If it's just allergies and you're in the US, try this eyedrop: Pataday Extra Strength (generic olopatadine 0.7%). It is over the counter and you should be able to buy it pretty much anywhere (CVS, Walgreens, etc.) Use it once a day and you should see symptom relief in about two weeks, but you need to be consistent with it.

See a eye doctor for an Rx if you want faster relief with steroid drops, although keep in mind that those need to be dosed more frequently, usually about 4x a day. Also, as with any eye drop aside from those specially formulated for it, take contact lenses out before using.

Source: I'm a fourth year optometry student who has been browsing HN for years. First time actually writing anything!

Thank you for your advice! I'll see if she's used any of those before and if not we'll look at trying them out.

A common cause: If she have been sleeping badly it could be that she had dried eyes, and that the eye lid get stuck to the eye and rift some of the “top layer” off. Feels like dust in the eye and hurts. Very hard to see the damage without good eye doctor equipment, and the doctor need to look for this kind of damage by magnifying and using the reflection of light on the surface of the eye to see it.

Happened to me three months ago.

The eye doctor will give prescription on eye cream to reduce the possibility of bacterial infection and to smooth the eye. This helps a lot.

The eye repair itself quick (<1week) but it takes 1-2months before it is as strong as before, so remember to use eye drops if the eyes is a bit dry.

This is quite common my eye doctor told me.

Oh my goodness that sounds very unpleasant! Did that affect both your eyes at the same time? Did it result in itching or more localised pain on a specific part of your eye? I'm wondering if this could have happened to both her eyes concurrently... thank you so much for your suggestions.

I get terrible itchy eyes (along with sneezing, itchy roof of mouth). It's allergies for me. Confirmed dust mite allergy but there is other stuff, I'm sure (hayfever etc). I take an over-the-counter antihistamine every day (cetirizine, swapping with loratadine every now and then). Also wash bedding once a week and ensure the vaccum cleaner's HEPA filter is cleaned. I still get the odd seemingly inexplicable awful day but the above measures have stopped it from messing with my life (when it's very bad I just have to rest...). Has taken decades to get to this point!!

One thing a doctor said stuck in my head after the dust mite allergy was confirmed - he said that in every case like this that he has seen, the patient suffers from at least 2 out of 3 of the "triumvirate" consisting of allergies, asthma and eczema. That is indeed the case for me.

That really rings true, my wife has all three - I believe she calls herself 'atopic'. Thank you for your suggestions, I'll change the hepa filter on the vaccum and get better at washing our bedding :D she already takes OTC antihistamines regularly so thats a good start. It sounds like our experiences are quite similar. All the best with your allergies!

In general, this sounds like you have 5 directions to investigate:

1. Bacterial infection. Ask a doctor for antibiotic eye drops.

2. Viral infection. Ask a doctor for antiviral drugs. Alternatively, see if it gets better or worse if you boost or weaken her immune system.

3. Yeast infection. Ask a doctor for the appropriate cream.

4. Allergy. Does Cortison make it weaker? Air purifier with hepa filter. $500 and helps against a lot of things, including some bad smells.

5. Autoimmune reaction. Ask a nearby university if they are willing to run a microarray test to see which genes are active in the eye fluid. It tends to cost $10 + 10 minutes of work if you order that for research purposes.

Edit : can't find the paper, but i remember that covid increases your risks of eye fungi. Something about black mushrooms in India

Thank you for your reply, it does fit with allergens as you say (reduced immune system helped so we dont think viral or bacterial). I'll take a look at the auto immune tests - we do have a good university nearby so may be in luck :)

As for the fungal issues with Covid, I recall that was because people took massive doses of steroids depressing their immune systems, so I don't think that's the cause here.

How long can the 1-2-3 infections in your list persist?

Shouldn’t viral infections get eliminated by the body eventually?

My ex wife had herpes on her eyelids.

Sounds like allergies. Carpets are your enemy, get those out of there. There are certain types of carpets that are better than others but in general they all capture allergens.

You can have blood work done to find out what she's allergic to. They'll probably start with the obvious ones like pollen and animals.

I'm allergic to pollen, cats and dogs.

Summers are a mix of awful and sunshine, but I get through them with regular antihistamines.

I actually own a dog, which is fine as long as I clean the apartment every week, have almost no carpets and take care of the dogs fur and skin.

But my allergies show themselves in more ways than just the eyes. I'd say the eyes are the last sign. The first sign is itching of the throat, sneezing and a runny nose.

