DISORDERS Allergies and the Eyes Approximately 22 million people in the US suffer from seasonal itchy, swollen, red eyes. Airborne allergens, such as house dust, animal dander and mold constantly bombard the eyes and can cause ocular allergies at any time. But when spring rolls around and the plant pollen starts flying, it seems like everyone starts crying. Seasonal allergic conjunctivitis, or hay fever, is the most common allergic eye problem. Various antihistamine and decongestant drops and sprays can soothe irritated eyes and nose. Make every effort to avoid allergens. An allergist can help determine what you are allergic to so you can stay away from it. Staying away from outdoor pollen may be impossible, but remaining indoors in the morning when the outdoor pollen levels are highest may help control symptoms. If you are allergic to house dust, open windows and keep household filters clean. Cool compresses decrease swelling and itching. Artificial tears dilute the allergens and form a protective barrier over the surface of the eye. Avoid rubbing the eyes. It makes the symptoms worse. If seasonal allergic conjunctivitis is a problem, see an ophthalmologist. There are several new safe and effective anti-allergy drops that can be prescribed. An ophthalmologist can also make sure symptoms are not being caused by a more serious problem. > Return to top Blepharitis Eyelids are essential to maintaining the health of the cornea. Blepharitis, an inflammatory condition, referred to as granulated eyelids, causes an irritation of the lids that can impact the eye's health. In severe cases, styes, keratitis (inflammation and irritation of the cornea) and conjunctiva (inflammation of the conjunctiva, the outer, clear covering of the sclera) can occur. Blepharitis is a common and usually chronic problem that can be controlled by extra attention to lid hygiene. In some occurrences, if an infection is present, medication may be necessary for treatment. Symptoms of blepharitis can be a itchy, sandy sensation of the eyes, red and/or swollen eyelids, and crusty or flaky skin on the eyelids. A routine examination of the eyelashes and lids can detect the presence of blepharitis. Much like dandruff, there is no cure for blepharitis, but it can be controlled. You can treat blepharitis by soaking a clean washcloth in hot tap water and placing the compress on closed eyelids for five minutes, and then repeating the process. (To warm the compress, you can also place a dampened washcloth in the microwave for 15-20 seconds. Be careful to check the temperature of the washcloth against your hand before applying to the eyelids.) After this first step, gently scrub the eyelids with equal parts baby shampoo and water placed on a cotton swab or washcloth. Thoroughly rinse with warm water. The cleansing of the eyelids should be done two or three times daily for two weeks. In severe cases of blepharitis, anti-inflammatory or antibiotic drops or ointments may be necessary. > Return to top Bullous Keratopathy Bullous keratopathy is a condition caused by edema (swelling) of the cornea, resulting from failure of the delicate, inner corneal layer, known as the endothelium, to remove fluids from the cornea. When the endothelium layer fails, its ability to pump fluids from the cornea are comprised and it cannot maintain clarity in vision, producing a cloudiness. The more fluids retained in the cornea, the more cloudiness increases and swelling occurs, which reduces vision. As the swelling progresses, small blisters known as 'bullae' can form on the corneal surface. These bullae can intermittently rupture causing sharp pain, creating a foreign body sensation in the eye. Bacteria can invade the ruptured bullae and lead to a corneal ulcer. Most frequently, bullous keratopathy occurs due to progressive loss or dystrophy of endothelial cells caused by diseases such as Fuch's dystrophy or by trauma to the endothelium layer. On occasion, damage to the endothelium layer can be due to intraocular surgery (such as cataract surgery) where there is intra- operative or postoperative corneal endothelial trauma caused by a poorly designed or malpositioned intraocular lens implant. Sensation of pain, on-going discomfort after surgery, or continued irritation can be symptomatic of a more serious condition that can impair your vision if left unchecked. Cornea edema and bullae can be seen on examination with your ophthalmologist. Treatment such as dehydrating agents (e.g. hypertonic saline), occasional use of intraocular pressure-lower agents and soft contacts may be recommended. In severe cases, corneal transplantation may be indicated by your ophthalmologist. > Return to top Cicatricial Pemphigoid Cicatricial pemphigoid is an autoimmune disease that predominantly affects individuals in the later decades of life, although it can occur in young adults. The disease is chronic, bilateral (affecting both left and right eyes), progressive in scarring and shrinking of the conjunctiva (the outer, clear covering of the sclera, the white part of the eye) and can develop opacification of the cornea. The cornea's epithelium layer or outer surface is affected in about two-thirds of cases of cicatrical pemphigoid. Small blisters or erosions can form on the epithelium causing scarring that can lead to blindness. Aggressive systematic therapy is pursued to preserve sight, as systematic steroids do not adequately control the disease progression. The primary treatment for cicatrical pemphigoid is oral cyclophosphamide (Cytoxan). Approximately three-fourths of patients who tolerate and are treated with this therapy have clinical remission after medication is discontinued. For patients that cannot tolerate Cytoxan, an alternate therapy of Azathioprine or oral dapsone is used. Immunoflourescent testing (a check for circulating antibodies) for cicatrical pemphigoid can be conducted for detection, although this testing is highly unreliable and can provide negative results. Biopsies may be necessary to obtain accurate testing as this disease can mimic other illnesses and is difficult to diagnose. As with other autoimmune diseases, it is important to have frequent examinations with an ophthalmologist who can monitor your medical history as conditions can progress rapidly and early detection can save your sight. > Return to top Our Practice l Services l Publications l Map & Directions l Contact Us l Privacy Policy Cataracts l Cornea and External Diseases l Corneal Transplants l Refractive Errors Refractive Surgery l Optics All contents © copyright 2002-2004 Corneal Consultants of Colorado, P.C. All rights reserved. Development by Mindshare HDV. Allergies and the Eyes Blepharitis Bullous Keratopathy Cicatricial Pemphigoid Conjunctivitis (Pink Eye) Herpes Simplex Keratitis Herpes Zoster