Understanding itchy eyes
We’ve all experienced the frustrating cycle of itchy eyes — itching, irritation, redness, swelling and then back to itching. This is usually caused by allergies, but there can be other reasons as well. Identifying the cause — whether it's pollen, pet dander or an infection — is key to finding relief.
Whatever the cause, itchy eyes are often accompanied by other bothersome symptoms, including:
- Burning or stinging sensation
- A gritty feeling in the eye
- Swollen eyelids
- Eye redness
- Eye dryness
- Increased tearing
- Blurred vision
- Light sensitivity
Itchy eyes are usually manageable, but there is a golden rule you must follow:
Resist rubbing your eyes.
The temptation to keep rubbing your eyes is undeniable, but rubbing them makes the itching worse. Rubbing triggers mast cells, which are a type of immune cell. These cells release histamine, which worsens your discomfort, amplifies the immune reaction and prolongs your symptoms.
Causes of itchy eyes
Rubbing won't help your itchy eyes. In fact, it can make things worse.
Itchy eyes can be caused by several factors, such as allergies, chronic conditions, dryness or infections.
Allergies
A common cause of chronic eye itching is eye allergies, also known as allergic conjunctivitis.
Seasonal allergies
Seasonal allergies (seasonal allergic conjunctivitis) are the most common type of eye allergy. Seasonal allergies flare up at specific times of the year, most commonly in spring and summer. They are typically triggered by airborne particles released by plants, known as allergens. The most common outdoor allergens include:
- Tree pollen
- Grass pollen
- Weeds
Year-round allergies
Year-round allergies (perennial allergic conjunctivitis) cause symptoms throughout the year. These symptoms are caused by reactions to indoor allergens, such as:
- Dust mites
- Pet dander
- Mold
Some rare conditions can cause severe year-round eye allergies. These include:
- Atopic keratoconjunctivitis (AKC) – This chronic allergic condition causes year-round intense symptoms of itchy eyes. It is commonly associated with atopic dermatitis (eczema). AKC often occurs with thickened, rough eczematous patches on the eyelids.
- Vernal keratoconjunctivitis (VKC) – This chronic, severe allergic condition primarily affects younger males. It also causes significant light sensitivity (photophobia) in addition to symptoms of itchy eyes.
Without proper management and early treatment, both AKC and VKC carry a risk of vision impairment and corneal scarring.
Why do allergies cause itchy eyes?
An allergic response to pollen, mold or other allergens results in itching, redness and other symptoms due to a cascade of reactions in the body. Understanding how to manage itchy eyes becomes easier once you understand how an allergic response develops.
1. First exposure
When you first encounter a specific allergen (like tree pollen), your immune system mistakenly sees it as harmful.
- IgE – Your body responds by creating specialized proteins called immunoglobulin E (IgE) antibodies.
- Mast cells – The IgE antibodies then bind to immune cells known as mast cells. This prepares them to recognize that specific allergen in the future.
2. Repeated exposure
When your eyes are exposed to that same allergen again, your system is ready to respond.
- Cell activation – The returning allergen binds to the waiting IgE antibodies, triggering mast cell degranulation (release of chemicals).
- Chemical release – This influx of chemicals triggers the release of powerful inflammatory compounds into tissues.
3. Allergic reaction
An important chemical released by mast cells is histamine. This is the main substance responsible for the intense, persistent feeling of itching. It also causes nearby blood vessels to expand, leading to redness. Histamine directly affects nerve endings and blood vessels. This leads to the common discomfort of an eye allergy.
The immediate symptoms of histamine release in the eyes’ tissues include:
- Itching – This is the most noticeable symptom of eye allergies.
- Redness and swelling – You develop swollen eyelids and the eye surface begins to look puffy and red.
- Burning and watering – You start feeling a stinging sensation and notice watery discharge.
An allergic reaction has two general phases. These phases are:
Fast reaction phase
The first stage of an allergic reaction is called the fast reaction phase:
- It happens quickly — often within seconds or minutes.
- It lasts about 20 to 30 minutes.
- During this time, mast cells release substances, such as histamine, that trigger symptoms.
- These symptoms include intense itching, watery eyes, eye redness, eyelid puffiness and tiny bumps on the eye’s surface.
Late reaction phase
The second stage of an allergic reaction is called the late reaction phase:
- It develops several hours after the initial allergen exposure.
