How to approach the management of seasonal allergies

 

 

Every spring, ophthalmologists typically see a big influx of patients seeking relief from the itching and watery eyes that come with allergies.

Eric D. Donnenfeld, MD, Ophthalmic Consultants of Long Island, Rockville Centre, NY, said the first thing ophthalmologists should do is to be certain that allergic conjunctivitis is the right diagnosis.

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“Sometimes diseases like dry eye can mimic allergy, so you want to make certain what you are dealing with,” Dr. Donnenfeld said. “Allergies usually present as itching, and there may be some systemic component to it as well. It can be a little difficult to diagnose.”

Looking at the pallor of the conjunctiva or presence of pale discharge can point toward allergies, he added. In bad cases, Horner-Trantas dots and papillary changes also can be evident.

 

New diagnostic tool

Dr. Donnenfeld said a new point-of-service testing option that identifies a patient’s allergy is available through Doctor’s Allergy Formula (Bausch & Lomb). This in-office device takes about 3 minutes to use, with results in 15 minutes. It uses a panel of 60 allergens that are specific to each region of the country.

With findings such as these in hand, ophthalmologists can be certain of their diagnosis, as well as help patients maximize the effectiveness of any medications they use. For example, someone who is allergic to pollen might want to dose before going outside. Someone who is allergic to dust mites might be advised to do it before going to bed.

 

Patient education

Education is an essential part of helping patients manage seasonal allergies, said Michael B. Raizman, MD, New England Eye Center, Tufts University, Boston.

“There are many excellent eye drops available, but many patients won’t be satisfied with eye drops alone if we don’t help them reduce their exposure to allergens,” Dr. Raizman said.

The following are clinical tips for limiting patients’ exposure to allergens.

 

Outside exposure

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