmer temperatures.

It’s not just in the countryside either…

Increased air pollution may also be to blame. Pollutants found more in cities, including diesel particles, irritate the lining of the airways and make them more sensitive and cause an inflammatory response. Studies have shown people who live in areas of higher pollution are more likely to have more severe nasal symptoms.

The techy stuff!

Particles in the air from trees, grasses, weeds and pollen trigger an allergic reaction in the body. The immune system sees these particles as a threat and makes antibodies in response.  These antibodies bind to special cells involved in the immune response called mast cells which are found in various structures in the body including the eye.  During exposure to the pollen, the mast cells release a powerful chemical called histamine in an attempt to rid the body of the threat. This is where the trouble starts, as histamine dilates blood vessels causing fluid to leak which in turn triggers a runny nose, sneezing, red and itchy eyes.

If you know you suffer from hay fever, you can take action in advance. Corticosteroid nasal sprays such as Nasonex or Flonase are available over the counter and can be used 2 weeks before usual symptoms start. They work by reducing local inflammation but it can take a little while for them to take effect. Oral antihistamine tablets work well and are widely available, and creams containing antihistamine can help skin rashes and itchy skin.  However, all of these preparations are often ineffective in treating red itchy eyes due to the low concentration actually reaching the eye.

How you can help yourself

• Pollen levels in the air tend to be highest in the morning because they have risen throughout the night; and again at around 5pm because many plants release their pollen later in the day. Try not to sit outside in the late afternoon.
• Keep windows closed at these times to reduce the amount of pollen that manages to get into your home.
• Watch the weather forecast. Rain can either raise pollen levels or reduce them, depending on the type of rain. Heavy droplets may break pollen grains into smaller particles, increasing the problem, but gentle rain absorbs pollen and brings it down to the ground where it can do no harm.
• High pollen levels are more likely on a hot, sunny day with little wind, because pollen grains stay airborne for longer then. So take extra precautions on bad days, such as wearing wraparound sunglasses to stop pollen affecting the eyes.
• Keep eyeglasses on whenever you go outside during the pollen season.
• Keep car windows closed and use the air conditioning on the “recycle air” setting.

• Don’t hang your washing out in the fresh air – try and tumble dry to so you don’t find pollen has attached itself to your clothing. Especially your bedding!
• If you know you always get hay fever symptoms at a certain time of year, start using them in the two weeks running up to that time. Keep an eye on when your symptoms start one year and adjust the timing accordingly.

Treatment for the eyes

If nasal sprays and oral antihistamines are ineffective for your itchy red eyes there are 2 main eye drops that can be used.

The first eye drop is a mast cell stabiliser containing sodium cromoglycate such as Opticrom. This works by stopping the mast cells from releasing histamine and as such is useful for regular hay fever sufferers just before symptoms start.

The second is an antihistamine eye drop such as Otrivine which tackles the histamine after it’s been released. These drops work well in the short term but regular sufferers may also need to use a mast cell stabiliser in conjunction. Newer prescription-only drops are available from Focus Medical Eye Centre which are dual acting combining the mast cell stabiliser and antihistamine in one.

Please speak to our team about assessment and treatment via our Minor Eye Conditions clinic. This is a free NHS run service for patients registered with a local GP for any minor eye complaint including red eye.