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How to treat itchy eyes

When this allergy symptom hits, you need fast relief. Here’s where to turn.

If you’ve ever experienced dry, red, burning, itchy, or watery eyes, you know you need fast relief when this allergy symptom hits. Thankfully, there are many effective treatments. In fact, there are so many options that it can be overwhelming to narrow it down to the best allergy medicine for itchy eyes. Here, learn what your options are, along with expert advice on how to pick the most effective itchy eye medication for you.

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What causes itchy eyes?

Allergic conjunctivitis is the most common cause of itchy eyes, according to Jovi Boparai, MD, an ophthalmic surgeon in the U.S. Department of Veterans Affairs, and co-founder of CorneaCare. Additionally, there are several health conditions that can cause itchy eyes, including viral conjunctivitis (pink eye), blepharitis (eyelid inflammation), meibomian gland dysfunction (dysfunction of the eyelid oil glands), and corneal infections. However, these are less common.

“Itchy eyes occur because of a chemical called histamine,” says Dr. Boparai. Along with itching, other symptoms include burning, swollen eyelids, swelling of the white part of the eye, redness of the eye and eyelids, foreign body sensation, light sensitivity, watery discharge, and blurry vision.”

Common allergens that trigger these telltale symptoms are:

  • Pollen from grasses, flowers, ragweed, and trees
  • Pet dander and hair 
  • Indoor and outdoor mold
  • Dust mites 

Allergic conjunctivitis can makes eyes particularly itchy in the corners. According to Dr. Boparai, this is likely because the part of your eye where your tears drain is located close to your nose, near the corners of your eyes. “As the histamine is released into the eye and tear film, your eyes will naturally move the tears to the nasal corner of your eyes, causing a buildup of histamine there, leading to itching,” Dr. Boparai explains.

Allergic conjunctivitis affects nearly 40% of the population, tends to be seasonal, and affects most people during allergy season. The good news is that complications are rare and the condition isn’t life-threatening. Itchy eyes can have a strong impact on a person’s quality of life. This type of itchy eye is best treated with allergy medication.

RELATED: Pink eye vs. allergies

Best allergy medicine for itchy eyes

Most of the medications used to treat eye allergies are topical, in the form of eye drops—but oral allergy medications can also be used. 

Everyone is different and some treatments work better than others. Your primary care physician is a good first step. They will examine you and will suggest well-liked effective medications. If your eye symptoms do not get better, you can meet with an eye doctor, either an optometrist or ophthalmologis

Let’s take a look at the most commonly suggested allergies for itchy eyes, how they work, and some examples of these medications.

Decongestant eye drops

Decongestant eye drops are the first line of defense when it comes to treating itchy eyes caused by seasonal allergies, according to the American Academy of Ophthalmology. These medications are a topical vasoconstrictor, which means they work by narrowing the blood vessels in the eyes to reduce eye irritation and redness. They can be found over-the-counter (OTC), often combined with an antihistamine. They usually relieve symptoms quickly and need to be administered about four times a day.

Some common decongestant eye drops available over the counter include:

Side effects

Some eye specialists don’t recommend decongestant eye drops for itchy eyes because of potential side effects. “Decongestant eye drops can lead to worsening redness and injury to the ocular surface,” says Dr. Boparai. If you do use this treatment, it’s best to keep it short term. It’s with long-term use that most side effects occur. 

Antihistamine eye drops and mast cell stabilizers

The second and third most recommended treatments for itchy eyes caused by seasonal allergies are antihistamines and mast cell stabilizer drops, according to the American Academy of Ophthalmology. These two medications are often combined into one eye solution. Antihistamines decrease allergy symptoms by blocking histamine receptors in the eye. Mast cell stabilizers also prevent the release of histamine and other chemicals released during allergic reactions. So, both of these components decrease itchy eyes at the source, blocking the allergic reaction from flaring.

Examples of combination antihistamine/mast cell stabilizer eye drops include:

Elestat must be prescribed by a healthcare provider, the rest are available over the counter.

