Itchy eyes treatment guide

Itchy Eyes or Dry Eyes?

As the hay fever season sets in, you may find yourself fervently seeking answers as to why your eyes are feeling irritated and uncomfortable...
  • Why are my eyes itchy?
  • How to relieve itchy eyes?
  • Home remedies for itchy eyes?
  • Causes of itchy eyes?
  • Treatment for itchy eyes?

Allergy usually causes mild to moderate symptoms which respond to non-medicated treatment. However, sometimes symptoms can be extremely severe and debilitating with swelling of the eyelids and a sensation of grittiness and burning 🔥

What are allergic eyes?

Allergic eyes, also known as allergic conjunctivitis, is a common condition that occurs when the immune system overreacts to allergens in the environment. This can cause inflammation and irritation of the eyes, leading to symptoms such as itching, redness, swelling, and watering.

What are the causes of allergic eyes?

The most common cause of allergic eyes is exposure to allergens such as pollen, dust mites, pet dander, and mould. Other possible causes include:

  • Seasonal allergies: These are caused by exposure to airborne allergens, such as pollen and dust mites.
  • Perennial allergies: These are caused by exposure to allergens that are present year-round, such as mould and pet dander.
  • Contact allergies: These are caused by direct contact with an allergen, such as cosmetics or jewellery.
  • Atopic dermatitis: A chronic skin condition that can develop on your eyelids and around your eyes, causing itchy skin and red, swollen eyes. 

What are the symptoms of allergic eyes?

The symptoms of allergic eyes can vary from person to person, but they often include:

  • Itching: This is the most common symptom of allergic eyes.
  • Redness: The eyes may become red and bloodshot.
  • Swelling: The eyelids may become swollen.
  • Watering: The eyes may water excessively.
  • Burning: The eyes may feel burning or irritated.
  • Sensitivity to light: The eyes may become sensitive to light.
  • Blurry vision: The vision may become blurry.

How is allergic eyes diagnosed?

Your doctor will typically diagnose allergic eyes based on your medical history and a physical examination. They may also ask you about your exposure to allergens. In some cases, your doctor may order tests such as a skin prick test or blood test to confirm the diagnosis.

Itchy Eye Treatment: First things first

  1. Do not rub or continue rubbing your eyes! This actually makes things worse.
  2. Wash eyes using a gentle eyelid foaming cleanser.
  3. Apply cold compress, such as an ice pack or an ice cube wrapped in a clean cloth. This can help to minimise itchiness
  4. Use preservative free Lubricating Eye DropsThis helps to flush away the allergens and dilute inflammatory molecules mediating the allergic reaction.
  5. Identifying and removing the cause of the allergy, if possible. HEPA filters are worth trying if avoidance is difficult.

💡 Symptoms can sometimes be extremely severe and debilitating and require medication and treatment!

Next Step: Anti-Allergy eye drops

Using these approximately a week before the expected allergy season may help reduce the symptoms associated with eye allergies. 

Dual Action Agents: Anti-Histamine & Mast Cell Stabilisers

  • Zaditen Unit Dose (OTC) 
    Ketotifen fumarate 0.025%, ✅ preservative-free, use twice a day
  • Eyezep (OTC) 
    Azelastine 0.05% but contains BAK, one drop in each eye twice daily
  • Patanol (Prescription Only) 
    Olopatadine hydrochloride 0.1% but contains BAK, use twice a day. Treatment may be maintained for up to 14 weeks, if considered necessary.
  • Alaway Unit Dose 
    Ketotifen fumarate 0.025%, ✅ preservative-free, use twice a day.
  • Pataday 
    Olopatadine 0.2% but contains BAK, 1 drop in each eye once daily.
    Only available for over-the-counter sale in the United States of America.

Mast Cell Stabilisers

Generally they can take 3-7 days to show an effect, they should be used to prevent symptoms before they occur and can be used as long as necessary.

  • Cromo-Fresh (OTC) 
    Sodium Cromoglycate 2%, preservative-free, 1-2 drops in each eye 4-6 times daily and then 1-2 drops twice a day as maintenance


Ask you doctor before use if you are trying to become pregnant or wish to breastfeed

  • Zyrtec Levocabastine (OTC)
    Contains BAK, one drop in each eye, twice daily 

💡 Do not use anti-allergy eye drops that contain the preservative benzalkonium chloride (BAK) while wearing contact lenses. BAK may form deposits and cause discoloration to soft contact lenses

💡 You may feel a slight burning sensation in the eye shortly after using the eye drops

Next Step: Oral Anti-Histamines

When avoidance measures become challenging, oral antihistamines can assist individuals. They are particularly beneficial for those experiencing rhinitis at the same time, as they reduce hives and mucosal congestion. Moreover, they offer the advantage of reaching deeper into orbital structures, which may be difficult for anti-allergy eye drops to achieve, such as addressing eyelid swelling.

  • Zyrtec 
    Cetirizine hydrochloride, 1 tablet every 24 hours as necessary
  • Telfast 
    Fexofenadine hydrochloride, 1 tablet every 24 hours as necessary
  • Claratyne
    Loratadine, 1 tablet every 24 hours as necessary

💡 All oral anti-histamines have anti-cholinergic effects to some degree - side effects such as dry mouth, dry eyes and tachycardia.

💡 Seek medical advice before doing so!

Severe Allergy: Steroid eye drops*

Steroid eye drops are only used in severe cases for short term quick and effective inflammatory control before transitioning to the usual anti-allergy eye drops (above) for long term management

  • Fluorometholone Alcohol 0.1%
    • Pulse dosage: 4 times a day for 48 hours, then 2 times a day for 24 hours then once a day for 24 hours then STOP
    • Concurrently giving anti-allergy eye drops!

💡 They should only be used short term and ONLY under medical supervision

Subscribe to Aelo Newsletter