I'm somewhat allergic to dog hair yet live happily with a poodle. It sheds very very little hair and if groomed fairly often (professionally) then even less. I'm not suggesting you to change the little friend! But it might help somebody in search :)

Thank you for your thoughts - I agree it sounds like allergies, and I know the previous owners had a dog so I'd thought of getting new carpets, but perhaps just getting rid completely is the answer. We'll try and get in touch with an allergist too :)

Your wife might be too young for this, but it's worth getting tested for Sjögren's syndrome, in order to rule it out. Sjögren's syndrome can cause dry itchy eyes.

It's estimated to affect about 1-4 million people in the United States. (Mostly women 40-60, sometimes younger) It is an autoimmune disorder.

Thank you but I looked up the symptoms and she only really has the dry eyes, thank goodness! That sounds like a difficult one to manage.

I've had this before from dust mites. I was able to eliminate them from my small apartment with a dehumidifier and freezing my bedding plus occasional Claritin (loratadine), but immunotherapy is the ultimate way to address allergies.

There's even a yc startup doing immunotherapy these days wyndly https://news.ycombinator.com/item?id=26227807

Thank you that's fascinating, can I ask how you knew it was dust mites? We've been worried about the humidity being too low so your suggestion to dehumidify is a surprise. The startup looks great but we'd have to identify the cause of the reaction first :)

Would suggest consulting an allergologist. And as other have suggest get an Air purifier with a HEPA filter. I have allergies which manifests as eye itch and heavy sneezing. Installing Air purifiers had a immediate effect on my allergy symptoms.

Thank you, we actually have a fairly hefty HEPA filter so I'll set that up and see if it helps

It may be a long shot, but I'd like to add - don't neglect simple things like dryness at home. Are there any issues with mucosa, issues with sleeping (headache in the morning, hard to get up, blocked nose)? You seem to do worry about that (you mentioned central heating off). I advice putting a few hygrometers in your place and get a feeling of at what levels you guys feel comfortable with, especially at night.

Me and my wife had a lot of issues because of that. Itchy eyes, sore throat, dry mucosa or trouble with breath at night. Me at first due to years of work in air conditioned offices. It was always better when I had a few days off. Now it came back due to remote work and winter season. Wife had problems with mucosa and sore, itchy eyes. It got worse after she gave birth and stayed home a lot.

I try to manage it using air humidifiers, those large ones that double as air cleaners, with large hepa filters and so on. Anything smaller is just a toy. I've got a large one running almost 24/7 in the winter and it's usually barely sufficient even with our small flat.

Bear in mind: - I think both moisture and temperature at home has a lot of inertia. Plain reading from a hygrometer is often confusing so take into account what's happening around (large temp drop outside, rain, laundry at home, etc.).

- I live in a "block" (large house with many flats) and even if I don't use heating, others do. This impacts dryness in my place a lot.

- Cheap "Home use" hygrometers are often mediocre and tend to fail quickly (in my case broken ones has shown just a few % difference all year round). I have no other advice here other then replacing those that act weird.

- Home use air humidifiers on the market (Europe, in price range around 250 Euro) are often way to small to make any difference. The bigger the better, there are ones that double as air cleaner. They have large fans and push a lot of air through. That works VERY well.

Thank you for your thoughts - would you mind recommending an make of air purifier? The only ones I can find seem too small to be what you are describing

With humidifier - I have a Sharp KC F-32. That was the cheapest thing with humidifier that was available in stores locally. Large filters. Decent airflow. Silent mode that is really silent. Simple humidifier that I think works well. "Auto mode" that works harder when the device has water AND it's below 50% humidity. A nice basic setup.

It takes some effort to keep the water "filter" (it's actually a saw-shaped element that just absorbs water like a sponge to make it easier to evaporate) clean. Especially that Sharp claims it should be used with plane water, not distilled water. I don't buy new ones that often as it's somewhat pricey, but clean them once in a while with warm water with lemon (that domestic, citric acid used commonly for food) and make sure it's not wet when not used.

The actual filters (carbon and hepa) are very easy to clean and I have not had to replace them yet, so don't worry about costs of those.

I had something similar, itchy eyes/eyelids with small dots on the lids. I was told it's blepharitis (https://my.clevelandclinic.org/health/diseases/10032-blephar...) and was told to use a eyelid scrub (https://www.webmd.com/eye-health/how-to-use-eyelid-scrubs) twice a day.

It worked. My eyes stopped itching, and over many months, the frequency of the dots decreased too.

Thank you that sounds very interesting, we'll try your suggestion

If screen use is up, she may not be blinking enough. "computer vision syndrome".

