From your visit
Allergic eyes: what helps, and what makes it worse
Reviewed November 2026 · Dr. Sam Khoury, Optometrist
This page is for patients examined in this office and found to have allergic conjunctivitis, the itchy, watery, red eyes of hay fever and other allergies.
Allergy itches; it does not hurt. Call the same day for pain, light sensitivity, a change in vision, thick discharge, or one eye red and the other not. If you wear contact lenses and an eye is red and sore, take the lens out and call. Call (609) 246-0236. If the office is closed, or you cannot reach us, go to a hospital emergency room — most have an ophthalmologist on call.
Itching is the signature of allergy. Pollen, dust mite, pet dander or mold lands on the surface of the eye, the cells there release histamine, and the eye itches, waters and swells. It is not an infection, it is not contagious, and it is very treatable. The two things that matter most are using the right drop every day through the season, and not rubbing.
Why not to rub
Rubbing feels wonderful for a few seconds and makes everything worse for hours: it squeezes more histamine out of the cells, so the itch returns stronger. Over years, hard rubbing is also one of the strongest known links to keratoconus, a thinning of the cornea, and it is the reason allergic children and teenagers are worth watching. Cold is the substitute: a cold compress, or artificial tears kept in the refrigerator, calms the itch without pressing on the eye.
The drops, and how to use them
- An antihistamine and mast-cell stabilizer drop, over the counter: ketotifen (Zaditor, Alaway) twice a day, or olopatadine (Pataday) once a day. These both relieve the itch within minutes and stop the cells releasing histamine, so they work best used every day through the season, starting a week or two before it, rather than only when the eye itches.
- Chilled preservative-free artificial tears as often as you like, to rinse pollen off the surface and cool the eye.
- Leave the redness-relief drops on the shelf. Drops that promise to get the red out narrow the vessels for a few hours and rebound. Combination allergy drops that contain a decongestant have the same problem.
- Oral antihistamine tablets help the nose and the eyes, but many dry the eye out, which makes the surface more irritable. If you take one and your eyes feel gritty, add the tears.
- A steroid drop, only if it was prescribed, for a short course when the eye is very inflamed. Follow the schedule exactly and stop when it ends. Steroids used longer than prescribed can raise eye pressure and bring on cataract, which is why each course starts with an examination and is never repeated from a leftover bottle.
Contact lenses in allergy season
- Daily disposables are the right lens for allergy: a fresh surface every morning with no pollen or deposits built up on it.
- Drops first, lenses in fifteen minutes later, and the drop again after the lenses come out at night. Most allergy drops are not for use with lenses in.
- Glasses on bad days. A lens on an itchy eye is a lens you will rub.
Reducing what reaches your eyes
- Wraparound sunglasses outdoors in pollen season.
- Windows closed and air conditioning on high-pollen days; a HEPA filter in the bedroom.
- Shower and wash your hair before bed, so pollen does not spend the night on your pillow.
- Wash bedding weekly in hot water for dust mite; keep pets out of the bedroom for dander.
- If allergies are severe or year-round, an allergist can identify the trigger and offer immunotherapy, which treats the cause.
When it is not allergy
Itching with stringy mucus in a child or teenager with eczema or asthma, especially a boy, can be a more intense form of eye allergy that needs prescription treatment and closer follow-up. Burning rather than itching, worse by evening, is usually dry eye. Grittiness with crusted lashes is lid inflammation. Each is treated differently, and if the routine above has not helped within two weeks, that is the reason to come back rather than to add more drops.
Your next visit
Keep the interval set at your exam. Call sooner if the routine above has not helped within two weeks, if a steroid drop was prescribed and you need more, or if anything in the box at the top happens.
Khoury Eye Care, Hamilton Mall, 4403 Black Horse Pike, Mays Landing.
Sources
The figures and recommendations on this page come from the following. Ask at your visit if you would like a copy of any of them.
- American Academy of Ophthalmology. Conjunctivitis Preferred Practice Pattern. 2018.
- Bielory L, Delgado L, Katelaris CH, et al. ICON: diagnosis and management of allergic conjunctivitis. Annals of Allergy, Asthma and Immunology. 2020;124(2):118-134.
- Hashemi H, Heydarian S, Hooshmand E, et al. The prevalence and risk factors for keratoconus: a systematic review and meta-analysis. Cornea. 2020;39(2):263-270.