For some people, dry eye pain is increased and complicated by eye allergies. Standard allergies that affect one's eyes can include allergies to house dust, mold and mildew, cat dander, smoke, and much more.
In addition, some people have a mild or strong adverse reaction to particular substances, such as cleaning chemicals. This reaction might or might not be an allergic reaction per se, but can cause a great deal of discomfort all the same.
Unfortunately, people with eye allergies are often allergic to many of the artificial tears or other lubricants used for dry eye. Doctors unaware of this problem might recommend that you use products that, in fact, make your dry eyes feel worse rather than better.
This Web page includes information about the following topics for people with both dry and allergic eyes:
- Avoiding allergens — including many eye drops!
- Allergic reactions to eyelid compresses
- Baking soda solution to wash face
- Aloe vera "lotion"
- Non-allergenic shampoo and lotion
- Chemically sensitive products or hair salon
- Non-preserved eyedrops carried in sandwich bags
- Non-allergenic methods for housecleaning
- Products safe for people with asthma and allergies
- Heating and air conditioning systems
- Humidifiers and air cleaners
- Window coverings
- Cloth surfaces that cannot be washed
- Washable visor
- Cataract surgery
Allergic or sensitive responses vary widely from one individual to another. For this reason, the information on this page might or might not be relevant to your situation. You must discover what affects you, and you and your doctor must decide what strategies might help alleviate your response to substances that make your dry eye pain worse.
Because many allergy medicines, both eye drops and oral, can cause or worsen dry eye, you might find that you cannot use medication to suppress allergic reactions but instead must try to avoid allergens. Therefore, you might find it helpful to avoid some or all of the following:
- Avoid over-the-counter or prescription eye drops for eye allergies (often used for eye irritation due to seasonal allergies). Many of these eye drops cause or increase dry eye. Search Google.com for "[name of eye drop] side effects" to see if the drop you want to use causes dry eye. Many over-the-counter oral allergy medicines also cause dry eye.
- Avoid eye drops or artificial tears that contain preservatives. One
example of a preservative that can cause an allergic reaction is
thimersal, but there are many more.
Caution It is important to understand that it is possible to use a new eyedrop or eye ointment successfully for 2 or 3 weeks — and then develop an allergic reaction to it.
Tip! If most eye drops, artificial tears, ointments and gels hurt your eyes, try Refresh Lubricant Eye Drops (not to be confused with Refresh Plus, which contains carboxylmethylcellulose, an ingredient in many eye drops that some eyes cannot tolerate). Refresh Lubricant Eye Drops contain polyvinyl alcohol and povidone, and can be used by more people than Refresh Plus and many other eye drops. Refresh Lubricant Eye Drops are available at MedShopExpress.com or at Drugstore.com.
- Avoid vaseline, mineral oil, and lanolin, including antibiotic eye ointments that contain these ingredients.
- Avoid make-up, hairspray, perfumes, "air freshioners," and any lotions, creams, soap, or shampoo that contain fragrance or dyes.
- Avoid aromatic oils and incense.
- Avoid powders, especially fine powders, such as talcum powder, powdered spices, powdered laundry detergent, and cleaning powders.
- Avoid liquid cleaners that contain fragrance, dyes, or other allergens, such as many types of dishwasher liquid or laundry detergent. Avoid bleach, ammonia, and other harsh liquid cleaners.
- Avoid car exhaust and gas fumes (at gas pump). Diesal fumes might be especially toxic to your eyes.
- Avoid old buildings with dirty heating and air conditioning ducts.
- Avoid indoor and outdoor pollution.
- Avoid sleep masks (used to block out light) that cannot be washed. One that you can wash, and that you store in the refrigerator to keep it cool, is available at OscarDehn.com. Click the Therapy for Travelers link. Get the Eye Travel mask, not the one that contains aromatic oils. Clean it with rubbing alcohol or with baking soda. Do not freeze this eye mask, and do not put it in the microwave.
People with blepharitis or meibomianitis are often told to use a warm compress to loosen crusts on their eyelids, massage the lids to express oil from the meibomian glands, and then vigorously scrub the edges of the eyelids (where the eyelashes emerge from the eyelids) with a commercial lid scrub, or with a cotton swab or cotton ball dipped in diluted baby shampoo (one part baby shampoo to 10 parts water), or dipped in mineral oil. In some cases, one then applies a topical antibiotic ointment to the lids. This regimen can be problematical for someone with allergic eyes in one or more of the following ways:
- If the washcloth is not completely clean or if it contains the residue of a detergent that contains perfume, your eyes might react painfully.
