Ocular Pruritus

Introduction

Itching of the eyes is termed ocular pruritus. Nearly everyone experiences itchy eyes at some point. There are many underlying causes of itchy eyes which should not be overlooked. 

Causes Of Ocular Pruritus

Common allergens such as dust, smoke, or animal proteins irritate the eye and result in itching due to the release of a chemical substance called histamine. This reaction may lead to redness and swelling of the eyes. However, other factors may also lead to itchy eyes. The etiological factors of ocular pruritus can be divided into the following broad categories:

1. Seasonal Variation

1. Allergies due to seasonal variations are the most common cause of ocular pruritus. Pollen grass, shrubs, fungus, or molds can be the underlying cause. 

2. Smoke And Dust

1. The gritty sensation or feeling of sand under the eyes could be due to smoke and dust present in the environment. This is a common cause of ocular pruritus.

3. Dry Eyes

1. Tears are produced each time we blink and help to lubricate the eyes. They are made up of water, mucus, and oils. Decreased production of any of these constituents results in dry eyes. This may be accompanied by itching or irritation.

4. Eye Strain

1. Staring at screens or studying/working for longer durations without adequate blinking may result in irritation and ocular pruritus.

5. Blepharitis

1. This is an inflammation of eyelids and eyes that results from malfunction of the oil glands that line your eyelids. The eyes become red, swollen, and may stick together due to mucus discharge. This can lead to itchy eyes.

6. Sjogren syndrome

1. This is an autoimmune disease characterized by dry eye and dry mouth.

7. Makeup products and soaps

1. These products may lead to blockage of the oil glands lining the eyelids and subsequent blepharitis, an oily tear film, or an allergic reaction to the ingredients in the products. 

8. Traumatic injury

1. Injury to ocular structures may lead to irritation and itching.

Signs And Symptoms

The signs and symptoms of ocular pruritus may be:

• Itchiness

• Excessive tearing

• Burning sensation

• Foreign body sensation

• Red-eye

• Stickiness or mucus discharge

• Sneezing 

Evaluation Of Ocular Pruritus

The physician may ask the following questions to rule out the underlying cause:

• History of onset and duration of symptoms?

• History of asthma, allergies, or skin condition?

• History of tearing or foreign body sensation?

• History of using contact lenses?

• New skin products/soaps/makeup?

The physician will examine your eyelids, cornea, and conjunctiva to identify the cause of your symptoms.

Management Of Ocular Pruritus

The treatment of ocular pruritus depends on the eradication of underlying cause and some general measures for prevention. Its management can be divided into the following categories:

• General management/Lifestyle modification

• Avoid triggering factors

• Eyeshield/glasses to protect from allergens and dust

• Follow contact lens hygiene guidelines

• Avoid rubbing the eyes

• Wash hands properly before touching eyes

• Blink eyes more often while staring at screens or reading

• Cold compresses can help to relieve irritation

• Medical management

• A physician may recommend medications depending on the underlying causes of ocular pruritus. Generally, the following classes of medications are usually prescribed:

• Steroid eye drops

• Antibiotic eye drops

• Antihistamine eye drops

• Non-steroidal anti-inflammatory eye drops

• Artificial tears

• Systemic antibiotics in cases of severe infection

If you suffer from itchy eyelids, contact ESA for an evaluation. All of our physicians can diagnose and treat ocular pruritus and will be more than happy to help you achieve optimal eye health!

References

1. The Itchy Eye: Diagnosis, Management of Ocular Pruritus. (2016, March 23). American Academy of Ophthalmology. Retrieved March 10, 2022, from https://www.aao.org/eyenet/article/itchy-eye-diagnosis-management-of-ocular-pruritis

2. Hellem, A. (2022, January 5). Itchy eyes: Causes and cures. All About Vision. Retrieved March 10, 2022, from https://www.allaboutvision.com/conditions/itchy-eyes.htm#:%7E:text=Most%20of%20the%20time%2C%20itchy,t%20help%20your%20itchy%20eyes.

3. Itchy Eyes: Symptoms, Causes, and Treatment. (2020, July 24). WebMD. Retrieved March 10, 2022, from https://www.webmd.com/eye-health/itchy-eyes-symptoms-causes-treatment

Author

Eye Surgeons Associates Drs. Meiraj A. Siddiqui, Zuhair H. Peracha, Manal H. Peracha-Riyaz, Eric Zuckerman and Leila Siblani are dedicated to excellence in eye care and service. We utilize the latest treatment methods and procedures, including routine eye care, cataract surgery, glaucoma treatment, retinal disease management, diabetic eye treatment, and eyelid surgery.