Managing ocular discomfort from allergies in patients with active lifestyles

This article aims to provide practical strategies for managing ocular discomfort in patients who lead active lifestyles, helping them navigate their outdoor pursuits with greater comfort. Image credit: AdobeStock/nataba

“When is it going to rain?” This is usually a question about when to plan your run, but it takes on more significance for individuals experiencing seasonal allergies. Outdoor enthusiasts will be exposed to elevated levels of allergens, particularly during days with high pollen counts. Rain will benefit these patients, washing the pollen from the air, but it will worsen symptoms for those allergic to grasses and mold.

Regular exercise is widely recognized for its health benefits, including boosting the immune system, enhancing circulation, and reducing inflammation. These factors can be advantageous for allergy sufferers, as improved blood flow helps flush allergens from the body more efficiently. However, exercising outdoors, especially during peak pollen seasons, can lead to increased exposure to allergens and heightened respiratory rates, and amplify allergy symptoms. This article aims to provide practical strategies for managing ocular discomfort in patients who lead active lifestyles, helping them navigate their outdoor pursuits with greater comfort.

To effectively manage this dual impact, it's crucial for patients to be proactive in their approach. Here are some recommended strategies:

Choose exercise times wisely

Encourage patients to monitor local pollen counts and schedule outdoor activities during times of lower allergen exposure, such as early morning or after rainfall, when pollen levels are typically lower. Cell phone apps can provide real-time pollen and allergen alerts, allowing patients to proactively avoid triggers. Some apps can also track other environmental factors such as air quality and humidity, providing insights into potential allergen exposure that patients can use to make informed decisions about their activities and environments. Many of these apps also allow subscribers to add how they are feeling and their symptoms to analyze trends. The top-rated apps include, in no particular order: My Pollen Forecast, klarify, AllergyCast(by Zyrtec), Allergy Plus (by Pollen.com), and IQAir AirVisual Air Quality (for air pollution and fire information).

Consider indoor options

Suggest engaging in low-impact activities indoors, such as swimming, yoga, or Pilates. Recommend strength training as an alternative to longer-duration cardio exercises. These workouts minimize prolonged exposure to allergens while still providing benefits to overall health and fitness.

Preparation is key

Proper preparation is essential for patients looking to mitigate ocular discomfort due to allergies. Encourage them to adopt the following strategies:

1. Antihistamines: Encourage patients to consider over-the-counter antihistamines and/or nasal sprays before exercising, as these medications can help control allergic reactions and minimize symptoms.
2. Eye drops: Using lubricating eye drops can help alleviate dryness and irritation caused by allergens. Additionally, using antihistamine or steroid eye drops before an activity can prevent the whole cascade of events.
3. Nasal irrigation: Recommend using a neti pot or saline nasal spray to enhance nasal breathing and reduce irritation. Rinsing the nasal passages can help clear out allergens and provide relief from congestion.
4. Stretching: Recommend a warm-up to lessen symptoms as increased circulation helps flush allergens out of the body more quickly.
5. Protective gear: Suggest wearing a cap or sunglasses to shield the eyes from airborne allergens. This simple measure can significantly reduce the amount of pollen and other irritants that come into contact with the eyes.
6. Facial wipes: Advise patients to keep facial wipes handy to clean their faces, eyelids, and lashes if they start having symptoms during their activities.

Practice postexercise care

To minimize allergen contact and alleviate any discomfort after exercising, patients should adopt a routine that includes the following:

1. Shower and change clothes: Advise patients to shower promptly after exercising and change into clean clothes. This practice helps remove pollen and other allergens from the skin and hair, preventing further irritation.
2. Use saline nasal spray: Recommend using saline nasal spray post exercise as well to rinse the nasal passages to clear out any lingering allergens that may have been inhaled during outdoor activities.

Understanding seasonal patterns

As eye care professionals, we must educate our patients about the seasonal patterns of allergens to enhance their understanding and management of symptoms. Humidity also plays a role in allergies; for example, humidity less than 50% helps reduce dust and mites. In warmer temperatures, plants will release pollen earlier and for longer periods. Research indicates that climate change has worsened these patterns, with a study showing that North American pollen concentrations rose by 20% from 1990 to 2018, coupled with an earlier onset and prolonged allergy season.¹ This shift underscores the need for proactive management strategies to help patients effectively navigate these seasonal changes, as follows.

1. Spring (March through May): During this time, tree pollen is prevalent, followed closely by grass pollen. The overlap of these 2 allergy sources can lead to high pollen counts and severe allergy symptoms for many patients.
2. Summer (May and July): Grass pollen becomes the dominant allergen during the summer months.
3. Fall (August through November): Ragweed and mold spores become more common in the fall, further complicating allergy management for patients.

Immunotherapy as a long-term solution

While immediate relief measures are essential, it is important to discuss long-term solutions with patients who experience severe symptoms. Immunotherapy, such as allergy shots or sublingual tablets, is the only treatment that modifies the immune response to allergens, providing lasting relief. This approach can be particularly beneficial for patients who struggle with persistent or debilitating allergy symptoms despite other management strategies.

Managing ocular discomfort from allergies in patients with active lifestyles requires a comprehensive approach that combines education, preparation, and proactive strategies. By understanding the interplay between exercise, allergens, and immune responses, we can better support our patients in maintaining their health and enjoyment of outdoor activities. As we adapt our strategies to consider changing environmental factors, we can help ensure that our patients continue to thrive despite the challenges posed by seasonal allergies. By sharing these insights and strategies, we empower our patients to navigate their allergies while enjoying active lifestyles, ultimately enhancing their overall quality of life.

Reference:

1. Anderegg WRL, Abatzoglou JT, Anderegg LDL, Bielory L, Kinney PL, Ziska L. Anthropogenic climate change is worsening North American pollen seasons. Proc Natl Acad Sci USA. 2021;118(7):e2013284118. doi:10.1073/pnas.2013284118