- You might be allergic to the agent used to bleach the cotton on the cotton swab or cotton ball, or your dry eyes might not be able to wash out tiny fragments of cotton that get onto your eyelid or into your eye.
- You might be allergic to a commercial lid scrub.
- You might be allergic to baby shampoo.
- You might be allergic to mineral oil.
- You might be allergic to the antibiotic ointment. Typically, ointments
for dry eye contain either petroleum jelly (vaseline), mineral oil, or
lanolin, and some people are allergic to one or all of those.
If you use ointment Note that ointment allergy is now sometimes ameliorated by adding a steroid to the ointment — check with your doctor or pharmacist about obtaining this type of antibiotic ointment.
- You might be allergic to all of the above.
- If you have both dry and allergic eyes, "vigorously" scrubbing the edges of your eyelids with anything might leave your eyelids sore for hours.
What can you do? See What eyelid compresses can I try for blepharitis or meibomianitis? on the Vitamins & Compresses page, and ask your doctor if any of the compresses described there (such as the baking soda compress or boric acid compress) are safe and appropriate for you.
If you get allergens on your face and eyes and don't want to wash near your eyes with soap, dissolve 1 teaspoon of baking soda (not baking powder) in one or two cups of lukewarm water. Standing over a sink, close your eyes, and then either splash the baking-soda water solution onto your face and eyelids, or dip a lint-free tissue into the water and pat your face and eyelids with the tissue. With your eyes still closed, rinse the baking-soda water off your face either by splashing water from the tap onto your face, or by using tap water to wet another lint-free tissue and wipe your face off with the tissue. Be sure to rinse all the baking-soda water off your eyelids before you open your eyes. (For where to get lint-free tissues, see Lint-free tissues.)
Do not scrub your face or eyelids with baking soda. Be sure to use just a little baking soda dissolved in a lot of water.
If you are allergic to lotions and creams but have dry skin, after washing your face or hands, apply aloe vera gel. Use only 99% pure, fragrance-free, clear, non-mentholated aloe vera gel (available, for example, in Seattle at Trader Joe's stores).
If you have an allergic or sensitive reaction to shampoos, skin lotions, and similar products, and find that even some products advertised as fragrance-free and dye-free still hurt your eyes, one company that produces products formulated to avoid all dyes, fragrances, parabens, lanolin, and formaldehyde is the following:
Pharmaceutical Specialties, Inc.
P.O. Box 6298
Rochester, Minnesota 55903-6298
1-800-325-8232 or 1-507-288-8500
Another option is to wash your hair with baking soda (not baking powder).
Whether using hypoallergenic shampoo or baking soda to wash your hair, if you also have severe dry eyes as well as allergic eyes, try washing your hair in the shower while wearing swimming goggles, such as the Seal Swim Mask described on the Moisture Chamber Glasses & Goggles) page.
Products designed for chemically sensitive people are also often useful for people with eye allergies. One Web site that lists such products is Unscented or Mildly Scented Products, or search Google.com for "unscented soap", "unscented shampoo", or whatever it is that you are looking for.
Look in the yellow pages for your city to see if there are any hair salons that cater to chemically sensitive people. Even if you are not chemically sensitive, this type of salon will be easier on your eye allergies.
If you are allergic to preservatives used in eyedrops, use single-use artificial tears such as Refresh Lubricant Eye Drops (available at MedShopExpress.com or at Drugstore.com). To keep single-use artificial tear containers clean, put a handful of them in a sandwich bag before putting them in your pocket or purse.
If standard cleaning powders and chemicals hurt your eyes, try the following:
- Kitchen and bathroom Use a cup of baking soda or vinegar dissolved in a half bucket of water. Vinegar will probably not hurt your eyes from an allergic point of view, but to prevent it from stinging dry eyes, wear goggles while cleaning (see, for example, the safety goggles described on the Moisture Chamber Glasses & Goggles) page.
- Counters and dusting Use rubbing alcohol (99% is best) to clean counters and to dust plastic, metal, and other surfaces that won't be harmed by alchohol. If you are allergic to mold and mildew, rubbing alcohol is handy because it evaporates without leaving moisture. If you are allergic to house dust, never use a feather duster, because that spreads dust throughout the air — and into your face and eyes.
- Vacuuming Use vacuum cleaner bags with hypoallergenic filters. Some vacuum cleaners, such as the Miele, come with multiple filters, including a HEPA filter. If you are allergic to house dust, try to vacuum right before you wash your hair.
Products recommended for people with asthma and/or allergies are available from a variety of sources. Here are three:
- Allergy Asthma Technology, phone number 1-800-621-5545.
- Allergy Control Products, phone number 1-800-422-3878.
