Ocular pruritis – itchy eyes – is a common complaint. In many cases, itchy eyes can be treated at home, and they will improve in a short time. However, sometimes itchy eyes can be a warning of a problem that could cause damage to your eyes. Knowing the difference, and when to get medical attention is the key to dealing with itchy eyes.
What causes itchy eyes?
The most common cause is an allergic reaction. If you have seasonal allergies, you are probably familiar with this symptom. Blepharitis is another common cause. The word “blepharitis” means irritation or inflammation of the eyelids. There are many eye irritants that can make your eyes itch. The other common cause is infection, which is usually caused by viruses. Bacterial infections are less common but could be more serious.
Allergic conjunctivitis
Allergic conjunctivitis is a red and itchy eye caused by allergy. Conjunctivitis means inflammation of conjunctiva, which is a clear moist membrane that covers and protects the white part of your eye and the undersurface of your eyelid.
Allergic conjunctivitis is caused by exposure to an allergen, which is anything that triggers a reaction from your immune system. If you are one of the 40 percent of people with allergic conjunctivitis, you may have symptoms all year (called perennial allergic conjunctivitis) caused by pet dander or dust mites. If you have seasonal allergic conjunctivitis (often called hay fever), you have symptoms from tree, grass, or weed pollens.
People without allergies do not react to allergens, but people with allergies have an immune system that identifies an allergen as a foreign invader and mounts a defense, which is your allergy symptoms. Allergic conjunctivitis affects both eyes and symptoms can include itching, burning, redness, and a clear watery discharge. Other keys to diagnosing allergic conjunctivitis include:
- Symptoms are only triggered by exposures.
- The reaction includes other allergy symptoms like an itchy, runny nose, and sneezing.
- A cold compress or use of an over-the-counter (OTC) antihistamine or allergy eye drops give quick relief.
- You have other allergies such as asthma or eczema.
Itchy eyelids
The medical term for itchy eyelids is blepharitis which means inflammation or irritation of your eyelids. Like allergic conjunctivitis, blepharitis usually affects both eyes. The most common cause is clogging of tiny oil glands located near the eyelashes. Blepharitis may also be caused by dandruff, a skin disease called rosacea, eyelash mites, or dry eyes.
The key to diagnosing blepaharitis are the symptoms that occur along with itching. They include:
- Redness
- A gritty sensation in the eyes
- Burning
- Red swollen eyelids with a crusty eyelash
- Eyelids that stick together
Eye irritation
Eye irritation is not a single eye diagnosis. It is a broad term that incudes conjunctivitis and blepharitis but also includes many other causes. Depending on the cause, symptoms may include itching along with redness, pain, grittiness, dryness, blurred vision, swelling, and sensitivity to light. Some of the other causes of irritation are:
- A foreign body stuck in the eye like dirt or sand
- A scratch of the outer surface of the eye, called a corneal abrasion
- Blocked tear ducts
- Contact lenses
- Eye strain
- Smoke or smog
- An eye pimple, called a stye
Irritation caused by long-term (chronic) dryness may be related to immune system diseases like rheumatoid arthritis, Sjogren’s syndrome, lupus, or multiple sclerosis.
Infectious conjunctivitis
The most common infection that causes itchy eyes is a viral infection, called viral conjunctivitis or “pink eye.” The viruses that case viral conjunctivitis are usually the same ones that cause common colds, called adenoviruses. Unlike other causes of itching, eye infections are contagious. Viral conjunctivitis usually starts in one eye and spreads to the other eye in a day or two. It usually goes away after several days without treatment.
Symptoms of a viral conjunctivitis include redness and itching. The pink color of the eye is due to swelling of tiny blood vessels. Viral conjunctivitis also causes a watery discharge, but it is thicker than a watering eye. It may cause the eyes to stick together and blur your vision. You may suspect this cause if you have been in close contact with others who have pink eye or a cold.
Bacterial conjunctivitis is much less common than viral but can be more serious and require treatment with antibiotics. The key to bacterial conjunctivitis is that it usually affects just one eye, and the symptoms are more intense. The eye may be painful, gritty, and sensitive to light. Discharge from the eye is thicker and may be discolored (green or yellow).
How to relieve itchy eyes
In most cases, itchy eye can be relieved with home treatment and OTC medications. What works best depends on the cause:
- For allergic conjunctivitis, a cool compress over the eyes is very helpful. OTC meds that may help include oral antihistamines and anti-allergy eye drops. Two eye drops recommended by eye doctors are olopatadine (Pataday) and ketofitin (Alaway, Claritin Eye, and others brand names).
- For blepharitis, a hot compress or eye mask relieves itching. It also helps to clean the eyelids of crusts with an eyelid cleaner called Ocusoft.
- For eye irritation caused by a foreign body, corneal abrasion, blocked tear duct, contact lens, or a stye, you should check in with a healthcare provider.
- For viral conjunctivitis, cold compress and OTC artificial tears may help until the infection clears.
- Bacterial conjunctivitis should be seen by a healthcare provider. It is better not to self- treat with OTC antibiotic drops.
One thing to avoid when you have itchy eyes is rubbing your eyes too frequently and roughly. Although it is a normal reaction to rub your ryes when they hurt or itch, too much rubbing can cause damage to the covering of your pupil, called the cornea. This condition, called keratoconus changes the shape of your cornea and can cause changes in vision. Continually feeling like you have rubbed your eyes is another reason to see a healthcare provider or an eye specialist.
