Everyone loves spring, right? What’s not to like? Those warm sunny days reappear after the colder winter months; the garden comes alive with a riot of spring blossom; everyone’s in a good mood.
But what about dry eye sufferers? Could spring be their least favourite season?
Isn’t winter worse for dry eyes?
Winter is traditionally the month we associate with dry eyes. The combination of cold dry weather and indoor heating conspires to make conditions worse for dry eyes. But spring can actually bring a worsening of symptoms, rather than relief. Seasonal allergies (hayfever) and the drops used to treat them can play havoc with dry eyes.
Can antihistamines cause more harm than good?
Antihistamines are one of the cornerstones of allergy treatment. They work by stopping a chemical called histamine from attaching to your body’s cells. Histamine is produced by your immune system in response to allergens – foreign material that your body doesn’t recognise as itself. Histamine causes tissues to leak and swell, which allows the special cells of your immune system to quickly get to the area. This can be helpful, and in most people the scale of the immune reaction is normal. But if you are allergic to the allergen, the reaction is excessive and the resulting runny noses and streaming eyes (and more) can be a real pain. Antihistamines physically block histamine from reaching its target by attaching to the histamine receptors on our cells. And that’s what can cause a big problem if you suffer from dry eyes. Some antihistamines (especially older generations of the drug) can also block another type of receptor found on the walls of certain cells of your body. This results in a range of effects including dry mouth, blurry vision, urinary retention, drowsiness and, you’ve guessed it, dry eyes. Newer versions of the drug cause less severe effects but they still cause problems for dry eyes.
What’s the best way to manage hay fever if you have dry eyes?
Antihistamines are not the only drug used to manage allergy. Steroids (also known as corticosteroids) have an anti-inflammatory effect on your body and can switch off allergy in a different way to antihistamines. Steroid eye drops also have some potential side effects (including raised intraocular pressure) so should only be prescribed by your therapeutically endorsed optometrist (or your GP or ophthalmologist). Most eye drops come in a bottle and contain preservatives. These are very hard on your eyes, especially if you suffer from dry eyes and should be avoided as much as possible. Ask your therapeutically endorsed optometrist if you can get your eye drops specially compounded from a compounding pharmacist, in vials rather than the usual bottle, so that you can avoid contact with preservatives.
Another type of medicated eye drop (Prednefrin Forte) combines a lower dose of corticosteroid in combination with a decongestant (phenylephrine) which shrinks blood vessels and can provide rapid relief from the symptoms of allergic conjunctivitis (or seasonal allergies).
Can artificial tears help?
Unpreserved artificial tears can help to flush the irritating allergens out of your eyes, but they do nothing to switch off the allergic response and inflammation that is occurring in your body. You really need the powerful effects of medicated eye drops to bring relief.
What about antihistamine tablets?
This is a common question: what if you bypass the eye by taking the antihistamine systemically? Unfortunately, this method of taking the drug also aggravates dry eye symptoms, so it is best to avoid antihistamines where possible and manage the allergy in other ways.
Is there anything else I can do?
Avoiding allergens can be impossible, especially if you live in an area that is effected by pollens and dust. But inflammation is worsened by heat, so one of the best home remedies to reduce your symptoms is to use a cold compress. For best effect, use one of those gel packs eye masks straight from the freezer. Add a layer of tissue paper and mould the mask into your eye sockets. Lie back and relax!