- Allergy Be Gone, phone number 1-866-234-6630.
This type of company carries mattress and pillow protectors that shield you from dust mites, which thrive in pillows, mattresses, and box springs.
- Buy a washable hyperallergenic pillow and enclose it in a pillow protector that protects you from dustmites.
- Or, instead of using a pillow, use a clean towel or old sweatshirt enclosed in a pillowcase. That way, you can wash the "pillow" instead of having to protect yourself from it.
- If you get frequent eye infections or styes, launder the pillowcase often, using a fragrance-free detergent. If necessary, run the pillowcase through an extra rinse cycle to be sure to wash out all of the detergent.
- If you have a cat, put a fresh pillowcase on each day just before you get into bed.
In an asthma products catalog, you can also find furnace and air conditioning filters, as well as non-allergenic shampoo, lotions, laundry detergent, dishwashing liquid, spray cleaners, spray automotive cleaners, and many other products.
If you are allergic to house dust, mold, mildew, or cats, have the heating ⁄air conditioning system in your house cleaned at least once a year. See entries for "Air Conditioning Systems–Cleaning" or "Ventilation Systems–Cleaning" in the Yellow Pages.
If air movement, even when the air is clean, hurts your eyes, wear moisture chamber glasses or goggles (see Moisture Chamber Glasses & Goggles). For the room where you spend the most time, you can seal off the main heating system and buy a stand-alone radiator from a hardware or department store. A radiator heats the room with no air movement. Locate it far enough away from you that it cannot "bake" your dry eyes.
Another option is to use a plug-in flat-panel heater near the desk or chair where you sit most often (search for "under-desk heater" in Google.com).
A more comprehensive and more esthetic solution is to install Econo-Heat electric wall-mounted panels in one room or throughout your home. These economical panels provide clean heat, providing gentle circulation of warm air without the use of a fan. For more information, see their website at Eheat.us. For a source in England, see Slimheat.com.
In a car, whenever possible, avoid turning on the air conditioning or the heat. Open the windows if it is hot; wear a coat and gloves if it is cold.
Humidifiers are often recommended for people with dry eyes. However, if your eyes are also allergic, a humidifier that is not kept clean can add allergens to the air, and it can promote the growth of mold and mildew. Many humidiers must be cleaned with bleach, which can burn dry eyes. If you do use bleach, wear safety goggles or other goggles to protect your eyes (see the Moisture Chamber Glasses & Goggles page). One type of humidifier, which we have not tested yet but which might help, is the "Germ-Free Humidifier," which you can find by searching DrugStore.com or Google.com.
Air cleaners, such as those with HEPA filters, are often recommended for people with allergies. However, these cleaners cause air movement that can cause dry eye pain. One air cleaner that may cause less air movement than the HEPA cleaners is the Ionic Breeze GP Silent Air Purifier with Ultraviolet Germicidal Protection, which you can find by searching SharperImage.com. If the air movement does dry out your eyes, consider wearing moisture chamber glasses or goggles while running the air cleaner.
Despite the ominous-sounding name, the Chem-Dry method of carpet cleaning is often preferred by people with allergies because it is both non-toxic and, unlike steam cleaning (which might in some cases foster the development of mold or mildew), dries quickly.
If possible, remove carpets altogether. If you use area rugs, make sure they are machine-washable.
Curtains can be a repository for dust and animal dander. Use easy-to-clean blinds or curtains that are easy to remove and that can be washed in hot water.
Don't buy (or, at least, avoid) upholstered furniture, fabric-covered office chairs, cloth knick-knacks, and anything else that can't be washed. If you must use such furniture, you might be able to clean it by wiping it down with 99% rubbing alcohol.
Many people with dry eye suffer from photophobia — light, especially bright sunlight, hurts their eyes. In addition to wearing sunglasses or tinted lenses in your prescription glasses or sport goggles, you can wear a sun visor. If you have eye allergies, however, you need a sun visor that is washable. You can order a washable, adjustable, affordable sun visor in a wide variety of colors from WalkersHatShop.com, or call them at 1-888-448-4767. They have styles for men as well as for women.
Another good reason to wear a sun visor if you have eye allergies is because suntan lotion probably hurts your eyes.
Here are some strategies for co-existing with a cat for a person with eye allergies :
- Try not to let the cat near your face, especially your eyes. Do not kiss your cat. If you do kiss your cat, wash your face, neck, hands, and arms with fragrance-free soap or with a little baking soda dissolved in a cup or two of water.
- Use only machine-washable bedding for yourself, and wash it often (twice a week or more) in hot water. Use fragrance-free detergent.
- Use only machine-washable bedding for your cat (such as old towels), and wash it often (twice a week or more) in hot water. Use fragrance-free detergent.
