What to do when your eye is swollen from allergies
Allergic rhinitis triggered by the pollens of specific seasonal plants is commonly known as «hay fever», because it is most prevalent during haying season. However, it is possible to own allergic rhinitis throughout the year. The pollen that causes hay fever varies between individuals and from region to region; in general, the tiny, hardly visible pollens of wind-pollinatedplants are the predominant cause. Pollens of insect-pollinated plants are too large to remain airborne and pose no risk. Examples of plants commonly responsible for hay fever include:
- Trees: such as pine (Pinus), birch (Betula), alder (Alnus), cedar (Cedrus), hazel (Corylus), hornbeam (Carpinus), horse chestnut (Aesculus), willow (Salix), poplar (Populus), plane (Platanus), linden/lime (Tilia), and olive (Olea).
In northern latitudes, birch is considered to be the most common allergenic tree pollen, with an estimated 15–20% of people with hay fever sensitive to birch pollen grains.
A major antigen in these is a protein called Bet V I. Olive pollen is most predominant in Mediterranean regions. Hay fever in Japan is caused primarily by sugi (Cryptomeria japonica) and hinoki (Chamaecyparis obtusa) tree pollen.
- Grasses (Family Poaceae): especially ryegrass (Lolium sp.) and timothy (Phleum pratense). An estimated 90% of people with hay fever are allergic to grass pollen.
- Weeds: ragweed (Ambrosia), plantain (Plantago), nettle/parietaria (Urticaceae), mugwort (Artemisia Vulgaris), Fat hen (Chenopodium), and sorrel/dock (Rumex)
Allergic rhinitis may also be caused by allergy to Balsam of Peru, which is in various fragrances and other products.
Predisposing factors to allergic rhinitis include eczema (atopic dermatitis) and asthma.
These three conditions can often happen together which is referred to as the atopic triad. Additionally, environmental exposures such as air pollution and maternal tobacco smoking can increase an individual’s chances of developing allergies.
Resources We Love
Favorite Orgs for Essential Pink Eye Info
American Academy of Ophthalmology (AAO)
Learn every the fundamentals about pink eye from the professional medical association of ophthalmologists (medical doctors who specialize in eye care).
The site displays some eye-opening photographic and video examples of conjunctivitis, as well as quick home remedies.
American Optometric Association (AOA)
The AOA looks at the essential aspects of pink eye, including causes, diagnosis, and treatment. Because excellent hygiene is one of the best ways to control conjunctivitis, the association instructs readers on best practices to prevent this inflammation.
The College of Optometrists
The College of Optometrists highlights guidelines on the diagnosis and management on a type of conjunctivitis that occurs in newborns within the first month of life.
The cause is a sexually transmitted disease in a parent. The site discusses diagnosis, prevention, and treatment.
Centers for Disease Control and Prevention (CDC)
The CDC gives in-depth information about causes, treatments, and the diverse types of this ailment, including viral, bacterial, and allergic conjunctivitis. The site features a fact sheet, a helpful infographic, and a podcast by a pediatrician who specializes in the condition.
A digital extension from the American Academy of Pediatrics, this group answers parents’ health questions regarding children of every ages, including inquiries concerning conjunctivitis.
For example, one of the AAP doctors replies to a query asking “Do I need to hold my son home if he has pink eye?”
National Eye Institute
Part of the National Institutes of Health, this organization lays out the facts about pink eye, telling you how to recognize it, take care of it, and avoid getting it altogether. You can also search for news, events, and latest research on the topic.
Favorite Orgs for Related Pink Eye Info
American Board of Internal Medicine Foundation (ABIMF)
ABIMF supports the Choosing Wisely initiative to promote conversations between clinicians and patients.
The site addresses several eye-heath subjects, such as conjunctivitis. The website explains when antibiotics are and aren’t needed for pink eye.
Measles and Rubella Initiative
Because measles has been making a comeback recently among unvaccinated children and pink eye can be a symptom of measles, it’s helpful to know other symptoms of measles and how to identify the potentially life-threatening disease. The Measles and Rubella Initiative describes the serious health consequences from measles and why vaccination is so important.
