How to address itchy eyes at the pharmacy counter or drive-thru window

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Nearly 66 million (one in five) Americans suffer from itchy eyes caused by seasonal and/or perennial allergies. In any given year, pharmacists and health care professionals face questions during allergy season about itchy eye symptoms that can easily be confused with dry eye disease or viral infections. This year, many are now asking a new question: Are my symptoms related to allergies or COVID-19?

Dr. Michael Cooper

During the pandemic, many people may be apprehensive about visiting their primary care doctor, and their eye doctor’s office might be closed or only open for urgent and emergent care. Instead, some might choose to rely on their pharmacist for information and advice on how to address itchy eyes. Here’s what pharmacists should know this year, or any year, about treating allergy eyes:

Ask a simple, open-ended question

Lines at the drive-through window are likely longer than usual, and those at the counter now require people stand six feet apart. A tip for quickly guiding customers presenting with itchy eyes to a treatment is simply asking: “Have your eyes ever itched before?” The keyword here is “ever.” It introduces chronology into the situation. This forces the patient to think from a historical perspective when the itching first presented itself — perhaps it began when flowers started to bloom — tying the itch back to allergy season.

Recognize when it is allergies (and when it’s not)

Allergies often affect both eyes equally with itching and redness. The person may complain they feel the need to rub their eyes throughout the day as the itching is constant. A viral infection can include symptoms of watery or “goopy” discharge from the eyes. Asking about other symptoms: Scratchy throat, cough and fever can help discern between allergies and a viral infection.

It might be dry eye

Without much else to do, people are spending more time on their phones, computers, tablets and televisions than ever before, which means they’re blinking their eyes less often. Too much screen time can mean dry eyes that are described as feeling gritty or like sandpaper. Asking the question “Have you been using the computer or television more often, or playing video games for extended periods of time?” can help put these symptoms into perspective for the patient. If the itching or redness is worse in one eye — or comes and goes intermittently — that is more likely to be dry eye. This might lead you to recommend a lubricant eye drop for relief.

Think over-the-counter first

While optometrists like me are taking telehealth and urgent care appointments and still working hard for our patients, people don’t have access to routine care, and some are losing access to their employer-sponsored insurance due to layoffs. Fortunately, two formulations of olopatadine, formerly only available via prescription, are now available over the counter so you can point customers to the store shelves to find relief for ocular allergy itch. PATADAY Once Daily Relief (olopatadine 0.2%) and PATADAY Twice Daily Relief (olopatadine 0.1%) eye allergy itch relief drops provide long-lasting, prescription-strength relief for itchy allergy eyes.

Know when to send
them to the doctor

Sometimes urgent care, telehealth, or even emergency visits are necessary. Pharmacists should exercise common sense when it comes to customers with a verbose list of symptoms and an overall physical appearance that suggest they are dealing with something more serious. In these cases, the customer should be encouraged to consult their doctor.

Dr. Michael Cooper is an optometrist and director of innovation and research at Solinsky Eye­Care as well as a paid consultant to Alcon.


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