That time of year again — Seasonal allergies

Blog vol 6.46. That time of year again — Seasonal allergies.

The dark side of spring. Yes, there are fresh smells, new blooms, birds busily building nests, but there are also pollen and grass and seasonal allergies. Allergies start to show up in my chair and behind by biomicroscope: wet, itchy, red eyes, headaches, scratchy throats, and shortness of breath.

So why does the loveliness of spring wreck such havoc for some people?

The offender is a small particle, usually pollen, that is captured and processed by specialized cells called antigen-presenting cells (APCs).  These APCs present fragments of the allergen (antigens) to the T cells (a type of lymphocyte). 

This T cell activation releases chemical signals, such as cytokines, that stimulate other immune cells including B cells and mast cells. The B cells then produce antibodies, specifically immunoglobulin E (IgE), which are specialized in recognizing and binding to the specific allergen.

When the sensitized individual is re-exposed to the same allergen, the allergen binds to the IgE antibodies on the surface of mast cells or basophils. Spring comes, pollen counts go through the roof and we see allergic conjunctivitis.

The combination of allergen with IgE antibodies on mast cells or basophils triggers the release of chemical mediators, including histamines, leukotrienes, and prostaglandins. Histamine, in particular, plays a significant role in producing immediate allergic symptoms. It is these histamines that we are trying to stop. They cause blood vessels to dilate, leading to increased blood flow and leakage of fluid into tissues. This results in local swelling, redness, and heat. Histamine also stimulates the nerve endings causing itching and pain.  It can get serious when increased mucus production from the histamine affects the respiratory tract.

In some cases, an additional response, known as the late-phase response, may occur some time  after the initial allergic reaction. It is characterized by the infiltration of immune cells, including eosinophils and other inflammatory cells, into the affected tissues. This leads to prolonged inflammation and persistent symptoms. This late-phase response is more serious and requires more intervention.

How to help?

1.    Reduce exposure - if you have known sensitivities, be aware of seasonal changes. This is difficult, wearing an N95 mask and safety goggles is not for the fashionista.

2.    Timely response - seek medical help; eye-related, call our office and set up a visit

3.    Treatment depends on severity -

Mild - cold drops and cold compresses

     Moderate - antihistamine drops (go with mast cell stabilizers, quick working)

Severe - oral Benadryl and antihistamine drops (and possibly a soft steroid drop) and cold compresses and patience😊

The key to all this is early intervention to reduce symptoms, restore comfort, and to prevent late-phase allergic response (nasty).

Please call if you have seasonal symptoms.

Enjoy your Spring, and Summer, and Fall….



The good doctor