What to Do About Your Red, Itchy Eyes

Every day, Dr. Farah Khan sees patients who are trying their best to claw their inflamed eyes out. They march miserably in, one after the other, with identical complaints. “Itching is a hallmark symptom, and it can be very intense,” says Khan, an allergist who’s a spokesperson for the American College of Allergy, Asthma and Immunology. “Then there’s redness and some swelling, and you can have a little clear, watery discharge.”

If there’s any saving grace, it's that the symptoms are transient. Khan’s patients are suffering from seasonal allergic conjunctivitis, a common ailment that’s especially likely to flare up in the spring, summer, and fall, when pollen counts are highest. 

Here’s what to know about the condition, plus what to do about red, itchy eyes.

What causes seasonal allergic conjunctivitis

Allergic conjunctivitis is triggered by airborne allergens, like pollen that wafts off trees, grasses, and weeds. “Allergens are basically attacking your eyeballs,” Khan says. They land on the whites of the eyes and inner surface of the eyelids, binding to mast cells, which play a key role in allergic reactions. When mast cells come into contact with an allergen, “they burst open, and then a bunch of inflammatory mediators get released, including chemicals like histamine,” Khan says. “Histamine drives a lot of itching and swelling and redness, so you have this local allergic reaction happening with your eyes, which is why you're getting all the symptoms.”

Read More: 10 Weird Symptoms That Might Be Allergies

It’s easy to confuse allergic conjunctivitis with that other, better known kind of conjunctivitis: pink eye. But there’s an easy way to differentiate the two. “Sometimes people wake up and think, ‘Uh oh, do I have pink eye?’” Khan says. “But typically allergic conjunctivitis is bilateral—why would the grass pollen attack one eye and not the other?” Pink eye, on the other hand, is more likely to affect just one eye.

Preventing allergic conjunctivitis

Minimizing contact with allergens is the best way to protect your eyes. You can do that by staying inside, keeping your windows shut, and using your A/C if you have access to one. It's also a good idea to turn off ceiling fans. “They get very, very dusty, and nobody ever really climbs up there and wipes the top of the blades,” says Dr. Michelle Andreoli, a clinical spokesperson for the American Academy of Ophthalmology and an ophthalmologist at Northwestern Medicine. “You lay there all night, and your ceiling fan is blowing allergens and dust over your eyelid skin, which will make you itchy.”

Keep your pillowcases clean, too—they’re probably harboring lots of allergens that seeped off your skin and hair. If you don’t feel like washing your bedding, Andreoli suggests wrapping your pillow in a fresh T-shirt every night. “You can rip it off in the morning and throw it in the machine,” she says. “It seems less cumbersome than owning seven pillowcases and changing them every day.”

Treatment options

Remember when you were a kid and everyone told you not to scratch your mosquito bites? The same rule applies to itchy eyes. “You're grinding in the irritant or allergen, and you're almost guaranteeing that five minutes later, you're going to itch even more,” Andreoli says.

When Andreoli’s patients tell her they want to scratch their eyes out, she instructs them to gently rinse their eyelids and eyelashes with a tiny bit of mild face soap. “That debulks the oil off our eyelashes—which is sticky—and it gets all of the allergens and irritants off,” she says. “By removing the oil, less is going to stick to our eyelashes throughout the day, and our eyes won't be as itchy and irritated.” 

It’s also a good idea to get in the habit of jumping in the shower to rinse off after spending time outside, and then changing into a clean set of clothes. That will help ensure you're not tracking pollen around all day.

Over-the-counter antihistamine eye drops can make a big difference for people with allergic conjunctivitis. Lots of brands are available, and they work by blocking histamine—which helps reduce symptoms like itching and redness. Most drops are designed to be used every 12 to 24 hours, Andreoli says. You can pair them with lubricating eye drops, often called artificial tears, which provide relief by moisturizing the eye.

Read More: How to Protect Your Eyes While Staring at a Screen All Day

It can also feel good to press a cold compress or ice pack against your eyes. Andreoli’s patients usually find that doing so reduces swelling, redness, and that maddening desire to scratch.

If you lean into OTC options and they don’t help, schedule an appointment with an allergist. Your provider will aim to figure out what's triggering your symptoms—and what kind of regimen will work best for your needs. “If you're just having nasal symptoms, or if you're just mostly having eye symptoms, we can come up with some targeted therapies,” Khan says. That might mean allergy shots or mast cell stabilizer eye drops, which can help prevent or reduce symptoms like itching, redness, and tearing.