Favorite Blogs Related to Pink Eye
Nationwide Children’s Hospital Children’s Blog
This blog gives parents access to the most current pediatric news and research.
A portion of the blog gives parents a guide to pink eye with advice on symptoms and home care.
«Hay fever» redirects here. For the frolic, see Hay Fever (play).
|Other names||Hay fever, pollinosis|
|Pollen grains from a variety of plants, enlarged times and about mm wide|
|Specialty||Allergy and immunology|
|Symptoms||Stuffy itchy nose, sneezing, red, itchy, and watery eyes, swelling around the eyes, itchy ears|
|Usual onset||20 to 40 years old|
|Causes||Genetic and environmental factors|
|Risk factors||Asthma, allergic conjunctivitis, atopic dermatitis|
|Diagnostic method||Based on symptoms, skin prick test, blood tests for specific antibodies|
|Differential diagnosis||Common cold|
|Prevention||Exposure to animals early in life|
|Medication||Nasal steroids, antihistamines such as diphenhydramine, cromolyn sodium, leukotriene receptor antagonists such as montelukast, allergen immunotherapy|
|Frequency||~20% (Western countries)|
Allergic rhinitis, also known as hay fever, is a type of inflammation in the nose which occurs when the immune system overreacts to allergens in the air. Signs and symptoms include a runny or stuffy nose, sneezing, red, itchy, and watery eyes, and swelling around the eyes. The fluid from the nose is generally clear. Symptom onset is often within minutes following allergen exposure and can affect sleep, and the ability to work or study. Some people may develop symptoms only during specific times of the year, often as a result of pollen exposure. Numerous people with allergic rhinitis also own asthma, allergic conjunctivitis, or atopic dermatitis.
Allergic rhinitis is typically triggered by environmental allergens such as pollen, pet hair, dust, or mold. Inherited genetics and environmental exposures contribute to the development of allergies. Growing up on a farm and having multiple siblings decreases this risk. The underlying mechanism involves IgE antibodies that attach to an allergen, and subsequently result in the release of inflammatory chemicals such as histamine from mast cells. Diagnosis is typically based on a combination of symptoms and a skin prick test or blood tests for allergen-specific IgE antibodies. These tests, however, can be falsely positive. The symptoms of allergies resemble those of the common cold; however, they often final for more than two weeks and typically do not include a fever.
Exposure to animals early in life might reduce the risk of developing these specific allergies. Several diverse types of medications reduce allergic symptoms: including nasal steroids, antihistamines, such as diphenhydramine, cromolyn sodium, and leukotriene receptor antagonists such as montelukast. Often times, medications do not completely control symptoms and own side effects. Exposing people to larger and larger amounts of allergen, known as allergen immunotherapy (AIT), is often effective. The allergen can be as an injections under the skin or as a tablet under the tongue. Treatment typically lasts three to five years after which benefits may be prolonged.
Allergic rhinitis is the type of allergy that affects the greatest number of people. In Western countries, between 10–30% of people are affected in a given year. It is most common between the ages of twenty and forty. The first precise description is from the 10th century physician Rhazes. Pollen was identified as the cause in by Charles Blackley. In , the mechanism was sure by Clemens von Pirquet. The link with hay came about due to an early (and incorrect) theory that the symptoms were brought about by the smell of new hay.
Allergy testing may reveal the specific allergens to which an individual is sensitive.
Skin testing is the most common method of allergy testing. This may include a patch test to determine if a specific substance is causing the rhinitis, or an intradermal, scratch, or other test.
Less commonly, the suspected allergen is dissolved and dropped onto the lower eyelid as a means of testing for allergies. This test should be done only by a physician, since it can be harmful if done improperly. In some individuals not capable to undergo skin testing (as sure by the doctor), the RAST blood test may be helpful in determining specific allergen sensitivity. Peripheral eosinophilia can be seen in differential leukocyte count.
