Allergic conjunctivitis (Vernal Catarrh, Spring Catarrh) is caused by airborne allergens (eg.pollen, dust etc.) contacting the eye,. It typically presents as bilateral ocular pruritus (itching), redness, and watery discharge. It may be perennial (all year round) or seasonal (SAC) in spring or pollen season.

Basic eye care

 There are several general measures that are helpful to most patients with allergic conjunctivitis:

  • Patients should not rub their eyes because it aggravates irritation & leads to more rubbing.
  • Cool compresses can help reduce itching and eyelid swelling.
  • Frequent use of refrigerated or cooled artificial tears throughout the day can also help to dilute and remove allergens.
  • Allergen avoidance measures (avoid exposure to dust and pollen) eg. by using protective sunglasses or visor for two wheeler drivers are important in all forms of allergic conjunctivitis.
  • Patients should reduce or stop use of contact lenses during symptomatic periods, given the propensity of allergens to adhere to contact lens



Antihistamine / Vasoconstrictor combination products(nephazoline and phenaramine), antihistamines with mast cell stabilizing properties (olopatadine), mast cell stabilizers(cromolyn sodium) and, for refractory symptoms, topical glucocorticoids .

1. Mast cell stabilizers

 Mast cell stabilizing agents include cromolyn sodium. Full efficacy is reached 5 to 14 days after therapy has been initiated and therefore these medicines are not useful for acute symptoms .

2. Glucocorticoids

 Topical glucocorticoid (steroid eye drops) preparations may be considered in patients with refractory symptoms. Topical glucocorticoids should only be used for short "pulse therapy" of two weeks maximal duration in patients for whom antihistamines with mast cell stabilizing properties have not controlled symptoms adequately. Ocular side effects from glucocorticoids can be vision threatening and include cataract formation, elevated intraocular pressure (IOP), glaucoma, and secondary infections.

3. Artificial tears

Dry eye can coexist with allergic conjunctivitis and worsen it through two mechanisms.

  • Concentration of allergen in eye is higher with tear film insufficiency
  • Ability to rinse away the offending allergen is diminished
  • For patients with frequent episodes (ie, occurring more than two days per month), and for those with seasonal or perennial allergic conjunctivitis, we recommend a topical antihistamine with mast cell stabilizing properties (olopatadine)
  • For patients with SAC, treatment should be initiated at least two to four weeks before the anticipated onset of symptoms whenever possible to optimize effectiveness. Patients with concomitant rhinitis — In patients with concomitant allergic rhinitis, the addition of an intranasal glucocorticoid spray or an oral antihistamine can be helpful.

Conjunctivitis (Eye Flu)

Signs and symptoms include discharge, redness, watering , foreign body sensation, grittiness, matting (sticking) of eye lashes

Discharge from the eyes is more purulent (pus like) in bacterial conjunctivitis than in viral conjunctivitis (clear watery).


  • Prevention is better than cure is most apt for this condition.
  • Most important precaution is never to touch or rub your eyes without washing your hands.
  • Because these two conjunctivitis types are contagious, you should practice good hygiene once you do catch the infection such as frequent hand washing to prevent infecting your other eye or other people who share your environment.
  • Topical Antibiotics usually are the mainstay of treatment for bacterial forms of conjunctivitis.
  • Anti-allergic eye drops or tablets may also be used for infectious conjunctivitis and are most important if it is only an allergic conjunctivitis when eyes may be itchy, scratchy and irritated.
  • Place warm compresses on closed eyelids to soothe your eyes, ice or cold compresses are more helpful for allergic conjunctivitis.
  • Remember never to use steroid eye drops which are unfortunately frequently given over the counter by many chemists. Always consult your eye doctor (Ophthalmologist) as some types of conjunctivitis like adeno-viral may leave permanent marks or opacities on the cornea.