Eye Allergies

eye allergy

Also called allergic conjunctivitis or ocular allergy, eye allergy occurs when something you are allergic to irritates the conjunctiva. This is the delicate membrane covering the eye and the inside of the eyelid.

Like all allergies, allergic conjunctivitis starts when the immune system identifies an otherwise harmless substance as an allergen. This causes your immune system to overreact and produce antibodies called Immunoglobulin (IgE). These antibodies travel to cells that release chemicals which cause an allergic reaction. In this case, allergic reactions include eyes that water, itch, hurt or become red or swollen.

The most common causes of allergic conjunctivitis are seasonal allergens such as pollen and mold spores. People with seasonal allergic rhinitis (hay fever) normally notice their symptoms worsen when they go outdoors on days with high pollen counts.

Indoor allergens such as dust mites and pet dander can also cause eye allergies year-round. If you suffer from this type of allergy, you may notice your symptoms worsen during certain activities such as cleaning your house or grooming a pet.

Eye allergy symptoms can be very annoying. Yet they pose little threat to eyesight other than temporary blurriness. Unlike conditions such as pink eye, allergic conjunctivitis is not contagious.

However, red, itchy, burning and puffy eyes can be caused also by infections and other conditions that can threaten eyesight. If your symptoms are related to an eye allergy, chances are you will have problems in both eyes.

Typical symptoms include: •    Watery eyes •    Itchiness •    Sensitivity to light •    Redness •    Grittiness •    Eyelid swelling

These symptoms can occur alone or along with allergic rhinitis nasal symptoms. They typically appear shortly after exposure to the allergen.  Symptoms resulting from seasonal outdoor allergens tend to be worse than if your symptoms are due to indoor allergens such as dust mites or pet dander.  Symptoms may be reduced if you are taking allergy medications such as antihistamines, which suppress the allergic reaction. If dust or pet allergic, use a vacuum with a HEPA filter to reduce dust in your home or try keeping pets out of the bedroom to reduce exposure to their dander.

If pollen and other seasonal allergens are causing your misery, here are a few helpful suggestions:

  • Wear a hat with a wide brim to reduce the amount of allergen that blows into the eyes.
  • Sunglasses can also help reduce the amount of allergen that lands in the eyes.
  • Apply saline eye drops to the eyes after being outdoors to wash away allergens from the ocular lining.

Over-the-counter antihistamine pills and eye drops are often used for short-term treatment of eye allergy symptoms. However, prolonged use of some eye drops may actually make your symptoms worse. Your doctor may prescribe stronger medications if your symptoms are long-lasting. Corticosteroid eye drops are effective, but they often have side effects, even when used only for a short time. Use of this medication should be managed by an ophthalmologist due to the risk of side effects, such as glaucoma (increased ocular pressure), cataracts and infection.

Depending on what is causing your eye allergy symptoms, immunotherapy (allergy shots) can be very effective in providing long-term resistance to the triggering allergens.

The first step toward relief from annoying eye allergy symptoms is a proper diagnosis. An allergist / immunologist has specialized training and experience to accurately determine what is causing your symptoms and identify the best treatment approach that can help you feel better and live better.

 

