Itchy eyes are a common problem. The fact that itchy eyes are so common does not necessarily make them any easier to deal with.
Millions of Americans suffer from itchy eyes caused by allergies alone, according to studies cited in the Review of Optometry.
While a number of over-the-counter eye drops are available, the key to finding the right treatment for a specific case is to find out what’s causing it.
Many individuals visit ophthalmologists to find out what’s causing their symptoms and select the best treatment possible for their particular case of itchy eyes.
Sometimes, itchy eyes are caused by seasonal allergies. These can be treated effectively by over-the-counter eye drops with antihistamines and decongestants.
Other cases may be due to bacterial infection and require treatment by prescription anti-bacterial eye drops.
Effective treatment of itchy eyes requires matching the medication to the underlying cause. The following drops are generally available:
- over-the-counter drops, cosmetic purposes only: Visine, Clear Eyes, Refresh Redness
- over-the-counter drops, decongestants only: Visine LR
- over-the-counter drops, decongestants and antihistamines: Opcon-A, Naphcon-A, Visine-A
- prescription eye drops with antihistamines: Lastacaft
- prescription eye drops with mast cell stabilizers: Alomide, Crolom, Alocril
- over the counter, eye drops with antihistamines & mast cell stabilizers: Alaway, Claritin Eye, Visine All Day Eye Itch Relief, Refresh Eye Itch Relief, Zaditor
- prescription eye drops with antihistamines & mast cell stabilizers: Patanol, Pataday
- over-the-counter artificial tears: Refresh, TheraTears, Bion Tears, Visine Tears, GenTeal, Systane, Blink Tears, Murine Tears
- prescription artificial tears: Freshkote
- prescription anti-inflammatory eye drops: Acular LS, Acuvail
- prescription anti-bacterial eye drops: Azasite, Tobrex, Polytrim
- eye drops with steroids: Lotemax, Alrex, Durezol
There are a number of different eye conditions that may cause itchy eyes. These include pink eye, blepharitis, and dry eye.
Pink eye, or conjunctivitis, is a condition where the membrane covering the eye becomes inflamed. It is one of the most common causes of itchy eyes.
There are actually four different kinds of conjunctivitis:
- Viral: Caused by the same virus responsible for the common cold and just as contagious. This form generally goes away on its own in 7-14 days. Artificial tears can relieve symptoms, but severe cases may need prescription-only anti-inflammatory eye drops.
- Bacterial: Highly contagious, caused by bacteria, and marked by large amounts of pus. This form is best treated by prescription-only anti-bacterial eye drops.
- Giant papillary: This form, which affects the inner eyelids, is most often caused by wearing contact lenses.
- Allergic: This form is not contagious, since it is caused by individual reactions to certain substances. Allergies can prompt reactions such as itchiness and inflammation in the eyes, nasal passages, or both.
For allergic conjunctivitis, artificial tears can provide relief from dryness and also help wash the irritant from the individual’s eyes. Refrigerating artificial tears may make them more helpful for allergy sufferers.
Decongestant anti-allergy eye drops are available over the counter. Some of these may contain antihistamines, which can tone down the body’s response to allergens and reduce itchiness overall. These eye drops should only be used for short periods of time.
Other eye drops combine antihistamines, which help relieve allergy symptoms, and mast cell stabilizers. Mast cell stabilizers help to contain allergic reactions, tackle itchy eyes in two different ways, and are considered to be very effective. They are available over the counter and in prescription form.
Eye drops containing steroids are the most effective treatment for some long-term cases of allergic conjunctivitis.
Blepharitis is a condition in which the eyelids are irritated due to a variety of causes, including bacterial infection, dry eyes, and acne rosacea. The condition develops in the skin at the base of the eyelashes.
Blepharitis can cause the eyelids to thicken, promote styes, and lead the eyes to itch, burn, turn red, and develop crusts.
Treatment for this condition may include the use of artificial tears or steroid eye drops.
Dry eye is a condition in which the body does not make enough tears or enough of the right quality to keep the eyes moist and comfortable.
It can be caused by many factors, including:
- over-the-counter and prescription drugs
- changes in hormone levels
- environmental irritants such as smoke
- some autoimmune diseases such as lupus
Stinging or burning eyes, as well as frequent watering of the eyes due to irritation, are common symptoms.
Some over-the-counter eye drops, such as Visine, are only used for cosmetic purposes. In other words, they make the eyes look less red. However, the effects wear off quickly, and individuals tend to re-use them frequently. This can cause rebound problems with redness and inflammation.
Artificial tears are available over the counter. The preservatives used in artificial tears can bother some people, so preservative-free eye drops are recommended for individuals who need to use artificial tears several (more than six) times a day.
According to the American Academy of Ophthalmology, there is no limit to the number of times a day an individual can use preservative-free artificial tears to relieve itchy eyes.
Factors to consider when choosing eye drops
Reviewing these factors can help people and their care providers determine what’s causing a specific case of itchy eyes:
- Did itchiness come on quickly or slowly?
- Do they wear contact lenses?
- Is it seasonal?
- Do the eyes water?
- Do the eyes burn?
- Do they have allergies, asthma, skin rashes, or eczema?
- Does it feel like some object may be stuck in the eye or eyes?
- Do some situations, such as exposure to cats or dogs, or pollen, seem to trigger episodes of itchiness?
- Have they started using any new products, such as soap, make-up, or moisturizing cream, within the past 1-3 days?
When to see a doctor
Itchy eyes usually do not pose a threat to vision. However, they can cause a great deal of pain. They may also make people feel uncomfortable about their physical appearance or reluctant to go outside for fear of allergic reactions.
When itchy eyes interfere with an individual’s quality of life, it’s a good time to see a doctor.
Cases of bacterial conjunctivitis can also sweep through certain environments, such as schools. When exposed individuals develop the condition, it is important for them to seek medical treatment.
It is common for individuals to develop itchy eyes due to seasonal allergies. This fairly mild reaction is called seasonal allergic conjunctivitis, and the more chronic, less mild form is called perennial allergic conjunctivitis.
Neither of those forms of allergic conjunctivitis are usually associated with risks to vision, but other forms are. If an individual develops a severe case of conjunctivitis with a great deal of inflammation and redness in the eyes, seeing a doctor is recommended.
Although artificial tears are available over the counter, it can be difficult for individuals to find the best kind for their specific condition. Different brands are more effective with specific causes of dry eye. Working with a doctor can help people find the treatment that’s best for them.
Written by Danielle Dresden