Itchy eyes, also referred to as ocular pruritis, affect many people and are a common reason for visiting the optometrist. It can be caused by a variety of conditions, including allergies and infection.

Causes

Certain medical conditions can cause itchy eyes, as well as other accompanying symptoms. Some conditions may include:

 

Allergic conjunctivitis

This is the most common cause of itchy eyes. This occurs when the inner membranes covering the eye (the conjunctiva and the cornea) are irritated by an allergen. Some common things of this allergic reaction include:

  • pollen
  • mold
  • grass
  • weeds
  • pet dander
  • dust
  • dust mites
  • irritating substances, such as makeup, lotion, or contact lens solution

Allergic conjunctivitis can be group into:

  1. Atopic keratoconjunctivitis

This is the Inflammation of the cornea and the conjunctiva (the membrane that covers the front of the eye). This is a condition in which a person is genetically predisposed to an abnormal allergic reaction to a specific allergen. People with this medical condition produce higher than average levels of antibodies, and these may affect them all year round.

If the condition is not treated, the following symptoms may occur:

  • ulcers
  • scarring
  • cataracts
  • keratoconus, where the cornea thins and causes a cone-shaped bulge to develop
  • corneal vascularization, where blood vessels grow into the cornea

2. Vernal keratoconjunctivitis (VKC)

This is another condition where the membrane that covers the front of the eye becomes inflamed. The condition affects young boys most often and people with VKC typically present with raised, hard, cobblestone-like bumps on the upper eyelid.

Although commonly a seasonal condition, there are some people who experience VKC all year round. Some individuals who experience severe VKC may go on to develop corneal ulcers and scarring.

 

Pterygium

Pterygium is a wing-shape growth of the conjunctiva tissue (membrane covering the white part of the eye) encroaching upon the cornea from either sides.

 Atopic dermatitis

A form of eczema, this condition results in patches of dry and scaly skin. It can be irritating to the skin surrounding the eye, as well as other parts of the body.

 Dry eye syndrome

When the eye lacks moisture and lubrication, dry eyes can ensue. The eyes are less protected and more sensitive to dust or other airborne particles. This condition can lead to inflammation and scarring. The eyes become pepperish.

 Meibomian gland dysfunction

The Meibomian glands are located in the upper and lower eyelids and are responsible for oil secretion. When these glands are blocked or develop abnormally, tears produced by the eyes will not contain enough of the oil needed to maintain moisture.

 Blepharitis

This is a condition that causes inflammation of the eyelids in response to antigens produced by the staphylococcal bacteria and possibly eyelid mites.

 Contact lens-induced conjunctivitis

Contact lens wearers may at times experience an infection from contact lens use. At times, the cornea can be damaged and become scarred.

 Giant papillary conjunctivitis

This eye condition is often related to an allergic reaction of some sort and may present as large bumps under the eyelids (papillae).

Causes include:

  • VKC
  • atopic keratoconjunctivitis
  • contact lens use
  • artificial eye use
  • exposed sutures

Infectious conjunctivitis

The eyes are not immune to bacterial and viral infections. Some of the common bacteria found in infectious conjunctivitis include:

  • N. gonorrhoeae
  • Neisseria meningitides
  • Streptococcus pneumoniae
  • Haemophilus influenza
  • Staphylococcus aureus
  • Chlamydia trachomatis

Viral infections are fairly common and can be caused by the adenovirus, herpes simplex and herpes zoster.

Other causes

At times, certain medications can cause eye problems and side effects like dry eye. These medications include:

  • birth control pills
  • certain antibiotics such as penicillin
  • over-the-counter pain medications, such as ibuprofen and acetaminophen
  • decongestants including antihistamines
  • beta-blockers
  • antidepressants
  • artificial tears
  • some acne medications

Environmental factors such as prolonged computer use are associated with dry eye syndrome.

Dry eye syndrome, which contributes to itchy eyes, may also be associated with other environmental and medical factors including:

  • computer use
  • normal aging, especially in those over the age of 50
  • menopause
  • environmental factors, such as wind, dry air, air conditioning, smoking, and flying
  • medical conditions, such as diabetes, lupus, rheumatoid arthritis, and incomplete eyelid closure

 

When to see a doctor

Eye problems can sometimes require a medical evaluation by an eye doctor (optometrist), or in some cases a visit to the emergency room. It is recommended that people get urgent medical attention if they experience the following symptoms:

  • severe and continuous itchy
  • severe pain
  • sudden vision loss
  • eye redness with pain
  • visual changes, such as seeing circles around light
  • seeing shadows, cobwebs, or strings
  • sudden blurred vision
  • double vision
  • sudden onset of eye crossing or the appearance of a wandering eye
  • eye bulging
  • eye swelling
  • signs of infection, such as crusting or discharge
  • excessive tearing
  • eyelids sticking together, especially when waking up

 

Treatments

Treatment options for itchy eyes will depend on the cause. Options may include certain treatments and recommendations, such as:

Using a humidifier at home can help regulate moisture in the air and discourage itchy eyes.

  • identifying the cause and avoiding it
  • applying cool or warm compresses
  • maintaining good eye hygiene
  • stopping using contact lenses or using a different type
  • regulating air temperature and moisture
  • using of artificial tears
  • cleaning the eye with a saltwater solution
  • taking antibiotics or other medications
  • using over-the-counter decongestants
  • combining decongestants and antihistamines
  • applying medication to the eyes to increase tear production
  • using oral or nasal antihistamines and mast-cell stabilizers
  • having steroid injections above the upper eyelid

A healthcare provider will discuss recommended treatments based on the condition being treated and the individual’s medical history.

 

Prevention

The prevention of itchy eyes will depend on the root cause of the problem. It is important for people to speak with a healthcare provider to find out about the condition causing the eye problems. The doctor or eye specialist can also advise about any preventive measures that can decrease the frequency or severity of the condition.

There are several steps that people can take to encourage good eye health. People should:

  • Humidify the air in their home if living in a dry area or use dry heat to stay warm in winter.
  • Clean the filters in humidifiers carefully and regularly. Consider a HEPA filter for air cleansing.
  • Change the filters in the air conditioning and heating systems as recommended by the manufacturers.
  • Avoid rubbing their eyes. If their eyes are sore, they should sit down and apply a relaxing cool compress for 10 minutes.
  • Avoid smoke and smoking. Avoid scented candles, which can be irritating to the eyes. Any candle contaminates the air with soot and irritants.
  • Always use hypoallergenic products near their eyes.
  • Follow a healthful diet that includes vitamin A and omega-3 fatty acids.
  • Stay inside when pollen levels are high if they have allergies.
  • Use eye protection if working with anything dusty or sandy. Wearing sunglasses in wind and sun is more than just looking cool.

Strong odors, such as cleaning chemicals, perfumes, scents, or even onions can be irritating, cause inflammation, and provide a raw sore environment perfect for bacteria to land. People should try to avoid these where possible.

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