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Dry Eyes and Oral Allergy Medications? What to do?

Allergy season is upon us again bringing about the usual symptoms of runny nose, sneezing, conjestion and often times itchy eyes. Oral anti-allergy medications such as Zyrec, Clariton, and Allegra can be very helpful in reducing many allergy symptoms by effectively drying up the mucous membranes which are swollen and irritated by seasonal and other allergies. Unfortunately, these oral allergy medications can also cause dry eye.

Being that “all the plumbing is connected” when it comes to mucous membranes, oral medication can also dry up the surface of the eye which is essentially another form of mucous membrane. This can bring about the usual dry eye symptoms of burning, redness, sandy, gritty, and red eyes especially in those patients who already have underlying dry eye problems.

Ironically, this dryness from the oral allergy meds can actually make the eye allergy symptoms (redness, itching, and swelling) worse as the decreased tear production allows allergens to be concentrated in the eye and slows the natural “eye washing” that adequate tear production promotes. This can also increase the desire to itch (feels so good but need to resist!) which can further the allergic reaction and in turn cause even more itching and irritation.

So what to do?

If you are taking the oral medications just for itching eyes and are experiencing eye dryness, try discontinuing the oral meds and instead use over the counter anti-allergy eyedrops such as Extra Strength Pataday. We recommend using these eyedrops every morning for at least two weeks to get full effect and at least every other day throughout the allergy season or times of allergen exposure. If you are allergic to your household pet (which is suprisingly common!), you will need to use the eyedrops consistantly throughout the year. This is also true for those patients with dust and other allergies that occur year round. It is best to use the eyedrops preventatively and/or early on in the symtpomatic phase before the allergic reaction becomes severe and requires extended time to get the reaction under control.

If you are taking the oral medications for sniffling, sneezing, and congestion and are experiencing eye dryness, preservative free lubrication drops such as Retaine can be very helpful in adding to your own natural tears and also helping to wash out allergens. Avoid any eye whightening drops such as Visine and Clear Eyes which can temporarily make your eyes look better but can actually increase the allergic inflammation and cause more redness and irritation when the whitening effect wears off. This is also true of lubrication drops in bottles which contain inflammatory preservatives. Stick with preservative free in tubes/viles several times daily.

Both Extra Strength Pataday and Retaine Preservative Free eyedrops are available in our clinic.

Steroids, bringing out the big guns. Treatments recommended so far are non-steroidal antiflammatory (NSAID) in nature. If your eye allergies/dry eye is out of control even with NSAID treatment, you may need a steroid eyedrop to tame the inflammatory beast. These medications are prescription only and require monitoring by an eye care professional (Dr. Steve and Dr. Sarah).

If you are experiencing symptoms of dry eye or allergies, please contact our clinic to schedule a consultation. Urgent Care, virtual visits, nurse’s line, etc. are great for some concerns, but if you have an eye problem, see an eye doctor!

Thanks for reading!