OCULAR SYMPTOMS 

Eye Itching and Burning

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Introduction: Ocular burning and itching

Symptoms of ocular itching and burning are very common. The eye is susceptible to allergies and irritations due to the fact that it is a moist surface constantly in contact with the air, and all of its pollutants. Furthermore, bacteria thrive on moist surfaces, and can cause substantial irritation as well. Some of these bacteria related conditions can progress beyond simple itching, and can lead to a scratchy sensation or even pain. Other conditions capable of causing eye itching and burning that are discussed on other pages of this Symptom and Diagnosis section are listed below with possible distinguishing features.

Conditions:

For eye anatomy explanations, go to ANATOMY

Blepharitis

Blepharitis is a non-specific term signifying an infection of the eyelids. It is a extremely common cause of ocular redness, itching, burning, and generalized irritation. Other symptoms include discharge (especially in the mornings), a scratchy sensation, tearing, and temporary blurred vision. The condition tends to involve both eyes. Blepharitis occurs when bacteria begin to excessively grow at the edge of the eyelid. This is a moist surface with plenty of food for bacteria to thrive on, including exfoliated skin and oil secretions. People tend to avoid cleaning near the eye, further aggravating this problem. Bacteria at the edge of the lids create irritating toxins which irritate the eye, and the glands of the eyelids themselves can become infected.

There are about 30 glands which open at the edge of each eyelid, and these are oil producing glands. Some people have a dysfunction of these glands where the secretion is abnormally thick and becomes trapped in the gland. This creates further irritation and can lead to stye formation. People with the skin condition known as "rosacea" tend to have blepharitis and dysfunction of these oil glands.

Treatment of blepharitis involves foremost cleaning of the eyelids. Warm compress can be used to help loosen up debris. There are commercially available kits for eyelid cleansing ("Eyescrub", "Occu-cleanse") which also contain a mild soapy solution and small gauze pads. Some physicians recommend using diluted baby shampoo to clean the eyelid, although this can cause irritation in some people, and care has to be taken not to get soap in the eyes. Artificial tears during the day may help to relieve irritation. Antibiotic ointment can be used on the lids at bedtime to reduce the bacterial load. Sometimes antibiotics my mouth are needed.

This condition tends to have relapses, but continued efforts at eyelid cleaning may help to prevent problems.

Ocular allergy

The eyes are commonly affected by allergy, due to their constant contact with the air. Symptoms include itching, redness, lid itching and swelling, mucoid discharge, and eyelid matting in the mornings. There may be an association with hayfever or pollen allergies, with nasal congestion, itching, and running. Oral antihistamines can often relieve ocular symptoms as well. Over-the-counter allergy eyedrops can be effective, although eyedrops which are purely decongestants simply blanche out blood vessels on the surface of the eye. Prescription eye antihistamines may be more effective. Two eyedrop medications (Crolom and Alomide) block the release of histamine in the first place, but take some time to become effective. Cold compresses on the eyes may help to ease symptoms.

The eyes can commonly develop allergies to make-up applied on or near the lids. Any change in eye make-up followed by allergy symptoms may point to this as a cause. Some medications taken by mouth can cause an allergic reaction first seen around the eyes, with swelling and redness of the lids and skin around the eyes. Some eye medications, antibiotics, and glaucoma eyedrops can cause allergic reactions as well, some very commonly.

Some younger people can develop a variant of ocular allergy called "vernal conjunctivitis". This tends to be seasonal, and large lumps develop under the eyelids and can create severe symptoms of itching, lid swelling and droopiness, and discharge. A similar syndrome occurs with contact lens use (see Contact Lens for more information about this).

Phlyctenulosis

Phlyctenulosis (flick-ten-u-low-sis) is a blepharitis related complication of the cornea and conjunctiva. Bacteria at the edge of the eyelids (blepharitis) liberate toxins which get into the tears and irritate the eyes. In this complication, a hypersensitivity reaction, or allergic reaction develops on the cornea or conjunctiva. Symptoms include ocular redness, itching, burning, tearing, and the sensation that something is in the eye, especially with blinking. Sometimes a white spot can be seen near the edge of the cornea. This spot represents a sterile (non-infected) breakdown of the corneal surface, and can be very irritating.

Treatment is aimed at treating the underlying blepharitis, and at helping the cornea to heal. This condition is very responsive to steroid eye medication. Preventive measures include cleaning of the eyelid in order to prevent the hypersensitivity reaction.

Other Conditions causing eye burning and itching found on other pages: