Cooling temperatures, shorter days and the turning of leaves to bright autumn colors can also bring unwelcomed seasonal allergies, among them ocular allergies that can include irritating symptoms such as red, swollen, or itchy eyes, burning or tearing of the eyes, and an increased sensitivity to light.

According to the American Optometric Association, ocular allergies, or allergic conjunctivitis, is one of the most common ocular surface diseases in primary eyecare. Seasonal allergic conjunctivitis and perennial allergic conjunctivitis alone make up 95 percent of all allergic conjunctivitis in the U.S. Yet allergic conjunctivitis is often unaddressed largely due to its relatively benign nature.

The good news for fall eye allergy sufferers is that prevention and treatment for seasonal allergies is well within reach, even for contact lens wearers, and often can be treated with eye exams and over-the-counter products.

 Elise Kramer, OD.
“It's crucial for ODs and patients to understand that fall allergies are manageable with the right approach. Regular eye exams are essential for early detection and treatment,” said Elise Kramer, OD, Miami Contact Lens Institute. “Staying informed about local pollen counts and allergen triggers can also help individuals take proactive steps to protect their eye health during allergy season. ODs should also proactively treat any dry eye alongside seasonal allergies.”

She continued, “During fall allergies, the most common eye ailments include itchy and red eyes, which are the best-case scenarios because they can usually be managed with over-the-counter antihistamine and or antihistamine/mast cell stabilizer combinations drops. The worst case scenario can range from contact lens intolerance to keratoconjunctivitis or corneal ulceration. Dry eye can exacerbate these issues by increasing inflammation and symptoms. Those with dry eye will have higher exposure to allergens due to tear film-instability.”

Optometrists continue to play a key role in the diagnosis and treatment of eye allergies and also in educating their patients and providing needed guidance during the fall season.

Miriam Korik, OD.

“Optometrists have an important role in educating their patients about allergies and providing guidance on the best care for their eyes. Through patient counseling in the exam room and providing patients with digital resources (information on a practice’s website, and educational videos explaining signs and symptoms), ODs can help patients differentiate between eye allergies and other eye conditions,” said Miriam Korik, OD. “This can aid in early diagnosis and treatment, leading to quicker relief.”

Seasonal allergies can prove especially challenging for the 46 million contact lens wearers in the U.S. With contact lens safety awareness month just around the corner in October, it’s important that these patients receive reminders and resources on how best to deal with seasonal allergies.

“Contact lens wearers may find their lenses become particularly uncomfortable due papillary conjunctivitis, increasing friction between the palpebral conjunctiva and the surface of the contact lens. If not addressed, this can lead to contact lens intolerance,” said Dr. Kramer, a contact lens specialist.

“Allergens can also accumulate on the lenses’ surface, further increasing the allergic reaction. Ultimately, this can lead to further eye inflammation, irritation and increases the risk of infection. Eyeglass wearers, on the other hand, have a physical barrier that helps shield their eyes from some allergens although they can still experience itching and red eyes,” Dr. Kramer said.

According to Dr. Korik, ODs can recommend and prescribe a variety of treatment options to manage ocular allergies including topical over-the-counter drops such as artificial tears to lubricate the ocular surface and help wash out allergens, and topical antihistamine and mast cell stabilizer drops to help alleviate itchiness and prevent histamine release. Other solutions may include prescription therapy such as corticosteroid drops or cyclosporine drops to reduce inflammation; contact lens modification, cool compresses to reduce swelling and inflammation; and eyelid hygiene products to help remove allergens from the lids and lashes.

“Optometrists can remind their patients to come in prior to experiencing symptoms in order to not only treat allergies but also prevent allergic conjunctivitis. Patients should also be encouraged to identify potential allergens and avoid or even eliminate known allergens, if possible,” added Dr. Kramer.

For example, patients might opt to stay indoors on high-pollen days and keep windows closed. Proper hand and eyelid hygiene are also essential. Addressing any concomitant dry eye can help improve symptoms by indirectly improving tear film quality and quantity and decreasing overall inflammation. Wearing wraparound sunglasses outdoors can also help prevent allergens from getting into the eyes.

Elise Kramer, OD, and her son Emmanuel. Image via drelisekramer on Instagram