- Cover any furniture that the cat uses with a towel or sheet, don't sit on that furniture yourself, and wash the towels/sheets often (twice a week or more).
- Put a clean pillowcase on your pillow each night just before you get into bed.
- Have the carpets cleaned once every three months.
- Wash your hands each time you pet your cat, or wear powder-free,
hypo-allergenic disposable gloves. Some grocery stores carry
powder-free gloves, such as Aladan Gold/Neutraderm. Alternatively,
you can order disposable gloves over the Internet from
or search Google.com for "disposable
medical gloves." Throw the gloves
away immediately after petting the cat, because you can develop an allergy
to the gloves themselves if you wear them for too long at any one time.
Powder-free Be sure the gloves are powder-free. If you have allergies, you are probably allergic to the powder in "lightly-powdered" gloves.
- Save the cardboard core of paper towels and use these cores to pet your cat. You can also gently stroke the cat with the eraser end of a pencil — most cats think an eraser feels like a mother's tongue, so they especially like it. If your cat likes this, keep a pencil handy at your desk or computer, so that you can use it to "pet" the cat whenever he or she decides to interrupt your work.
- Keep a large supply of oversize T-shirts or loose old shirts. When you want to pick up your cat, put one of those shirts on over what you are wearing, pick up the cat, and then take the shirt off and toss it in the laundry after you put the cat back down. Wash your arms and face with baking soda.
- Make large, stable perches at two or more windows for your cat to lie on to watch the outdoors. These perches should be at least several feet away from where you usually sit.
- If you have a safe yard, install a cat door in a door or window leading to the backyard. Teach the cat to avoid cars and other machinery (even though you will, of course, try to ensure that the cat never comes in contact with cars or machinery), and how to get down from a tree. If your cat or kitten is not familiar with the outdoors, for the first six to nine months, go outside with the cat one hour each day, and follow the cat around to protect him or her and teach him ⁄her what to do. Only after that "training" period should you let the cat go outside by itself. Take a lightweight campstool and something to read when you go outside with a cat older than a kitten — much of its outdoor adventuring will consist of sitting around or lying down.
- If you don't have a tree in the yard, plant one. The cat should always have both a tree and the cat door available to go to in case of emergency. Some cats prefer to live outdoors 24 hours a day during warm months, even taking their meals outside if you will cooperate. This, obviously, helps minimize the amount of cat fur and cat dander in your home. Of course, cats should never be forced to stay outside against their will or in a yard without a tree.
- At least once a week, discard the entire contents of the cat box and replace with fresh, dust-free and fragrance-free litter. Use disposable gloves, or wash your hands with baking soda after changing the cat box. If dust from the dirty or fresh litter gets onto your face, wash your face and eyelids with a solution of one teaspoon baking soda dissolved in a cup or two of water. Try to time your schedule so that you change the cat litter right before you shower and wash your hair.
- If possible, hire someone to groom the cat every 3 months or so. Ask them to use a non-allergenic cat shampoo and not to put baby powder or any other "fragrant" spray or powder on the cat. If you bathe the cat yourself, take a shower and wash your hair afterwards, and expect to have to rest your eyes for one or more hours.
- If your cat likes to sleep with you, try to convince him or her to sleep away from your face. If you can afford to experiment with a solution that might or might not work, buy a storage or chest bed. These are beds built with drawers underneath. Open the top drawer near the foot of the bed just enough for the cat to get in, put a thick towel into it for bedding, and then try to convince the cat that the drawer would be a great place to sleep. Be sure and anchor the drawer so that it cannot close and trap the cat or close and injure the cat. You can find these beds at the following URLs:
- After your cat grows old and dies, do not get another one. Even if you are only mildly allergic to cats now, the allergy can get much worse.
Cataract surgery is usually not more difficult for someone with dry eyes than for anyone else. However, if you have eye allergies, two or three weeks after surgery you might develop an allergic reaction to Tobradex and Voltaren Ophthalmic, two eyedrops typically prescribed for post-cataract care. In addition, according to the Physician's Desk Reference, in "cataract surgery studies, keratitis [dry eye] was reported in up to 28% of patients receiving Voltaren Ophthalmic, although in many of these cases keratitis was initially noted prior to the initiation of treatment." For some people, this can mean that their dry eye condition is temporarily worse after cataract surgery. Because you are supposed to use these eyedrops for 60 days after surgery, be sure you have enough savings in case you are unable to work for two months.
Occasionally, someone reports a permanent increase in dry eye pain following cataract surgery. Therefore, people with severe dry eyes should not request to have cataract surgery before they really need it.