Allergy testing is not definitive. At times, these tests can reveal positive results for certain allergens that are not actually causing symptoms, and can also not pick up allergens that do cause an individual’s symptoms.
The intradermal allergy test is more sensitive than the skin prick test, but is also more often positive in people that do not own symptoms to that allergen.
Even if a person has negative skin-prick, intradermal and blood tests for allergies, he/she may still own allergic rhinitis, from a local allergy in the nose. This is called local allergic rhinitis. Specialized testing is necessary to diagnose local allergic rhinitis.
Allergic rhinitis may be seasonal, perennial, or episodic. Seasonal allergic rhinitis occurs in specific during pollen seasons.
It does not generally develop until after 6 years of age. Perennial allergic rhinitis occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.
Allergic rhinitis may also be classified as Mild-Intermittent, Moderate-Severe intermittent, Mild-Persistent, and Moderate-Severe Persistent. Intermittent is when the symptoms happen <4 days per week or <4 consecutive weeks. Persistent is when symptoms happen >4 days/week and >4 consecutive weeks. The symptoms are considered mild with normal sleep, no impairment of daily activities, no impairment of work or school, and if symptoms are not troublesome.
Severe symptoms result in sleep disturbance, impairment of daily activities, and impairment of school or work.
Local allergic rhinitis
Local allergic rhinitis is an allergic reaction in the nose to an allergen, without systemic allergies. So skin-prick and blood tests for allergy are negative, but there are IgE antibodies produced in the nose that react to a specific allergen.
Intradermal skin testing may also be negative.
The symptoms of local allergic rhinitis are the same as the symptoms of allergic rhinitis, including symptoms in the eyes. Just as with allergic rhinitis, people can own either seasonal or perennial local allergic rhinitis.
The symptoms of local allergic rhinitis can be mild, moderate, or severe. Local allergic rhinitis is associated with conjunctivitis and asthma.
In one study, about 25% of people with rhinitis had local allergic rhinitis. In several studies, over 40% of people having been diagnosed with nonallergic rhinitis were found to actually own local allergic rhinitis. Steroid nasal sprays and oral antihistamines own been found to be effective for local allergic rhinitis.
As of , local allergenic rhinitis had mostly been investigated in Europe; in the United States, the nasal provocation testing necessary to diagnose the condition was not widely available.
The goal of rhinitis treatment is to prevent or reduce the symptoms caused by the inflammation of affected tissues.
Measures that are effective include avoiding the allergen. Intranasal corticosteroids are the preferred medical treatment for persistent symptoms, with other options if this is not effective. Second line therapies include antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nasal irrigation. Antihistamines by mouth are suitable for occasional use with mild intermittent symptoms.Mite-proof covers, air filters, and withholding certain foods in childhood do not own evidence supporting their effectiveness.
Intranasal corticosteroids are used to control symptoms associated with sneezing, rhinorrhea, itching, and nasal congestion. Steroid nasal sprays are effective and safe, and may be effective without oral antihistamines.
They take several days to act and so must be taken continually for several weeks, as their therapeutic effect builds up with time.
In , a study compared the efficacy of mometasone furoate nasal spray to betamethasone oral tablets for the treatment of people with seasonal allergic rhinitis and found that the two own virtually equivalent effects on nasal symptoms in people.
Systemic steroids such as prednisone tablets and intramuscular triamcinolone acetonide or glucocorticoid (such as betamethasone) injection are effective at reducing nasal inflammation, but their use is limited by their short duration of effect and the side-effects of prolonged steroid therapy.
Allergen immunotherapy (AIT, also termed desensitization) treatment involves istering doses of allergens to accustom the body to substances that are generally harmless (pollen, home dust mites), thereby inducing specific long-term tolerance. Allergen immunotherapy is the only treatment that alters the disease mechanism. Immunotherapy can be istered orally (as sublingual tablets or sublingual drops), or by injections under the skin (subcutaneous).
Subcutaneous immunotherapy is the most common form and has the largest body of evidence supporting its effectiveness.
Antihistamine drugs can be taken orally and nasally to control symptoms such as sneezing, rhinorrhea, itching, and conjunctivitis.
