Itchy eyes: the causes and the most effective treatments

Eye itching is a very frequent discomfort, both among adults and children, and can have many causes, related to habits and living environment, as well as the predisposition to develop certain eye diseases or allergies.

Sometimes, it manifests itself as early as the morning, as soon as you leave the house, especially in spring when the spread of pollen is maximum, or in winter, when the cold and smog have a particularly irritating action on the delicate mucous membranes of the eyes.

In other cases, eye itching occurs gradually during the day and becomes significant in the evening, along with burning sensation and eye strain, after many hours in front of the computer or in a poorly lit work environment.

In most cases, alleviating the disorder is simple, but when the problem occurs for the first time or is accompanied by other “suspicious” symptoms it is necessary to consult the doctor to receive a precise diagnosis and the indication of the most suitable remedies in the individual case.

Itchy eye: the most common causes

Among the most common causes that lead to the onset of itchy eyes there is undoubtedly the solicitation of the immune system by various allergens, ie substances of natural or artificial origin present in the environment and harmless to most people, but which can be subjectively not tolerated and trigger an allergic reaction.

Among the main allergens that can cause itchy eyes are pollen from various plants (seasonal or perennial), dust mites, animal hair, molds, as well as countless compounds present in commonly used creams, detergents and cosmetics.

Even cigarette smoke, air pollution from traffic, dust from construction sites and fumes from production plants of various types can cause burning and itching in the eyes, but in these cases more than an allergic reaction these are phenomena of irritation and sensitization of an inflammatory nature, which do not involve the production of specific antibodies (immunoglobulins type E, IgE) against one or more allergens.

Both ocular itching due to allergies and irritative itching occur frequently among children, more often affected by allergic reactions and characterized by mucous membranes easily sensitized by external agents. A form of irritative itching at eye level typical of childhood-adolescence is, for example, that determined by the chlorine-added water of the pool or by the mix of salt water and intense light characteristic of a day at the beach, especially if you do not wear sunglasses and hat.

A form of itchy eyes very common among adults is, however, that associated with dry eye syndrome, a condition determined by a tearing defect, promoted by the intense use of vision, by non-ideal lighting situations and by prolonged stay in environments with dry air, dust or wind, which affects an increasing number of people due to prolonged use of computers , tablets and smartphones. In addition, this disorder is frequent in pregnant women due to changes in hormone levels.

Dry eye syndrome should never be neglected because, in addition to causing a marked irritation of the conjunctiva and considerable eye discomfort, over time it can cause damage to the eyes, especially if you usually wear contact lenses. The presence of an insufficient amount of tear fluid on the surface of the cornea, in fact, can damage it due to lack of adequate lubrication and consequent excessive rubbing with the lens, even if soft.

Another reason that should lead to consult the doctor in the presence of dry eye syndrome is that, in some cases, this disorder is linked to the presence of systemic diseases not yet diagnosed, especially of an autoimmune nature, such as systemic lupus erythematosus (SLE), rheumatoid arthritis or Sjogren’s syndrome, or diabetes or thyroid dysfunction.

Other causes of itchy eyes can be related to infections of the conjunctiva, (bacterial or viral conjunctivitis) or to inflammation or infection of the eyelids (blepharitis), acute or chronic.

Acute blepharitis, if also associated with ulceration of the eyelid mucosa, is usually caused by an infection (often staphylococcus or herpes simplex), while if ulcerations are not present it is probably an allergic or irritative reaction to substances accidentally in contact with the eyes or sensitizing cosmetic products.

At the origin of chronic blepharitis, however, there is often a dysfunction of particular glands present in the conjunctiva (called meibomian glands), which is found more frequently in people who also suffer from skin diseases such as rosacea or seborrheic dermatitis. In many cases, those suffering from chronic blepharitis are also affected by dry eye syndrome and tend to develop styes or chalazions (small nodules that appear in the central part or on the rim of the eyelids, due to occlusion and possible infection of a meibomian gland).

Symptoms of itchy eyes

Itchy eyes is in itself a symptom that, as we have seen, can be associated with various eye disorders or pathologies and systemic diseases. Depending on the origin that caused it, itchy eyes may be accompanied by other symptoms and types of discomfort more or less intense.

For example, in case of allergies to pollen, dust mites or animal hair, itchy eyes are almost always associated with redness, burning, swelling of the eyelids and even a noticeable increase in tearing.

As a rule, these disorders of the eye area are also associated with breathing problems, such as sneezing, feeling of stuffy nose, rhinorrhea (runny nose), decreased sense of smell and headache. Often, itching is also present in the nose and, sometimes, the lips, while in some cases respiratory problems can be more significant and affect the bronchi, manifesting themselves in the form of allergic asthma (more frequent in children-adolescents).

On the contrary, if it is “only” allergic conjunctivitis, triggered for example by cosmetics or sensitizing substances present in the air, generally the only symptoms present in addition to itching are those affecting the conjunctiva and eyelids (inflammation, redness, swelling, pain), accompanied by increased eye sensitivity and tear production.

