I am doing an upcoming podcast on all the causes and treatments for itching eyes: here is the outline
Causes of Itchy Eyes:
Itching is always due to inflammation that causes the release of eosinophils from mast cells. The causes are numerous. #1&2 are most common. Please make a visit if further questions.
1. Allergies:
- Seasonal Allergies (e.g., pollen, grass, mold)
- Perennial Allergies (e.g., dust mites, pet dander)
- Contact Allergies (e.g., from cosmetics, eye drops)
2. Dry Eye Syndrome:
- Insufficient tear production or poor tear quality (ie lack of oil or water)
- Environmental factors like dry air, wind, or prolonged screen use
3. Infections: usually occurs if you have a cold or have been around someone who was sick.
- Conjunctivitis (pink eye) - bacterial, viral, or allergic
- Blepharitis - inflammation of the eyelids
4. Irritation:
- Foreign bodies in the eye (e.g., dust, eyelashes)
- Smoke, pollution, or chemicals
5. Eye Strain:
- Prolonged reading or screen time without breaks
6. Contact Lens Use:
- Overuse, poor hygiene, or sensitivity to contact lens solutions
7. Medications:
- Side effects from medications like antihistamines or blood pressure drugs
8. Autoimmune Diseases:
- Conditions like Sjogren's syndrome affecting tear glands
9. Dermatological Conditions:
- Eczema or psoriasis around the eyes
10. Environmental Factors:
- Sun exposure, chlorine from swimming pools
Best Treatments for Itchy Eyes:
1. For Allergies:
- Antihistamine Eye Drops (e.g., over the counter: Optase Allegro, olopatadine, ketotifen): put in refrigerator as cold drops help stabilize mast cells and help itching stop.
- Oral Antihistamines if systemic relief is needed
- Avoidance of known allergens
- Cool Compresses to soothe the eyes
2. For Dry Eyes:
- Non preserved Artificial Tears for lubrication: put in refrigerator as cold drops help stabilize mast cells and help itching stop.
-Non preserved PRP (Platlet Rich Plasma) drops from your own blood are very effective for itching. Dr. Cremers recommends this in patients who cannot use steroids or have glaucoma or are sensitive to preservatives.
- Prescription Eye Drops to increase tear production (e.g., cyclosporine, lifitegrast)
- Omega-3 Fatty Acid Supplements for tear quality improvement
- Humidifier use at home or work
3. For Infections:
- Antibiotic Eye Drops/Ointments for bacterial conjunctivitis: if not better with the BOLDED options below writhing 2 days call for an Rx for an antibiotic/ steroid drop or ointment (though we prefer to try to avoid steroids unless nee due to risks of cataracts, which is curable AND glaucoma (ie nerve damage which can lead to blindness), which is not curable, if you use steroids over a period of time (ie some people can develop sudden high eye pressures even after a few days of any steroid use).
- Viral Conjunctivitis: takes usually 14 days to resolve on its own, but symptomatic relief can be provided with non preserved artificial tears or steroids. Dr. Cremers has used diluted betadine on 2 Optometrist with clear viral conjunctivitis who could not afford to get worse or pass it on to patients. It healed these 2 doctors within 24 hrs but would not recommend this at home as it burns without anesthetic and you have to be sure you are not allergic
- Warm Compresses and lid hygiene for blepharitis
4. For Irritation:
- Flush the Eye with clean water or saline if a foreign body is present
- Avoid Rubbing the eyes to prevent further irritation
5. For Eye Strain:
- Follow the 20-20-20 rule (every 20 minutes, look at something 20 feet away for at least 20 seconds)
- Adjust Screen Settings for comfort
6. For Contact Lens Users:
- Proper Hygiene and regular lens replacement
- Consider Daily Disposable contacts to reduce protein buildup
7. Medication-Induced:
- Consult with a healthcare provider about alternative medications if possible
8. Autoimmune Diseases:
- Management of the underlying condition with a specialist
9. Dermatological Conditions:
- Topical Steroids or other dermatological treatments under medical supervision
10. Environmental:
- Sunglasses to protect from UV and allergens
- Rinse Eyes after exposure to chlorine or other irritants
General Advice:
- please call office if symptoms persist, worsen, or if you experience pain, vision changes, or discharge from the eye.
- Avoid Self-Treatment with over-the-counter medications for extended periods without professional advice, as this might mask underlying issues or lead to complications.
Remember, while these treatments can alleviate symptoms, identifying and addressing the root cause is key for long-term relief.
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