Article provided by: www.AAAAI.org

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Stinging Insect Allergy

bee stingMost of us develop redness and swelling at the site of an insect bite. Yet people who are allergic to stinging insect venom are at risk for a much more serious reaction. This life-threatening reaction is called anaphylaxis .
Understanding differences in symptoms between a normal reaction and an allergic reaction can bring peace of mind. It is also important to have an accurate diagnosis so you can manage your condition and be prepared for an emergency.
An allergic reaction occurs when the immune system overreacts to an allergen. In stinging insect allergy, the allergen is venom from a sting. Most serious reactions are caused by five types of insects:
• Yellow jackets are black with yellow markings, found in various climates. Their nests are usually located underground, but sometimes found in the walls of buildings, cracks in masonry or in woodpiles.
• Honeybees have round, fuzzy bodies with dark brown and yellow markings. They can be found in honeycombs in trees, old tires or other partially protected sites.
• Paper wasps are slender with black, brown, red and yellow markings. They live in a circular comb under eaves, behind shutters or in shrubs and woodpiles.
• Hornets are black or brown with white, orange or yellow markings. Their nests are gray or brown and are usually found in trees.
• Fire ants are reddish-brown ants living in large mounds, mostly in warmer climates. They attack with little warning, inserting highly concentrated toxins that cause burning and pain.
Symptoms
Most people develop pain, redness and swelling at the site of an insect sting. This is a normal reaction that takes place in the area of the bite.
A serious allergic reaction occurs when the immune system gets involved and overreacts to the venom, causing symptoms in more than one part of the body such as:
• Swelling of the face, throat or tongue
• Difficulty breathing
• Dizziness
• Stomach cramps
• Nausea or diarrhea
• Itchiness and hives over large areas of the body
This severe allergic reaction is called anaphylaxis.
Insect stings can cause serious symptoms that are not allergic. A toxic reaction occurs when the insect venom acts like a poison in the body. A toxic reaction can cause symptoms similar to those of an allergic reaction, including nausea, fever, swelling at the site of the sting, fainting, seizures, shock and even death. A toxic reaction can happen after only one sting, but it usually takes many stings from insects.
Serum sickness is an unusual reaction to a foreign substance in the body that can cause symptoms hours or days after the sting. Symptoms include fever, joint pain, other flu-like symptoms and sometimes hives.
Diagnosis
If you think you might be allergic to stinging insects, an accurate diagnosis is essential. An allergist / immunologist has specialized training and skills in determining the cause of your symptoms. Your allergist will conduct a thorough health history followed by allergy testing to determine what, if any, allergens put you at risk for serious reactions to stinging insects.
Avoiding contact with stinging insects is the key to successfully managing this allergy. These steps can help:
• Insects are most likely to sting if their homes are disturbed, so have hives and nests around your home destroyed. Because this activity can be dangerous, you should hire a trained exterminator.
• If you spot stinging insects, remain calm and quiet, and slowly move away.
• Avoid brightly colored clothing and perfume when outdoors. Many stinging insects are searching for food and could confuse you with a flower.
• Be careful outdoors when cooking, eating or drinking sweet beverages like soda or juice. Cover food and drinks to keep insects out.
• Wear closed-toe shoes outdoors and avoid going barefoot to steer clear of stepping on a stinging insect.
• Avoid loose-fitting garments that can trap insects between material and skin.
If you have an anaphylactic reaction, inject epinephrine immediately and call 911.
After a serious reaction to an insect sting, make an appointment with an allergist / immunologist. With proper testing, your allergist can diagnose your condition and determine the best form of treatment.
Immunotherapy (allergy shots) may be effective long-term treatment for stinging insect allergy. Your allergist will give you shots containing small doses of your allergen, allowing your body to build a natural immunity to the trigger.

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Skin Allergy Overview

skin allergy

Irritated skin can be caused by a variety of factors. These include immune system disorders, medications and infections. When an allergen is responsible for triggering an immune system response, then it is an allergic skin condition.

Atopic Dermatitis (Eczema)
Eczema is the most common skin condition, especially in children. It affects one in five infants but only around one in fifty adults. It is now thought to be due to “leakiness” of the skin barrier, which causes it to dry out and become prone to irritation and inflammation by many environmental factors. Also, some people with eczema have a food sensitivity which can make eczema symptoms worse. In about half of patients with severe atopic dermatitis, the disease is due to inheritance of a faulty gene in their skin called filaggrin. Unlike with urticaria (hives), the itch of eczema is not caused by histamine so anti-histamines do not control the symptoms. Eczema is often linked with asthma, allergic rhinitis (hay fever) or food allergy. This order of progression is called the atopic march.

Allergic Contact Dermatitis
Allergic contact dermatitis occurs when your skin comes in direct contact with an allergen. For instance, if you have a nickel allergy and your skin comes in contact with jewelry made with even a very small amount of nickel, you may develop red, bumpy, scaly, itchy or swollen skin at the point of contact.

Coming in contact with poison ivy, poison oak and poison sumac can also cause allergic contact dermatitis. The red, itchy rash is caused by an oily coating covering these plants. The allergic reaction can come from actually touching them, or by touching clothing, pets or even gardening tools that have come in contact with the oil.

Urticaria (Hives)
Hives are an inflammation of the skin triggered when the immune system releases histamine. This causes small blood vessels to leak, which leads to swelling in the skin. Swelling in deep layers of the skin is called angioedema. There are two kinds of urticaria, acute and chronic. Acute urticaria occurs after eating a particular food or coming in contact with a particular trigger. It can also be triggered by non-allergic causes such as heat or exercise, as well as medications, foods or insect bites. Chronic urticaria is rarely caused by specific triggers and so allergy tests are usually not helpful. Chronic urticaria can last for many months or years. Although they are often uncomfortable and sometimes painful, hives are not contagious.

