Tears, Redness, and Itchiness: Could It Be Allergic Conjunctivitis? Causes and Management

Hello, I am Na-eun Kim, an optometrist at BGN Eye Clinic (Jamsil).

I have a little weekend morning routine: turning on the washing machine, grabbing a cup of coffee, and binge-watching variety shows or dramas I missed. It’s nothing extraordinary, but spending all week in the examination room makes these quiet moments truly precious to me.

As I enjoy my weekend, I sometimes recall things that happened in the clinic during the week. Recently, there was a moment I thought, "I definitely need to write about this on the blog." It's a story about a patient whose tears just wouldn't stop during an examination.

"Why won't my tears stop...?"

It was right when we were about to start the vision test. A male patient in his late twenties sat in front of the machine, and as soon as I pulled up the chart, tears began to stream down his face.

At first, I briefly thought, "Ah, he must be really nervous." I smiled and asked, "Are you feeling very anxious? Sometimes people tear up during exams."

However, the patient smiled awkwardly and replied, "Actually... rather than nerves, my eyes have been constantly itchy and watering lately. I even took medication today, but it's still happening." At that moment, I immediately knew it wasn't because of anxiety.

Not Just Tears: 'Allergic Conjunctivitis'

Throughout the examination, tears continued to flow from his eyes, and I noticed his hands unconsciously reaching up to rub them. If the tearing was simply due to fatigue, it usually subsides naturally over time, but his case was different.

The edges of his eyelids were slightly swollen, his conjunctiva was red and bloodshot, and there were signs of red irritation on the skin around his eyes. When these symptoms appear, the first thing we suspect is allergic conjunctivitis.

What is Allergic Conjunctivitis?

Allergic conjunctivitis is exactly what it sounds like: an allergic reaction occurring in the eyes. Our body's immune cells mistakenly identify specific substances (allergens) as a "threat," triggering an excessive inflammatory response in the conjunctiva. This results in excessive tearing, accompanied by severe itching and redness.

Common Trigger Factors

Changing Seasons and Pollen

During the changing seasons of spring and autumn, the increased pollen and fine dust in the air easily come into direct contact with the eyes. Especially in spring, when cherry blossoms, weeds, and grass pollen are airborne, there is a surge in patients experiencing itchy, watery eyes. Washing your face or using artificial tears after going outside is absolutely essential.

Pet Dander

If you have a dog or cat, the primary allergic trigger isn't usually the "hair itself," but rather the skin proteins (dander, saliva, urine components) attached to it. Pet hair also lingers on carpets, sofas, and bedding, making regular cleaning a necessity.

Dust Mites and Mold

Symptoms often worsen right after moving, after a deep clean, or during humid seasons like the monsoon. There are many cases where people say, "My eyes have been itchy since moving to a new house." This is highly likely due to the combined effects of new furniture off-gassing, dust mites, and mold.

Prolonged Contact Lens Wear

Airborne dust, pollen, and bacteria easily adhere to the surface of contact lenses. Especially if worn for more than 10 hours a day, tears cannot adequately wash away the allergens, exacerbating the symptoms. When experiencing symptoms, it is always safer to switch to glasses.

In summary, the triggers for allergic conjunctivitis can stem from seasons, environments, and lifestyle habits. That is why lifestyle management is just as important as medical treatment. Our patient also mentioned, "There was a lot of dust recently due to moving." In such cases, simple artificial tears are not enough; treatments like antihistamine or steroid eye drops must be combined with strict environmental management.

Daily Allergy Prevention Methods

Ultimately, the key to preventing the recurrence of allergic conjunctivitis is reducing irritation factors in your daily life.

1. Strict Hand Hygiene

Your hands are constantly carrying bacteria and allergens. Touching your eyes with unwashed hands can significantly worsen inflammation.

• Wash your hands with soap for at least 30 seconds after returning home.

• When your eyes itch, do not rub them; instead, use a cold towel or ice pack.

2. Manage Your Home Environment

Dust mites and pet dander float in the air, causing constant irritation.

• Wash bedding at high temperatures (60°C or higher) at least once a week.

• Use a vacuum cleaner equipped with a HEPA filter and dehumidify the room regularly.

3. Wash Your Face After Outings

The first thing you should do after coming home is wash your hands and face to remove any allergens left around your eyes.

4. Choose Glasses Over Contact Lenses

On days when allergy symptoms are severe, make sure to wear glasses. Lenses cause allergens to stay in your eyes much longer.

5. Utilize Artificial Tears

Storing preservative-free artificial tears in the refrigerator and using them cold is highly effective for relieving itchiness and washing out allergens.

Our Eyes Respond to Even the Smallest Changes

I calmly explained the test results. "The tearing you're experiencing right now is highly likely a symptom of allergic conjunctivitis, not just nerves. Fortunately, there is no major issue, but managing it through an accurate medical diagnosis will make you feel much more comfortable."

Hearing this, the patient finally let out a big sigh and smiled. "Ah, what a relief... I was actually more nervous because I thought it would be embarrassing if I kept crying during the exam. But there was a real reason for it."

Our eyes send signals even at the slightest changes. Please don't just brush it off as fatigue; if symptoms persist, I highly recommend seeking a professional consultation. This has been Na-eun Kim, an optometrist at BGN Eye Clinic (Jamsil).