- Additional immune cells enter the eyes’ tissues, leading to ongoing inflammation.
- This causes your eyes to remain red, swollen and uncomfortable for several hours or longer.
- As the reaction continues, additional tears drain from your tear ducts into your nose. This can carry allergens along and sometimes worsen nasal allergy symptoms.
Environmental irritants
Itchy eyes may result from direct irritation or from conditions that trigger or worsen an allergic response. This can look a lot like allergy symptoms. Various factors in your environment can cause itching, redness and watery eyes:
- Airborne irritants – Smog, tobacco smoke, strong winds or dry weather can worsen itchy eyes. It's best to stay indoors when air quality is poor, especially during heavy wildfire smoke.
- Small particles – Sand, dirt, an eyelash or even eyelash extensions may cause itching and irritation.
- Product reactions – Makeup, lotions and soaps can be irritating. Exposure to chemicals, such as chlorinated pool water, can also trigger itchy eyes.
- Eye drop ingredients – Preservatives, such as benzalkonium chloride (BAK), used in eye drops and solutions, can irritate the eyes or cause an allergic reaction.
Dry eyes
Dry eye disease (DED) is a common issue. It often causes symptoms such as itching, burning and a gritty feeling in the eyes. DED occurs when your eyes don’t produce enough tears or when tears evaporate too quickly. Since DED and ocular allergies share similar symptoms, it can sometimes be hard to tell them apart.
Digital eye strain
Digital eye strain can develop when your eyes focus on a digital screen for extended periods of time. When you stare at a screen, you usually blink less. This can quickly destabilize your tear film, leading to irritation and itchy eyes. It can also worsen existing conditions, such as dry eyes.
Infections and inflammation
Certain eye infections and inflammation can cause symptoms of itching and discomfort. These include:
- Infectious pink eye – Also known as infectious conjunctivitis, this is usually caused by a virus or bacteria. It can lead to eye irritation and itching.
- Blepharitis – This is recurrent eyelid inflammation, often linked to bacteria or microscopic mites. Symptoms usually include itching, swelling and redness at the lid edges. There may be flaking or crusting of the skin around the eyelashes.
Skin conditions around the eyes
Inflammatory skin conditions can sometimes affect the face. One such condition is eyelid eczema (atopic dermatitis), which is associated with atopic keratoconjunctivitis. If patches of eczema develop near the eyes, they can worsen eye irritation and itching.
Contact lens irritation
Wearing contact lenses can contribute to itchy eyes, eye pain and an increased risk of dry eye. It may be caused by sensitivity to a lens material or contact lens solution. Additionally, the surface of a contact lens collects deposits over time that can irritate the eye, such as:
- Allergens
- Proteins
- Debris
Additional factors associated with contact lens wear can worsen irritation and itching. These include:
- Wearing lenses for too long
- Improper cleaning
- Not replacing them on schedule
Giant papillary conjunctivitis (GPC) is a type of eye irritation that can happen when wearing contact lenses. It occurs when tiny particles of debris accumulate on the lens and irritate the inner eyelid. While allergies can make it worse, GPC is mainly caused by the physical rubbing of the lens against the eyelid.
Signs of GPC include:
- Worsening itching
- Mucus discharge
- Difficulty tolerating the lenses
- A feeling of having a foreign particle or object stuck in the eye
- The formation of large bumps (papillae) on the inner upper eyelid
Treatments for itchy eyes
Minor symptoms of eye itching and discomfort usually improve with simple at-home methods. Try to resist the urge to rub your eyes. This pressure triggers immune cells to produce additional histamine. As a result, both itching and redness become worse.
Try the following at-home treatments to see whether they provide relief. If symptoms persist or worsen, it’s important to consult your doctor.
At-home treatments
The most effective way to manage itchy eyes is to limit exposure to the substances that cause your symptoms. You can also find relief with simple self-care practices and over-the-counter treatments.
Reduce exposure to outdoor triggers
- Keep windows in your home and car closed and rely on air conditioning instead.
- Wear large protective eyewear, such as sunglasses or wraparound glasses. These help protect against airborne allergens and wind.
- Shower every evening to wash off accumulated pollen particles from your hair, skin and face.
Reduce exposure to indoor triggers
- Keep pets out of the bedroom to reduce exposure to animal dander.
- Use a dehumidifier to control mold, and use special bedding covers to limit dust mites.
- Clean the house with damp rags or mops to keep dust levels low.