When conjunctivitis or blepharitis caused by bacterial or viral infections are present, itchy eyes (only one or both) is generally less intense, while inflammation, burning and pain prevail. In case of bacterial infection, viscous and opaque, greyish or yellowish secretions are usually also present, which tend to form “scabs”, while in case of viral infection the secretions are more liquid and clear and small reddened and painful ulcers may be present.

Even the itching associated with dry eye syndrome is less “lively” than that of an allergic nature and always secondary compared to the sensation of foreign body or “sand in the eye” (due to dryness of the mucous membranes), eye sensitivity (especially towards light), burning and pain. In the most severe forms of dry eye, visual disturbances (blurred or double vision) may also develop. Paradoxically, another sign typically associated with dry eye itching is intense tearing, especially in the morning.

Remedies for itchy eyes

The remedies to be used to regain well-being in case of itchy eyes are closely linked to the causes that determined it. So, if you do not know exactly the origin of the discomfort, if the disorder is associated with other signs or symptoms and / or persists for more than a day or two, the first thing to do is to contact your doctor to investigate the situation.

If the itching appears to be related to a more serious eye disease and worthy of specific treatment, the doctor will prescribe an eye examination that will allow to specify the problems present and to identify the most appropriate drug therapy.

In general, if the itching in the eyes is caused by an allergy to pollen or other environmental allergens or by an allergic conjunctivitis towards cosmetic products, the first thing to do to relieve the discomfort and prevent it from recurring is to reduce exposure to triggers as much as possible.

Since this is not always feasible, antihistamine-based eye drops can be used to obtain relief from eye symptoms. If in addition to itchy eyes, the allergy also causes significant respiratory symptoms (even to the point of preventing you from sleeping well) the doctor may prescribe the intake of antihistamine drugs by mouth.

When eye problems are due to dry eye syndrome, the first recommended treatment is the regular application, several times a day, of artificial tears, preferably prescribed by the doctor after an eye examination and the evaluation of the state and characteristics of the eyes in the individual case.

The application of eye drops and artificial tears takes a few minutes, but must be done carefully, after washing your hands well. To achieve the desired relief it is enough to slightly tilt the head back, instill 1-2 drops of liquid, without placing the spout of the bottle on the mucous membranes, or touching it with your hands. The eyes should then be closed and reopened slowly for a few times, to better distribute the liquid.

In case of conjunctivitis or blepharitis associated with infections, it may be necessary to use eye drops or ophthalmic ointments based on antibiotics, antivirals or antifungals (also in combination with each other), which the doctor will prescribe depending on the pathogen involved. In case of viral infections of the eye or by other microorganisms such as Acanthamoeba (cause of dangerous corneal infections), the treatment can be quite demanding and take some time before achieving a full recovery.

In the forms of ocular itching associated with considerable inflammation, eye drops or ophthalmic ointments based on corticosteroids can also be prescribed, which must however be used for the minimum period necessary and carefully following the indications and advice of the doctor to avoid secondary eye problems.

Regardless of the therapy identified, a very important precaution to avoid worsening the itching of the eyes and the inflammation that normally accompanies it is to avoid touching and rubbing the eyes, except for the maneuvers necessary for the application of drugs.

Natural remedies

When it is not linked to specific pathologies, worthy of treatment with targeted drugs, a natural approach can also be adopted to obtain relief from itchy eyes, using products based on active substances of plant origin with calming, anti-inflammatory and anti-redness action, or “physical” remedies, such as the application of fresh compresses on closed eyes for 5-10 minutes.

Among the plants that can improve itching and redness in the eyes, whose extracts are often included in eye drops designed for forms of modest eye irritation or sensitization, we can remember chamomile, calendula, eyebright, witch hazel, fennel, aloe vera and rose hips.

Other good practical rules for the prevention of eye irritation and itching, as well as for the protection of vision and eye health, include:

• avoid exposure of the face to intense light for prolonged periods and always wear sunglasses with certified quality lenses when you are outdoors, especially in the presence of “clear” light and near reflective surfaces (water, snow, etc.).
• optimize the lighting of computer, tablet and smartphone screens according to ambient light and take 5-10 minutes break every 1-2 hours of use
• Do not engage your eyes too much in twilight or dim vision efforts
• Do not spend too much time indoors with dry air, dust or smoke (home, offices, public places, etc.), but ventilate the rooms often and use humidifiers
• avoid staying in places where irritating cleaning products have recently been used or where deodorants, insecticides or any type of “chemical” aerosol that can sensitize the mucous membranes have been sprayed
• Do not use contact lenses if you suffer from dry eye syndrome, while you are applying ophthalmic drugs to treat inflammation or eye infections or when practicing water sports (especially in the pool)
• avoid applying cosmetic products on the eyes (eyeshadows, pencils, eye-liners, mascara, etc.), even if hypoallergenic and of good quality
• follow a healthy diet, rich in particular in omega 3 fatty acids (present in vegetable oils, bean sprouts, fish such as tuna, mackerel, salmon, etc.), which help relieve inflammation in case of dry eyes.