It is best to take oral antihistamine medication before exposure, especially for seasonal allergic rhinitis. In the case of nasal antihistamines love azelastine antihistamine nasal spray, relief from symptoms is experienced within 15 minutes allowing for a more immediate ‘as-needed’ approach to dosage.
There is not enough evidence of antihistamine efficacy as an add-on therapy with nasal steroids in the management of intermittent or persistent allergic rhinitis in children, so its adverse effects and additional costs must be considered.
Ophthalmic antihistamines (such as azelastine in eye drop form and ketotifen) are used for conjunctivitis, while intranasal forms are used mainly for sneezing, rhinorrhea, and nasal pruritus.
Antihistamine drugs can own undesirable side-effects, the most notable one being drowsiness in the case of oral antihistamine tablets.
First-generation antihistamine drugs such as diphenhydramine cause drowsiness, while second- and third-generation antihistamines such as cetirizine and loratadine are less likely to.
Pseudoephedrine is also indicated for vasomotor rhinitis. It is used only when nasal congestion is present and can be used with antihistamines. In the United States, oral decongestants containing pseudoephedrine must be purchased behind the pharmacy counter in an effort to prevent the manufacturing of methamphetamine.
Other measures that may be used second line include: decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies such as nasal irrigation.
Topical decongestants may also be helpful in reducing symptoms such as nasal congestion, but should not be used for endless periods, as stopping them after protracted use can lead to a rebound nasal congestion called rhinitis medicamentosa.
For nocturnal symptoms, intranasal corticosteroids can be combined with nightly oxymetazoline, an adrenergic alpha-agonist, or an antihistamine nasal spray without risk of rhinitis medicamentosa.
Nasal saline irrigation (a practice where salt water is poured into the nostrils), may own benefits in both adults and children in relieving the symptoms of allergic rhinitis and it is unlikely to be associated with adverse effects.
There are no forms of complementary or alternative medicine that are evidence-based for allergic rhinitis. Therapeutic efficacy of alternative treatments such as acupuncture and homeopathy is not supported by available evidence. While some evidence shows that acupuncture is effective for rhinitis, specifically targeting the sphenopalatine ganglion acupoint, these trials are still limited. Overall, the quality of evidence for complementary-alternative medicine is not strong enough to be recommended by the American Academy of Allergy, Asthma and Immunology.
Prevention often focuses on avoiding specific allergens that cause an individual’s symptoms.
These methods include not having pets, not having carpets or upholstered furniture in the home, and keeping the home dry. Specific anti-allergy zippered covers on household items love pillows and mattresses own also proven to be effective in preventing dust mite allergies. Interestingly, studies own shown that growing up on a farm and having numerous older brothers and sisters can decrease an individual’s risk for developing allergic rhinitis.
Signs and symptoms
The characteristic symptoms of allergic rhinitis are: rhinorrhea (excess nasal secretion), itching, sneezing fits, and nasal congestion and obstruction. Characteristic physical findings include conjunctival swelling and erythema, eyelid swelling with Dennie–Morgan folds, lower eyelid venous stasis (rings under the eyes known as «allergic shiners»), swollen nasal turbinates, and middle ear effusion.
There can also be behavioral signs; in order to relieve the irritation or flow of mucus, people may wipe or rub their nose with the palm of their hand in an upward motion: an action known as the «nasal salute» or the «allergic salute».
This may result in a crease running across the nose (or above each nostril if only one side of the nose is wiped at a time), commonly referred to as the «transverse nasal crease», and can lead to permanent physical deformity if repeated enough.
People might also discover that cross-reactivity occurs. For example, people allergic to birch pollen may also discover that they own an allergic reaction to the skin of apples or potatoes. A clear sign of this is the occurrence of an itchy throat after eating an apple or sneezing when peeling potatoes or apples. This occurs because of similarities in the proteins of the pollen and the food. There are numerous cross-reacting substances.
Hay fever is not a true fever, meaning it does not cause a core body temperature in the fever over –°C (–°F).