Self-care strategies
- Apply a clean, cold cloth or compress to your closed eyes to reduce swelling and irritation.
- Use preservative-free artificial tears. They can be applied frequently throughout the day. They flush out allergens and mucus while adding moisture to combat dryness. Refrigerating them enhances their cooling, itch-relieving benefits.
- Use over-the-counter (OTC) antihistamine eye drops for short-term relief of itching. Some drops also contain decongestants that temporarily reduce redness by narrowing blood vessels.
- Take an oral antihistamine to help manage generalized allergy symptoms, such as a runny nose.
Medical treatments
When symptoms are chronic, severe or simply not controlled by at-home measures and OTC remedies, consult your doctor. They may prescribe allergy eye drops that work quickly and provide longer-lasting relief than OTC drops. These include:
- Dual-action eye drops – Many prescription eye drops contain a combination of two medications. An antihistamine addresses immediate itching. A mast cell stabilizer helps prevent future allergic reactions.
- Mast cell stabilizers (preventative) – These drops work by blocking the release of histamine and other inflammatory mediators. They are helpful for preventing future reactions.
- Steroid eye drops (corticosteroids) – For severe eye allergies or flare-ups, doctors may prescribe short-term corticosteroid drops. These anti-inflammatory drops help reduce swelling, redness and itching quickly.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These prescription drops are available to help relieve eye itching.
How to prevent itchy eyes
The best way to manage chronic eye irritation is to reduce or eliminate exposure to the specific triggers that cause your flare-ups. This can be done by making simple adjustments to your home and daily routine:
Simple lifestyle adjustments
Your daily habits can have a big impact on reducing eye itching and irritation. It may help to:
- Avoid rubbing your eyes.
- Wash your hands often with soap and water, especially after spending time outdoors or touching pets.
- Shower at night to remove pollen if you’ve been outside during the day.
- Stay indoors when air quality is poor due to high pollen levels, smog or smoke.
- Wear large or wraparound sunglasses to shield your eyes from wind and airborne allergens.
- Keep your windows closed to keep pollen and mold spores from entering the house.
- Minimize indoor allergens by washing bedding and pillowcases frequently. Use allergy-reducing covers.
- Reduce dust and dander exposure by keeping animals out of your bedroom.
- Minimize carpets and use damp rags or mops for cleaning instead of dry sweeping, which stirs up particles.
Manage digital eye strain
Screen time and digital device use can contribute to eye discomfort. The following strategies can help minimize strain and help keep your eyes more comfortable:
- Limit your screen time as much as possible and take regular breaks when using a computer, tablet or smartphone. Remember to blink often to keep your eye surface moist.
- Use the 20-20-20 rule to reduce digital eye strain: Every 20 minutes, look at an object 20 feet away for 20 seconds.
- Use artificial tears.
- Don’t sit next to heating units, air conditioners or fans to reduce dryness.
- Adjust your monitor so the brightness is more comfortable for your eyes.
- Reduce glare.
Adjust your contact lens routine
For those who wear contact lenses, slight adjustments to your routine can help reduce itchy eyes. For example:
- Consider wearing glasses when allergy symptoms are at their peak. Allergens tend to stick easily to contact lens surfaces.
- Don’t sleep in contact lenses. Follow the wearing and replacement schedules recommended by your eye doctor.
- Clean your contacts nightly and change the storage solution in the case each day.
- Ask your eye doctor about daily disposable lenses, which can reduce the buildup of irritating debris.
Follow product safety instructions
Cosmetics, eye drops, and face lotions and oils can all irritate your eyes. Use these products safely by following these guidelines:
- Avoid sharing skin care products and makeup with other people.
- Regularly check the expiration dates of cosmetics and skin care products and replace them as needed.
- If you use eye drops frequently, choose preservative-free options to avoid irritation.
- Avoid using glittery makeup around your eyes.
When should you see an eye doctor?
The first step to managing itchy, irritated eyes is to make simple lifestyle adjustments. You can also try over-the-counter medication.
If symptoms persist, your vision changes or you have unusual discharge, schedule an appointment with your eye doctor for a full exam. They can determine the cause of your eye irritation and recommend the right treatment. Remember not to rub your eyes, and if they begin itching, start treatment right away.
If your symptoms don’t improve, an allergist can perform specialized tests to identify specific triggers. They can also offer longer-term relief through allergy treatments such as immunotherapy (allergy shots).