Angioedema
Angioedema is swelling in the deep layers of the skin. It is often seen together with urticaria (hives). Angioedema many times occurs in soft tissues such as the eyelids, mouth or genitals. Angioedema is called “acute” if the condition lasts only a short time such as minutes to hours. Acute angioedema is commonly caused by an allergic reaction to medications or foods. Chronic recurrent angioedema is when the condition returns over a long period of time. It typically does not have an identifiable cause.
Hereditary angiodema (HAE) is a rare, but serious genetic condition involving swelling in various body parts including the hands, feet, face, intestinal wall and airways. It does not respond to treatment with antihistamines or adrenaline so it is important to go see a specialist.

Skin conditions are one of the most common forms of allergy treated and managed by an allergist / immunologist, a physician with specialized training and expertise to accurately diagnose your condition and provide relief for your symptoms.

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GRASS POLLEN ALLERGY

Grass pollen is a common trigger for allergies — and symptoms like runny or stuffy nose, itchy eyes, and cough. If you might be allergic to grasses, here’s what you should know.
Grass Pollen Allergy Basics
Grasses tend to start growing in the early spring. In the late spring and early summer, they release pollen into the air. The wind can carry it for miles.
Grass pollen is fine and powdery. You may not see pollen in the air. But if you’re allergic, your body may react even to small amounts.
There are hundreds of types of grasses. Types that often trigger allergies include:
• Bermuda grass
• Johnson grass
• Kentucky bluegrass
• Orchard grass
• Redtop grass
• Rye grass
• Sweet vernal grass
• Timothy grass
• Bahia grass
What Makes Grass Pollen Allergy Worse?
• Dry, windy days. Wind carries pollen in the air, especially when it’s dry and sunny. When it’s cold or damp, pollen counts are usually lower.
• Eating certain foods. If you’re allergic to grasses, your allergy symptoms are more likely to be triggered by particular fruits and vegetables that have proteins like those in pollen. Celery, melons, peaches, oranges, and tomatoes may trigger an itchy skin rash.
• Unmowed grass. Most types of grass release pollen only when they grow tall. The pollen comes from a feathery flower that grows at the top. If you keep your lawn mowed, the grass is less likely to release pollen.
However, some grasses, like Bermuda grass, can still release pollen when kept short.
Controlling Grass Pollen Allergy
• Testing. The only way to know if you really are allergic to grasses is to get tested. Once you find out what’s triggering your allergies, you can better control your exposure.
• Avoiding triggers. Take steps to limit your exposure to grass pollen. Close windows on windy, summer days. Wear a mask when gardening.
• Changing out your lawn. It may seem drastic, but if you are sure that grasses in your yard are causing your symptoms, you could remove them. Replacing them with bunch grasses — like perennial rye grass and tall fescue — could help. These grasses don’t flower and release pollen until they’re 12 inches or taller. Other allergy-safe options for your yard include ivy and Irish moss. However, recognize that since grass pollens can travel miles, you will still be exposed.
• Treatment. Both OTC and prescription medications can help ease allergy symptoms. Allergy shots are most effective in ending grass allergies.
Article provided by: WebMD/RAP

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Rhinitis (Hay Fever): Tips to Remember

Do you suffer from frequent sneezing, congestion or stuffiness and an itchy or runny nose? If so, you may have a condition called rhinitis.

There are two types of rhinitis: allergic rhinitis and non-allergic rhinitis. Let’s talk first about allergic rhinitis.

Allergic Rhinitis
Allergic rhinitis is caused by allergens like molds, pollen and animals. These are substances which are usually harmless, but can cause allergic reactions in certain people.

Allergy symptoms are the result of a chain reaction that starts in the immune system. Your immune system controls how your body defends itself. For instance, if you have an allergy to pollen, your immune system identifies pollen as an invader or allergen. Your immune system overreacts by producing antibodies called Immunoglobulin E (IgE). These antibodies travel to cells that release histamine and other chemicals, causing an allergic reaction with symptoms such as sneezing, stuffiness, a runny nose, itching and post-nasal drip.

People with allergic rhinitis are also prone to itchy, watery eyes (called allergic conjunctivitis), and they may be more sensitive to irritants such as smoke, perfume or cold, dry air. Rhinitis can contribute to other problems such as asthma, sinus or ear conditions, or trouble sleeping.

Allergic Rhinitis Triggers
Seasonal allergic rhinitis, commonly known as hay fever, is triggered by outdoor allergens such as pollen and mold spores. Some people have symptoms year-round due to indoor allergens from pets, mold, dust mites and cockroach residue. This is called perennial allergic rhinitis. You can suffer from either seasonal or perennial allergic rhinitis, or a combination of both.

