Red eyes in spring can have many causes. Bacterial or viral infection, pollen allergy, contact lens irritation or dry eye: all can lead to red, watery, uncomfortable eyes. The distinction is important because the treatment is radically different depending on the cause. Putting antibiotic drops in allergic eyes doesn't help, and ignoring infectious conjunctivitis in the hope that it will go away can prolong contamination.
Seasonal allergic conjunctivitis affects around 30 % of people with allergic rhinitis, and is one of the most common eye conditions in spring.
Characteristic signs of allergic conjunctivitis
Allergic conjunctivitis manifests itself as intense itching of the eyes, often the first symptom to be noticed. The eye is red, swollen and watery, with clear, watery secretions. Both eyes are usually affected simultaneously, although one may be more affected than the other. Symptoms almost always accompany other allergic manifestations, such as rhinitis or sneezing.
Symptoms worsen after exposure to allergens, such as a windy outing, lawn mowing or a day with a high pollen count, and improve indoors or after rain. This exposure-related variability is an important diagnostic clue.
How to distinguish infectious conjunctivitis
Bacterial conjunctivitis is characterized by thick, yellow or greenish secretions that stick to the eyelids in the morning. It may initially affect only one eye, before spreading to the second. Itching is less marked than in allergy. Viral conjunctivitis, often associated with a cold or flu, produces clear secretions, but can be highly contagious and is frequently accompanied by adenopathy in front of the ear.
Photophobia, or pain in the face of light, is a sign that deserves special attention. It may indicate deeper involvement than the conjunctiva, such as keratitis or uveitis, and warrants urgent medical consultation.
Treatment options
For allergic conjunctivitis, oral antihistamines reduce ocular and nasal symptoms simultaneously. Antihistamine eye drops, available by prescription or over-the-counter in some formulations, offer faster local relief. Mast cell-stabilizing eye drops, such as cromoglycate, are effective in prevention when used regularly before the start of the pollen season. Cold compresses on the eyelids relieve itching and reduce swelling.
For bacterial conjunctivitis, antibiotic eye drops or ointments are prescribed by prescription. Contact lenses must be removed during treatment.
Frequently asked questions about conjunctivitis
Is allergic conjunctivitis contagious?
No. Allergic conjunctivitis is not contagious, as it has no infectious origin. Viral conjunctivitis, on the other hand, is highly contagious and is easily transmitted by direct or indirect contact with eye secretions.
Can I wear contact lenses if I have allergic conjunctivitis?
Lenses increase pollen accumulation on the ocular surface, often aggravating symptoms. During flare-ups, glasses are preferable. Daily lenses, changed daily, reduce allergen build-up compared with monthly lenses.
Do artificial tears help with allergic conjunctivitis?
Yes, by diluting and rinsing allergens from the ocular surface. Frequently used, preservative-free artificial tears reduce irritation and prolonged contact with allergens. They have no direct anti-inflammatory effect, but are a useful complement to specific treatments.
When to consult a healthcare professional
If you're unsure about the nature of your conjunctivitis, or if you experience eye pain, photophobia, blurred vision or redness that worsens despite treatment, you should seek medical advice without delay.
A physician or specialized nurse practitioner can distinguish between allergic and infectious conjunctivitis, and prescribe the appropriate treatment. A face-to-face or teleconsultation at one of our Omicron Clinic in Quebec gives you quick access.
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