For allergy patients, fall often means relief from the lush summer foliage thats responsible for much of their misery. But, just because the fall doesnt look like the summer or spring doesnt mean its not also a viable allergy season.

In the fall, you dont see mold outdoors, you dont see the ragweed problem quite as much, and the trees are not blooming, says Richmond, Va., allergist Anne-Marie A. Irani, M.D., That doesnt mean its not there.

Optometrist Bobby Chip Wood of Uvalde, Texas, adds that people forget that when plants start to die and when the ragweed blossoms, there are also allergy problems.

According to a 2002 survey done by the American College of Allergy, Asthma and Immunology, (ACAAI), 94% of patients said their quality of life deteriorated when they had allergic reactions. To better these patients lives, O.D.s must be on the lookout for fall allergens.

Autumn Allergens
There are two primary causes of fall allergy: ragweed and mold.

Most ragweed allergy issues are caused by two species: the normal/ small, ragweed (Ambrosia aratemisiifolia) and the giant ragweed (Ambrosia trifida).1 Ragweed has coarse yellow or green leaves and can be found in vacant lots, roadsides, backyards and anywhere else the sun is prevalent.2

According to the American Academy of Asthma, Allergy and Immunology (AAAAI), ragweed pollen is released August 15 and lasts until October. While it is most common in the Northeast and Midwest, all areas of the United States have some form of ragweed. In the South, ragweed pollination begins in January and lasts until October.2 Ragweed allergy symptoms include rhinitis or hay fever; sneezing; and inflamed, watery and itchy eyes.2

While ragweed isnt as common on the West Coast as it is in the rest of the United States, mold (the other fall allergen) certainly is.3

Mold spores peak in the late summer and early fall, and are found both outdoors and indoors.4 Outdoor molds can be found in falling leaves, vegetation, rotting wood and soil. Indoor molds enjoy the damp areas of washing machines, dryers, refrigerators, shower stalls, trash containers, basements and upholstery.3,4 Dr. Irani, who treats mostly children, has found that school carpeting, which tends to be old, can also be a mold source, due to dampness and possible floods.

Recently, in a study sponsored by the Centers for Disease Control and Prevention (CDC), the Institute of Medicine of the National Academy of Sciences found indoor mold and building dampness to be linked to respiratory problems. These problems include asthma in some with the chronic disorder and coughing, wheezing and upper respiratory tract symptoms in otherwise healthy individuals. Researchers came to this conclusion after reviewing the available scientific studies on mold and building dampness.5

Mold growth in the West Coast and Midwest doubles by summers end, especially in cold and dark areas where there is much rain.3 In the northern United States, outdoor mold hits its apex in the late summer and early fall.3 Common mold allergy symptoms include itchy runny nose, sneezing, nasal congestion, dizziness, watery and swollen eyes, blurred vision, eyelid twitching, eye redness, wheezing and cough.6

We really are diagnosticians when it comes to our patients eye care, says Dr. Schachet. If we dont stay on top of all of the allergy seasons, patients may be misdiagnosed as having dry eye or other ocular conditions, and as a result, the treatment regimen will be incorrect.

1. Tidwell J. Ragweed Pollen Allergy: The Number One Cause of Fall Hayfever. URL: July, 2004)
2. Topic of the Month: September 2002: Fall Allergies and Asthma. URL: July, 2004)
3. Where Allergy Relief Begins. Fall: The Season for Ragweed and Mold.URL:, (23 July, 2004)
4. Warner J. WebMD Health: Taking the Itch Out of Fall Allergies. Don"t let seasonal allergy symptoms spoil your fun. August 22, 2003. URL: (23 July, 2004)
5. The National Academies. News. Indoor Mold, Building Dampness Linked to Respiratory Problems and Require Better Prevention; Evidence Does Not Support Links to Wider Array of Illness. May 25, 2004. URL: (23 July, 2004)
6. Allergy Health. Home Doctor Self Help Tips: Allergy. Mold Allergy: Symptoms. URL: (23 July 2004)

Vol. No: 141:08Issue: 8/15/04