SUMMER SLOWLY, gradually loosens its grip; the sun retreats, heat, and humidity give way to cool autumn winds, and leaves trade their uniform green for hues of vibrant red and brilliant gold. The changing of the seasons is a wondrous thing, if only... ah ah ACHOO!!! If only, you didn’t have to spend it wondering whether your box of tissues is going to last you through the week. It’s an experience many of us are familiar with, an appreciation of the beauty of fall tempered by the dread of fall allergies. Eyes itch and redden and the nose can somehow be runny and stuffy at the same time making for a pretty miserable experience overall. Both organs are very sensitive to external stimuli, and the changing of the seasons certainly provides no shortage of these. But what exactly is happening in our bodies that causes dust and pollen to give us so much grief?

Ocular disease and allergies

   Seasonal allergic conjunctivitis (SAC), commonly known as pink eye, is one of the three main types of conjunctivitis and it is classified as an acute ocular allergy. As the name would suggest, SAC is a common condition during seasonal transitions, and it is mostly due to the increased amount of certain types of pollen. From May to June the cause is primarily grass pollen whereas in August and September the culprit is ragweed*. The allergic reaction that causes SAC occurs when these pollens make contact with the conjunctiva, a layer of loose connective tissue that covers the front surface of the eyeball and inner surface of the eyelids, causing inflammation**. The common symptoms of SAC are itchiness and hyperemia with the latter resulting from people rubbing their eyes due to initial irritation. This then causes the veins in the conjunctiva to expand, which makes the eyes appear red. SAC can also cause the eyes to produce a clear watery discharge. The reason the eyes have such a strong reaction is that the aforementioned seasonal pollen contains various antigens and lipids that trigger the body’s immune response***. Dry eye syndrome (DES) is another common ailment that occurs during autumn. In the fall, the temperature difference between night and day grows more pronounced than in the summer and the humidity begins to dissipate. Exposure to this suddenly much drier climate can lead to dysfunction in the lacrimal gland and accessory glands which provide tears to the eye leading to DES.

Allergic rhinitis

   Allergic rhinitis, also known as hay fever, is an allergic disorder that is caused by an abnormal inflammation and swelling of the nasal mucosa, a layer of moist tissue within the nose****. Due to this, people with allergic rhinitis sneeze frequently and suffer from a stuffy and or runny nose. The National Institute of Health has conducted research proving the connection between allergic rhinitis and SAC and when both conditions affect a person simultaneously it is referred to as rhino-conjunctivitis. People with allergic rhinitis usually suffer from SAC because the nose and eyes are connected by what is called the nasolacrimal apparatus where contaminated tears from eyes flow down to noes. As Doctor Lee Ji-hye from Seongdong I Nuri Acupuncture explains, for people with allergic rhinitis, these tears cannot be discharged due to swollen nose, and consequently, allergen contaminated tears that remain in eyes cause conjunctivitis*****.

   Like with SAC, rhinitis begins with exposure to a foreign irritant with the most common sources being pollen and mold spores that are discharged from decaying leaves. A dry indoor environment can also contribute to rhinitis such as when you use heaters to warm your home during colder seasons. When the mucous membrane becomes dry, the resistance against allergens and germs weakens with the ability to deal with infection being reduced******. The increased amount of house dust mites after humid weather in summer also causes allergic rhinitis. Exposure to these allergens triggers an antibody called immunoglobulin E******* which stimulates the nasal mucous membrane to releases histamine, a natural chemical that defends the body from invasive substances. Histamine that induces the mucous membrane to swell produces greater quantities of mucus in an attempt to force the detected substances out of the body.

Possible treatments

   Though the conditioned responses of SAC and allergic rhinitis are intended to help prevent infection and maintain your health, in this particular instance, they undoubtedly do more harm than good. Fortunately, there are a number of recommended practices to reduce the impact of seasonal allergies on your daily life. When dealing with SAC, it is important not to touch and rub the eyes even when experiencing itchiness. According to Professor Shin Hyun-jin from Kunguk University, rubbing eyes constantly can lead to other complications such as a thinning of the conjunctiva and retinal nerve********. Instead of rubbing, washing the eyes with clean water and putting on an ice pack could help. Wearing contact lenses should also be avoided to alleviate SAC symptoms as allergens like fine dust and pollen can be adsorbed into contact lenses and cause allergic inflammatory reactions. Moisturizing the eyes is also essential not only for SAC but also for treating eye dryness. Lubricant eye drops can help when the eyes feel stiff and irritated.

   As for people who have allergic rhinitis, they should make a habit of wearing a mask when going outside. This will reduce the opportunities for allergens to enter through the person’s nose. A study published by NCBI states that standard surgical masks can filter particles larger than 3 μm, whereas N95 respirators can filter particles as small as 0.04 μm.

   At home, frequent ventilation will bring in fresh air reducing allergens within the closed environment, and removing objects made of woolen fabric such as carpets can help get rid of dust mites. Nasal douching, which is cleansing the nose using a saline solution, can also help by removing the allergens and excess mucus within the nose*********. The way to do nasal douching is by putting the saline solution into one nostril and flushing it out the other, rinsing the whole nasal cavity. This can be done easily when using tools like a neti pot or nose sweeper. Nasal douching is more effective when the concentration of the saline solution is only a bit higher than body concentration which is about 3% and the temperature of the solution should be close to human body temperature to reduce irritation within the nose.

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   Seasonal allergies are an inevitable part of our lives. According to the Asthma and Allergy Foundation of America (AAFA), one ragweed plant can produce up to a billion grains of pollen during its lifespan. So preventing allergies altogether is likely a difficult task. But understanding the causes of seasonal allergies and knowing possible treatments can help you during seasonal changes in surviving these allergies and diseases.

*Kellogg Eye Center

**All About Vision

***NCBI

****Springer

*****Sdinuri

******Health Chosun

*******Cochrane

********Maeil Business Newspaper

*********WebMD