|Severe allergy cases do well with a low-dose topical steroid such as Bausch + Lomb’s Alrex.|
The right treatments can help young allergy sufferers get through the season in comfort.
You know it’s that time of the year when everyone in your office starts coming in with runny noses and watery eyes. Say hello to allergy season where the problem often manifests with itchy eyes or nose, increased tearing, red or pink eyes, mild swelling of the eyelids, sneezing, and nasal congestion. For a child with eye allergies either already wearing or wanting to wear contact lenses, the situation is even more challenging. Before you pass the tissues, brush up on remedies and eyedrop options to make your patients as comfortable as possible.
The best way to combat these issues head-on is to fit allergy-prone kids with daily disposables. These are by far the best solution as the one-day modality eliminates the need for constant cleaning and disinfection.
Lack of contact lens hygiene in children often leads to irritation and infections which is why addressing proper solutions and handling is key. Longer duration contact lenses will often accumulate more surface deposition, sensitivity from solution, and risk for allergy. In addition, cleaning solutions for monthlies or biweeklies can also trigger sensitivities and cause irritation. From a practitioner’s perspective, single use lenses provide a better solution which also encourages better compliance.
Allergy sufferers who wear contact lenses may show complications including decreased comfort and vision changes. Under the slit lamp, I usually see conjunctival injection, corneal staining, and papillae. In our practice, we’ve found kids who use daily disposables have improvement after one month of switching with significant advancements in comfort. In fact 80% of the contacts we prescribe for children under 18 include dailies.
For the teen or tween who simply must wear contacts as opposed to glasses yet can’t help rubbing their eyes due to allergies, there is a simple solution””antihistamines. For ocular allergies, topical antihistamines such as Bepreve (Bausch + Lomb), Lastecaft (Allergan), and Pataday (Alcon) are FDA approved for ages 2 and older.
In cases with more severe allergies evidenced by giant papillary conjunctivitis, I prescribe a low-dose topical steroid such as FML (Allergan), Alrex (Bausch + Lomb), and Lotemax (Bausch + Lomb) with a one- to two-week follow up.
None of these topical antihistamines are technically FDA approved for contact lens use but for those who wear their contacts no matter the pollen count, I usually recommend utilizing the drops first before putting lenses in to reduce the amount of preservative absorbed by the contact lens.
Bear in mind, for some, oral antihistamines alone aren’t enough; sometimes over-the- counter topical antihistamines are also necessary for added relief.
Needless to say, what works for one doesn’t work for all, which is why offering a scenario filled with variables is often the best course of action. And because allergy season can, for some, last all year, knowing what solutions work best is your best course of action.
Katherine Shen is an associate at Specialty Eyecare Group in Seattle and Kirkland, WA.
WHERE TO FIND IT:
Alcon Laboratories, Inc. •800-451-3937 •alcon.com
Allergan •800-347-4500 •allergan.com
Bausch + Lomb •800-828-9030 •bausch.com