Itchy, Red Eyes? How to Tell If It’s Allergy or Infection

What to consider before you self-treat

Itchy, Red Eyes? How to Tell If It's Allergy or Infection

If you have red, itchy eyes and it’s hay fever time, you likely assume that allergies are causing the problem — and that you can treat it on your own with over-the-counter eye drops. Unfortunately, it isn’t as simple as that.

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Even if you find a guide to help you choose the best eye drops from the drugstore aisle, you may treat for allergies when the real problem is an eye infection.

Before you head to the drugstore, here’s what you need to know about these two very different conditions.

Allergies or infection? Here’s how you can tell

Whether ragweed or pet dander is the culprit, allergens affect the eyes in the same way.

Eye infections can come from many causes — virus, bacteria, parasite or fungus — and the symptoms vary with the cause, but in general, infections have a longer list of symptoms when compared to allergies.

Common Symptoms Allergies Infections
Redness X X
Itching X X
Burning X X
Clear, watery discharge X X
Pain X
Gritty feel in eyes X
Sensitivity to light X
Thick discharge X – Bacterial
Mucus-like discharge X – Viral

The bottom line is that if anything more than tear-like fluids come from your eye or you feel eye pain, it’s likely more than allergies.

To get the right treatment, you’ll need your eye doctor to find out what’s behind your eye problem.

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Eye allergies aren’t contagious but they can be miserable to deal with. If it’s an infection, you run the risk of damaging your eye and/or spreading it to others.

How can you avoid eye problems?

You can minimize your risks for both eye allergies and infections. Keeping windows shut and other easily implemented strategies can help you survive seasonal allergies, while an air purifier can help you cope with indoor allergies.

Conjunctivitis (pink eye) is the most common eye infection, caused by a virus or bacteria. Either way, it’s easily spread.

Frequent hand washing is just one way to help prevent pink eye and other contagious diseases. Taking care with makeup and cosmetic contact lenses also helps prevent bacterial pink eye from spreading.

What to do when allergies or infections strike

Even if you fight the good fight, you may still sometimes need relief from itchy, watery eyes. Depending on your diagnosis, here are treatments that can help.

For allergies: Topical medications are usually better than general allergy remedies for treating eye allergies. Many allergy eye drops are extremely successful in treating symptoms. Some actually work to prevent symptoms by preventing the allergic reaction from getting started.

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Your doctor may suggest short-term medications to help control inflammation, such as steroid or anti-inflammatory eye drops. Over-the-counter artificial tears also can help keep eyes moistened and flush out allergens.

For infections: Viral infections generally clear up on their own, but cold compresses and lubricating eye drops can minimize symptoms. Your doctor may prescribe antibiotic eye drops to treat a bacterial eye infection.

For eye infections caused by fungi and parasites, the medication will depend on what’s causing the problem. Your eye doctor can help sort that out.

Getting quick diagnosis and treatment is the key when you have irritated eyes. No matter what’s causing the problem, your eye doctor can help you find the right treatment and the relief you need.

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Richard Gans, MD

Richard E Gans, M.D., FACS joined the Cleveland Clinic Cole Eye Institute in 2004. He is an accomplished surgeon and a comprehensive ophthalmologist.
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