Diagnosis of Allergic Rhinitis
An allergist/immunologist, often referred to as an allergist, has specialized training and experience to determine which allergens, if any, are causing your symptoms. Your allergist will take a detailed health history, perform a physical exam and then most likely test you for allergies. Skin tests show the results within 20 minutes. These results, as well as how frequent and bad your symptoms are, will be considered when developing a treatment plan. Steps to manage your symptoms may include avoiding the allergens you are allergic to, medications or allergy immunotherapy (allergy shots).

Treatment and Management of Allergic Rhinitis
The first step to manage this condition is to avoid allergens that cause symptoms. For instance, if you are allergic to dust mites, it is important to take steps to prevent exposure to dust mites, such as frequently washing bed linens in hot water. The same is true for outdoor allergens. Limiting your exposure during times of high pollen and mold counts may help reduce symptoms.

Sometimes taking steps to avoid allergens isn’t possible or it isn’t enough to control allergic rhinitis symptoms. That is when your allergist may prescribe or recommend medications or allergy shots.

Some medications for allergic rhinitis are best used daily to control inflammation and prevent symptoms, while others are used only as needed to relieve symptoms.

Nasal corticosteroid sprays control inflammation and reduce all symptoms of allergic rhinitis, including itching, sneezing, runny nose and stuffiness. Antihistamines in the form of liquid, pills or nasal sprays block histamine and may relieve itching, sneezing and runny nose. But they may not be as effective in reducing nasal stuffiness. Anti-leukotrienes in pill form can reduce all the symptoms of allergic rhinitis. Decongestant pills or nasal sprays can be used as needed if nasal stuffiness is not relieved with other medications. Decongestant nasal sprays should not be used for long periods of time because they can cause your congestion to return and worsen. Ipratropium nasal spray can be used specifically for a runny nose.

Your allergist may recommend allergy shots if your symptoms are constant, if you don’t want to take medications or feel that they are not enough, or if you want long-term control of your allergies with less need for medications. This treatment involves receiving injections periodically—as determined by your allergist—over a period of three to five years. Allergy shots have been proven effective in decreasing sensitivity to allergens.

Non-Allergic Rhinitis
Many people with rhinitis symptoms do not have allergies. If you have non-allergic rhinitis, avoiding allergens is unnecessary and won’t help your symptoms. This distinction is why it is important to visit an allergist to determine what you are as well as what you are not allergic to.

Non-allergic rhinitis usually begins in adults and causes year-round symptoms, especially a runny nose and nasal stuffiness. Strong odors, pollution, weather changes, smoke and other irritants may cause symptoms of non-allergic rhinitis. Non-allergic rhinitis symptoms can also develop as side effects of medications, including some blood pressure medicines, oral contraceptives or medications used for erectile dysfunction. Another type of non-allergic rhinitis is caused by nasal decongestant sprays such as oxymetazoline, when used for long periods of time. This type of medication-induced rhinitis is called rhinitis medicamentosa.

Treatment of Non-Allergic Rhinitis
Oral antihistamines and anti-leukotriene drugs generally do not benefit non-allergic rhinitis. However, treatment options include nasal corticosteroid sprays and nasal antihistamine sprays. Ipratropium nasal spray can relieve a runny nose and decongestant pills can be used as needed to relieve nasal stuffiness.

Other forms of treatment may be considered if you have problems with the structure of your nose, such as narrow drainage passages, tumors or a shifted nasal septum (the bone and cartilage that separate the right from the left nostril). In these cases, an operation may be needed.

Healthy Tips
• There are two forms of rhinitis: allergic and non-allergic. This distinction is important in order to provide the best plan for controlling your symptoms.
• The allergic form of rhinitis can be caused by outdoor allergens such as pollen and mold spores. This is referred to as seasonal allergic rhinitis or hay fever.
• Allergic rhinitis can also be caused by indoor allergens such as dust mites or pets. This is called perennial allergic rhinitis, as symptoms are usually year-round.
Feel Better. Live Better.
An allergist / immunologist, often referred to as an allergist, is a pediatrician or internist with at least two additional years of specialized training in the diagnosis and treatment of allergies, asthma, immune deficiencies and other immunologic diseases.

By visiting the office of an allergist, you can expect an accurate diagnosis, a treatment plan that works and educational information to help you manage your disease and feel better.

The AAAAI’s Find an Allergist / Immunologist service is a trusted resource to help you find a specialist close to home.

© 2013 American Academy of Allergy, Asthma & Immunology. All Rights Reserved.

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Nasal Steroids

Over-the-Counter Allergy Nasal Spray Triamcinolone – What Does It Mean for Patients?

