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Is It Chronic Dry Eye or Just Allergies? How To Tell

November 3, 2017

Believe it or not, two of the most common problems people have with their eyes (at least the most common problems that aren’t related to needing glasses or contact lenses) are dry eyes and allergies.

Interestingly enough, those two problems often have similar symptoms, even if they’re distinctly different disorders. And telling them apart isn’t made easier by the fact that a person can have both issues at once.

In order to clear up some of the confusion, we’ve listed the distinct causes and symptoms of dry eye and allergies below, along with some treatment options for both.

Dry Eye

You’ve no doubt heard the expression before that tears are salty, and indeed, it’s important to remember  that there are more ingredients in your tears than just water. A tear essentially has three layers: water, lipids, and mucin. Dry eye can occur when there isn’t enough of any of these three elements being produced.

The outer layer of a tear is the lipid layer, and its main job is to keep tears from evaporating or spilling over the margins of the eyelids. The lipid layer is created by glands located at the edge of the lids; these glands are called Meibomian glands. Most often, dry eye is caused by some kind of decrease in the layer of lipids, although there are some other medical conditions that can cause dry eye. A person suffering from dry eye will most often suffer from a burning sensation, a gritty feeling in the eyes and some reflexive tearing up.


It’s worth mentioning that one of the reasons that allergies and dry eye can feel similar is that allergy symptoms can also include burning and tearing, though the main symptom is itching, something  that doesn’t often occur with dry eye.

An eye allergy is typically caused by some sort of sensitivity to a substance that would normally not be harmful. When that substance comes in contact with cells in the eye called mast cells, that contact creates what’s called a histamine. Histamines cause redness, itching and swelling. Allergens most often arise from environmental causes, including cat dander, pollen and dust mites. But it’s important to know that there are more serious kinds of eye allergies that could eventually require medical attention.


The recommended treatments for dry eye and allergies are different, even if the symptoms are similar.  Treatment for dry eye often includes concentration on the Meibomian glands, finding the source of the underlying inflammation, and using lubricants to produce tears. Ocular allergy treatments can include antihistamines or mast cell stabilizers, which prevent the release of histamine, artificial eye lubricants, compresses and avoidance of the allergen.

If you wear contact lenses, it’s possible that your doctor may choose a different lens for you that’s made of a material more resistant to drying out. For those suffering from ocular allergies, a doctor might recommend wearing a disposable lens (typically one-day lenses), which will gives the eyes the best chance of avoiding the allergen entirely.

However, if a visit to the doctor isn’t possible for you in the short term, there are some over-the-counter options, as well. Some people use eye drops to combat dry eye and a general antihistamine for allergies, which can present other symptoms other than eye issues.

In severe cases, typically during allergy season, a prescription eye drop option might be needed. If this is required, a doctor will often advise the patient to use the drops each day through allergy season, even if they aren’t having symptoms.

It’s also possible that an oral antihistamine, the type that would be used for allergies, might actually exacerbate dry eye symptoms, in which case a doctor could additionally prescribe a nasal spray to stimulate lacrimal gland production.

In the event that you’re having symptoms of dry eye, ocular allergies or other issues, you can always give us a call at OCLI and we can arrange an appointment for you to get an evaluation.


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