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March 25, 2003


Contact Lens Wearers Who Are Allergy-Prone Can Be Helped, Says Emory Eye Center Specialist

ATLANTA -- Contact lenses wearers who suffer from seasonal allergies can take heart. A few timely measures may enable them to wear their lenses through the spring.

Estimates say that some 20 percent of the population suffers from allergic conjunctivitis (red, inflamed eye due to allergy). This discomfort and disruption in their daily lives can cause down time at work and discomfort during their leisure activities. Many a tennis match has had to stop in the spring or fall because of a contact lens problem due to pollen.

"Ocular allergy is a problem we see a lot of at this time of year," says Michael Ward, contact lens clinic director at the Emory Eye Center. "Because of the enhanced lifestyle afforded by lenses, patients still want to be able to wear them, even through their allergy-prone times."

Ocular allergy may be seasonal, perennial or skin contact allergies. "We see an increase in allergic conjunctivitis among contact lens wearers seasonally, mostly fall and spring. Our beautiful springtime in the South brings with it an abundant amount of pollens," he says.

The pollens create both physical and allergic challenges for contact lens wearers. "The familiar yellow pine pollen that covers our windows and cars, also coats our skin and eyes," says Ward. "It enters the tear film and gets circulated over, under and in our contact lenses. To the contact lens wearer it acts and feels like liquid sandpaper as it is carried away by our tears. The pine pollen is more of a physical irritant than an immunologic stimulus. It is the smaller pollens that tend to cause allergic reactions."

Most people who have allergies developed them in childhood. The causes may be many -- and sometimes from a combination of sources. They can be environmental (food, dust, etc.), genetic, caused by medications, or by contact with skin or eyes.

For eyes, the allergy usually affects the conjunctiva, the transparent mucous membrane that lines the inner surfaces of the eyelids and covers the sclera (white part of the eye), except at the cornea (front clear covering over the pupil area).

Types of allergies that impact the eyes and those wearing contact lenses include the following:

- An "acute allergic conjunctivitis" is the most common of the allergies, occurring suddenly. The eyes become red, the lids become swollen, and watering and tearing begin. Often this all clears up once the offending allergen is removed. Many people experience this phenomenon when confronted with cat dander.

- Others include seasonal ("hay fever") which is evidenced by the allergic runny nose occurring whenever the offending pollen is in bloom. Seasonal allergy's symptoms are less profound than that of the "acute" type.

- Chronic or perennial allergic conjunctivitis can occur year-round, as it is triggered by environmental allergens such as dust, mites and animal dander which can be present year-round in the home.

Allergic conjunctivitis, which includes the three types of allergy mentioned above, can be treated by avoiding the allergen, first and foremost. Beyond that, managing one's environment which can include the use of air conditioning, filtration devices, bedding products that reduce exposure to allergens, such as pillow and mattress coverings, and general good housekeeping can help greatly.

Often, keeping dust, dander, and mold at bay helps symptoms clear up. At times, the pets may need to be put outdoors or in a separate area of the house.

"Microfiber central air filters that carry the American Lung Association approval can help significantly in reducing indoor, airborne contaminants," says Ward. He suggests that during heavy pollen season contact lens wearers may use goggles or remove contact lenses while engaging in such activities as mowing a lawn. "Preservative-free artificial tears can be quite helpful in diluting and flushing out the pollen-laden tear film. We do not recommend the use of 'get-the-red-out' eye drops due to concern about vascular rebound," he says.

Other measures may include reducing the wearing time of the contacts, replacing disposable contacts more often during the offending seasons, and specific medications that may allow contact lens wearers to continue wearing their contacts. These may include anti-inflammatory drugs and antihistamines.

Ward cautions against the use of oral antihistamines because they can be problematic for some contact lens wearers, since the drugs may cause ocular dryness and exacerbate the pre-existing dry eye disease. Prescription medications containing ocular anti-inflammatory and antihistamine drugs may offer further relief if indicated.

"One simple method to relieve ocular itching is to rinse the face and eyes with fresh cold water. Additional benefit can be achieved by using a cold compress: put ice cubes inside a wet wash cloth and hold over the closed eyes," says Ward.

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