The U.S. Food and Drug Administration (FDA) recently approved nasal triamcinolone for over-the-counter use. This means that consumers will soon be able to go to their local drugstore and purchase a nasal steroid spray. Other brands will still be available by prescription. Previously, all nasal steroids were available only with a prescription so they required occasional monitoring by a medical provider.
There are benefits and risks that come along with the decision to allow access to over-the-counter corticosteroids. To help you make an informed decision, this article will describe the pros and cons. It will also explain the importance of working with your doctor even if the medicines may be obtained without a prescription.

What Are Nasal Steroids?

Nasal steroids are important medicines to help treat allergic rhinitis (hay fever). They are helpful in reducing nasal inflammation, nasal congestion, runny nose and sneezing.
Other medicines that are available to treat allergic rhinitis include oral antihistamines, nasal antihistamines, anti-leukotriene modifiers and nasal saline. Allergy immunotherapy (allergy shots) can also be given to improve the immune system to not react or desensitize itself to the allergens.
If you’re wondering which medicines and treatment strategies will work for you, your doctor will help you navigate the many options and will work with you to decide the best treatment plan.

What Are the Concerns with Using Nasal Steroids?

Although these medicines are safe under a medical provider’s care, they do have some potential risks and concerns:
1. Symptoms of allergic rhinitis can be similar to other ailments like sinus infections, viral colds, chronic sinus inflammation, sinus polyps, and in rare cases certain cancers and other serious problems. It is possible that consumers may treat the wrong condition and a more serious problem could go unnoticed.
2. Nasal steroids can lead to nose bleeds that can be very concerning to patients, which is why proper usage and technique are important. Your doctor can examine the nasal tissues to make sure no damage is occurring. A rare complication that can occur is a hole, or perforation, in the nasal septum (bone separating each nostril). To make sure this does not happen, individuals should be monitored and receive nasal exams.
3. Growth restriction is a well-known risk of using steroids, although topical steroids like nose sprays are less much risky than oral corticosteroids. Even so, every person is different and some are more sensitive than others. For that reason, height and weight should always be monitored.
4. Side effects involving the eyes, which include glaucoma and cataracts, are potential yet uncommon risk factors of topical steroids. Those at risk for these conditions should talk with their physician.
5. Since the medicine will be over-the-counter, you will likely have to purchase it “out of pocket,” which is the case with many antihistamines and heartburn medications. This could increase the amount of money you pay each year for health costs.
Unlike taking a pill, the way you use the nasal spray is important. As mentioned above, it is important to avoid spraying the medicine into the middle of the nose, the septum bone that separates the nostrils. Sometimes it helps to use a mirror, or have another person or doctor make sure this is being done correctly. If you do not use the medicine correctly, it may not work, or worse, could cause serious side effects.
As with all medications, the benefits and risks should be weighed before deciding on a treatment plan. When used properly, nasal steroid sprays can be very effective at treating allergies. It is just important to recognize that steroid nose sprays can create risks if not monitored or used correctly.
Your allergist is trained to help you navigate the best treatment course and monitor your health. He or she can explain the benefits and risks of these treatments and answer any concerns you may have. Together, you and your allergist can decide the best treatment plan.

This article has been reviewed by Linda Cox, MD, FAAAAI, Samuel L. Friedlander, MD and Thanai Pongdee, MD, FAAAAI.

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Is Your Asthma Allergic?

Is Your Asthma Allergic?
This article has been reviewed by Thanai Pongdee, MD, FAAAAI
Many of the symptoms of allergic and non-allergic asthma are the same but the triggers may be different.
Allergic Asthma Triggers
Allergic asthma, or allergy-induced asthma, is the most common form of asthma. If your asthma is allergic, your symptoms are most often triggered by inhaling allergens. An allergen is a typically harmless substance such as dust mites, pet dander, pollen or mold.
If you are allergic to a substance, this allergen triggers a response starting in the immune system. Through a complex reaction, these allergens then cause the passages in the airways of the lungs to become inflamed and swollen. This results in coughing, wheezing and other asthma symptoms.
Exposure to allergens may trigger the symptoms, but the real culprit in allergic asthma is the IgE antibody. The IgE antibody is produced by the body in response to allergen exposure. The combination of the antibody with allergens results in the release of potent chemicals called mediators. The mediators cause inflammation and swelling of the airways, resulting in symptoms of asthma.
Other Asthma Triggers
Some people with asthma do not have allergies. Asthma symptoms may also be triggered by exercise, viral or bacterial infections, cold air or by related conditions such as gastroesophageal reflux disease (GERD).
Knowing if your asthma is allergic is essential for taking control of your condition. Given the relationship between allergies and asthma, an allergist / immunologist is the best qualified physician to diagnose your symptoms and help you manage your asthma.
The AAAAI’s Find an Allergist / Immunologist service is a trusted resource to help you find a specialist close to home.

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