I have some gunnar glasses that sit close to the eye and wrap around so do a good job blocking air currents which (I think) helps with dryness

I had the same problems, starting when I was still in high school. Turned out it was a side effect from my hay fever allergies. Antihistamine works reasonably well. There are eye drops if your wife does not wear contact lenses or nose sprays and pills if she does.

And go see a real doctor.

You didn't mention allergy medication. It eliminates allergy symptoms for most people. An air purifier with a HEPA filter will help as well. If not, you're gonna need to talk to a real doctor.

I use Levocabastine whenever my eyes are itchy due to an allergic reaction. Can be used daily AFAIK.

You mentioned opticians - does she wear contacts? A buildup of proteins on contacts can cause itchiness and an allergic reaction in the eyelids. It's something I struggled with until I switched to dailies.

Seconded as an issue that I ran into from non-daily contacts. It is called "Giant Papillary Conjunctivitis" and can happen without warning after years of wearing non-daily contacts without any issue.

Switch to daily contacts to solve it after seeing an optician to discuss.

Are they still itchy after not looking at screens (or room LED lighting) with Pulse-Width Modulation (PWM) for several days? That might be worth looking into as they cause dry eyes for some people.

Perhaps something like Blephaclean daily cleaning wipes, helps get debris / dandruff from base of eyelids

Thank you, I think our next step will be something like these wipes as you suggest, that would take care of the alarming dermodex mites if theyre there too...

Test for Demodex mites infestation too

How alarming! We'll see about getting tested for this thanks

Not a doctor, but just some ideas if you're not already doing these (remember everyone can react differently to things so in the case of medicines read the contraindications and possible side effects and be aware before you choose to take or not):

- If you don't already, then drink plenty of water, get good sleep and do every-other-day small-bore exercise (like Tabata, or 4 minute HIT). Wonderful how much magic a bit of hydration, rest and exercise can do for overall health, which then affects and makes one more resilient to everything.

- Try an antihistamine. I find fexofenadine (Allegra) 180mg great in pollen-crazed spring. It is 2nd/3rd gen so zero sleepiness.

- Try a baby aspirin (100mg) before bed. Takes the edge of any chronic inflammation. Get a good brand like Bayer, they seem to be more effective.

- I find fluorometholone the go-to for short term eye itchiness. Don't want to use it too much because it lowers eye immunity increasing infection risk, but waaay more effective IMO than dexamethasone. Either 1% (0.1mg/ml) or 0.02mg/ml both good.

- See an opthamologist, not an optician--tho, I'm pretty sure that's what you already meant!

- Try 'alternative medicine' practitioners, like: Chinese medicine doctors, who prescribe herbs and maybe meridian point treatments; or Ayurvedic Indian medicine doctors. If you're not from their originating cultures, try to find some in an area where lots of people from that culture live and go to one those folks trust. They can take a wholistic/systemic view of what's going on with you, and try to address imbalances, that may manifest as localized symptoms--instead of a reductive view that just focuses on a small area, and biases toward targeting symptoms (to make an overly glib distinction)--but both approaches very much have their place, needless to say.

- Do some eye exercises, like focusing on points at different distances.

- Reduce the eye strain. Don't be spending all night in bed on the phone or device, or be 'pushing through' when your eyes are tired.

- Reduce alcohol.

- Vet all medications and supplements you're already taking, as well as foods, and discover if there are any triggers. How you might go about that potentially mammoth task tho, I leave as an exercise of the reader! Everyone can find their own way tho, of that I'm sure.

- Vet all personal care, health and beauty products, including things as basic as makeup, shampoo, moisturizer and toothpaste. Try going on a 'gunk fast' with zero such products applied (not just to the face, as they can absorb from any part of the body) for a few days or even (!!) a week. See if any effect. Very likely could be something in there. Even a brand of face mask could contains some sort of surface coating that's allergenic.

- If you do more of the household chores (and therefore exposed to more chemicals) try to share that around more and take turns.

- If you work in a place that involves chemicals or particular sorts of air-conditioning or filtration...consider if that could be an issue.

- Consider an environmental cause, even a natural one like trees on your common commute paths, or a local industrial plant.

- If you smoke, or vape...take a break and see if that helps.

- Try to avoid bringing the hands to the face, and rubbing the eyes.

- If there's a beard in the equation, try shaving it. May be the harborer of allergens, sadly.

- Buy a water filter, and an air filter, see if they help.

Good luck!

Thank you so much for taking the time to type all this out, its very kind of you. Sleep is definitely an issue at the moment - we have a newborn and catching up is difficult but I think the fatigue has contributed to this problem. And re opthalmologists, no she's just seen opticians, although theyve been very good it may be time to move to an opthalmologist or an eye doctor.

antihistamine eye drops.