Side effects

Antihistamine/mast cell stabilizers are helpful when you aree symptomatic, but shouldn’t be used preventively. “Antihistamine/mast cell stabilizer eye drops contain preservatives that are not gentle on the ocular surface, and if used long-term, can lead to dry eyes,” says Dr. Boparai. If you develop dry eyes while using them, artificial tears be used alongside antihistamine/mast cell stabilizers to decrease the dryness.

Oral antihistamines

Oral antihistamines treat allergy symptoms by blocking the release of histamine throughout the body. While they aren’t used as a first-line treatment for itchy eyes, they work well if you have other signs of allergies: itchy skin, sneezing, and a runny nose. Oral antihistamines work most effectively when used before your allergic reason begins.

You might be wondering if one oral antihistamine is better than another when it comes to treating itchy eyes. Does Zyrtec help with itchy eyes? What about Allegra or Claritin—is one better than the other? According to Dr. Boparai, it really depends on the individual. “Any of the commonly used anti-allergy oral pills may provide relief for itchy eyes,” he says. “Most patients must try a few before they find the right one.”

Some common oral antihistamines for the treatment of itchy eyes include:

All of these medications are available over the counter.

Side effects

The problem with oral antihistamines is that they can dry you out. “This creates a situation where there are not enough tears to wash allergens out of the eyes and as a consequence, oral allergy medications often make the eyes dryer and itchier,” says Thomas J. Stokkermans, OD, Ph.D., an optometrist and medical writer and reviewer for All About Vision. He recommends  using preservative-free artificial tears while taking oral antihistamines.

Anti-inflammatory eye drops 

When your eyes become irritated as a result of allergic conjunctivitis, you may experience inflammation, redness, dryness, and itchiness. That’s why anti-inflammatory eye drops are often recommended. There are  two types of anti-inflammatory eye drops: NSAID eye drops, which need to be used about four times a day, and corticosteroid eye drops, which should only be used for two weeks or less.

Some common anti-inflammatory eye drops include:

Acular is available over the counter. Alrex and Lotemax are prescription-only.

Side effects

There are a few side effects to watch for if you are using anti-inflammatory allergy eye drops. For NSAID eye drops, the most common side effects include burning or stinging. Contact your provider if this happens; they may be able to recommend a different brand or medication type. Long-term corticosteroid eye drops can cause infections, cataracts, and glaucoma, which is why it’s recommended to use these medications for less than two weeks. Not all eye drops are safe to use with contact lenses, so discuss potential interactions with your eye doctor to find the best eye drops for you. 

Artificial tears

Artificial tears can help with allergic itchy eyes in two ways. First, they  wash the allergens out of your eyes. Secondly, they moisten your eyes, which reduces redness and dryness, both of which can make your eyes feel itchy. “The reason is that patients may be on oral allergy medications, which makes the eye dry and less able to wash allergens out of the eye,” Dr. Stokkermans says. 

Some common over-the-counter artificial tear brands include:

Side effects

Artificial tears are usually well tolerated, but it’s possible to have an allergic reaction to these products. Symptoms include skin rash, shortness of breath, wheezing, and runny nose. Contact your healthcare provider right away if you experience these symptoms. Our experts also recommend only using preservative-free artificial tears. 

How to prevent itchy eyes

While medications can treat irritated eyes, preventing the irritation in the first place is always best. Options to prevent allergy symptoms include:

  • Minimize your allergen exposure.
  • Do not rub your eyes.
  • Wash your hands frequently with mild soap and water.
  • Wear sunglasses to reduce allergens from entering your eyes.
  • Wash bed linens frequently (especially the pillow case) and/or using allergen covers.
  • Vacuum pet hair frequently
  • Use HEPA filters to reduce indoor allergens

When to see a doctor

Itchy eyes are usually caused by allergies and are not something to be worried about. But in rare cases, itchy eyes may be a sign of a more serious condition. “Developing eye pain, blurry vision, mucoid discharge, light sensitivity, worsening eyelid redness and swelling, and worsening eye redness should prompt a visit to the eye doctor,” Dr. Boparai says.

Even if your symptoms are simply caused by allergies, itchy eyes are often disruptive to your life and uncomfortable. If your symptoms are seasonal, they will go away once allergy season ends, but that can be several months. Don’t hesitate to reach out to your primary care provider, eye doctor, or allergist to discuss options for relieving your symptoms.