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Seasonal Allergies vs. Occasional Dry Eye

Nearly 30 million Americans suffer from seasonal allergies every year.As the seasons start to change, eye care professionals should start thinking about the possible eye health issues that come with the switch to spring. This week is World Allergy Week, and seasonal allergies can cause a host of issues for patients and their eyes, but the symptoms can mimic those of occasional dry eye. Eye care professionals need to know how to identify and differentiate between these two eye health concerns.



Occasional Dry Eye

According to the Dry Eye Workshop (DEWS), occasional dry eye is “a multifactorial [issue] of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface.” Nearly 21 million Americans are plagued with ocular surface disease, with almost 4.3 million having recurring issues.

Occasional Dry Eye Symptoms

  • Burning (primary sign)
  • Corneal and conjunctival staining
  • Reduced tear meniscus
  • Sandy and gritty foreign body sensation
  • Keratitis
  • “Tired” eyes or ocular fatigue
  • Photophobia (rarely)

Seasonal Allergies

Allergies affect 50 million Americans every year, and 30 million people experience seasonal-specific allergies. With these seasonal symptoms, 70-80% of people experience ocular symptoms. Clinical signs of allergy-related occasional dry eye include extra blood in the vessels of the conjunctiva and eye lids, conjunctival chemosis and papillae, eye lid edema, and clear, watery discharge.

Seasonal Allergies Symptoms

  • Itching (primary sign)
  • Swollen lids
  • Tearing
  • Burning
  • Foreign-body sensation
  • Ocular dryness


Both occasional dry eye and allergies have environmental causes such as pollution, pollen, dry air, and animal dandruff. While allergies are primarily environmental, occasional dry eye can be induced by medical conditions like tear hyperosmolarity, Meibomian gland disfunction, and immune system disorders or even some medications like sleeping pills and pain relievers.

Distinguishing Which is Which

The reaction to eye rubbing can be an indication of whether a patient has occasional dry eye or allergies.

There are a few questions eye care professionals can ask patients to help decide if their symptoms are from allergies or occasional dry eye:

  • Do you have a family history of allergies?
  • When performing certain activities, do you have incidents of intense itching with tearing, redness, or swelling?
  • Do you ever use eye drops for itching or redness?
  • Do you use oral antihistamines at any time of year?
  • Are symptoms more noticeable when reading, watching TV, or using a digital device?
  • Do you notice symptoms more under certain climactic conditions like central air conditioning, forced hot air heating, or very dry weather?
  • When you rub your eyes, does it provide relief or make matters worse?
    • Rubbing the eyes can stimulate tears and relieve discomfort for those with occasional dry eye.
    • Adversely, patients with allergies will feel worse because it causes mast cell degranulation, a process that allows allergens to attach to the receptors in the eyes and cause the reaction.

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  1. Bowling, Ernie L. “Is It Dry Eye, Allergy or Both?” Review of Optometry, Jobson Medical Information LLC., Sept. 2012,
  2. Dang, Shirley. “The Link between Seasonal Allergens and Dry Eye.” Edited by Devin A Harrison, American Academy of Ophthalmology, American Academy of Ophthalmology, 20 Apr. 2017,
  3. Torkildsen, Gail, et al. “Dry Eye or Allergy: How to Make the Call.” Review of Ophthalmology, Jobson Medical Information LLC., 30 Dec. 2005,
  4. Kabat, Alan. “How to Differentially Diagnose and Treat Dry Eye, Allergy.” Healio, Healio, Nov. 2004,
  5. Groves, Nancy. “Allergy or Dry Eye: Which Is It?” OphthalmologyTimes, UBM Medica, LLC., 15 Mar. 2016,

4 thoughts on “Seasonal Allergies vs. Occasional Dry Eye

  1. Good post. Thank you for sharing these details on the seasonal allergies and occasional dry eye. So we will be also able to differentiate between the two in order to go with the proper treatment. Also sore eyes, red eyes, light sensitivity, blurred vision are among the most common symptoms of dry eyes.

  2. Eye allergy and occasional dry eye can happen to anyone irrespective of the season. In today’s polluted atmosphere, eye care is of utmost importance. Treatment of these issues as quickly as possible is very important.

  3. My eyes have always given me problems for as long as I can remember during the spring and fall months. As you listed above, I do think it is seasonal allergies because I do get itching and some tearing primarily. Granted, I think it would be best to go see an allergy doctor to make sure that it is in fact allergies and not something else.

  4. The fact that eye allergies are seasonal is a myth; it’s possible to suffer year-round with allergies. For example, people with seasonal allergic conjunctivitis (SAC) have symptoms that peak in the spring and fall. Those with perennial allergic conjunctivitis (PAC) tend to have milder symptoms all year long. Both SAC and PAC have similar symptoms and are treated in the same way.

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