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Relieving Chronic Dry Eye

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Don't Confuse Dry Eye Syndrome With Allergies

Medically Reviewed By William C. Lloyd III, MD, FACS
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man rubbing his eyes

Your eyes are itchy, burning, and bothersome. You assume that your allergies are kicking up, so you use antihistamine eye drops. But instead of getting better, your eye symptoms only get worse. What’s going on?

It’s possible that what you thought were allergies is actually dry eye syndrome. Dry eye sufferers don’t produce tears in sufficient quantity or of good enough quality to keep their eyes comfortable and healthy. The symptoms of dry eye can resemble those of allergies, but the treatment is different. In fact, antihistamines and nasal decongestants, which ease allergy symptoms, actually make eye dryness worse.

These guidelines can help you tell the difference between eye allergies and dry eye syndrome. And that can help you find effective relief for your irritated eyes.

Similar but Different Symptoms

Although the symptoms of eye allergies and dry eye syndrome are similar, they’re not identical. Here’s what to look for:

Dry eye syndrome

Symptoms of dry eye include:

  • A gritty feeling as if something is in your eye

  • Eye stinging or burning

  • Stringy discharge from the eyes

  • Bouts of excessive watering after periods of a dry sensation (reflex tearing)

  • Eye pain and redness

  • Blurry vision

  • Heavy-feeling eyelids

These symptoms are sometimes brought on by menopause or diseases that affect tear production, such as lupus and rheumatoid arthritis. They may also occur after taking medications that reduce tear secretion. These include antihistamines, decongestants, high blood pressure medicines, sleeping pills, anti-anxiety medicines, and pain relievers.

A dry, windy climate tends to make dry eyes worse. So do smoke and air conditioning, which speed up tear evaporation.

Eye allergies

Symptoms of eye allergies include:

  • Itchy eyes (#1 symptom)

  • Eye stinging or burning

  • Watery discharge from the eyes and a runny nose

  • Eye redness

  • Sensitivity to light

  • Swollen eyelids

These symptoms develop shortly after exposure to an allergen. The worst offenders are pollens and molds. People with these allergies may notice eye symptoms after spending time outside in the spring or fall. Those with allergies to animal dander or dust mites may notice that their symptoms get worse after brushing a pet or cleaning the house.

Eye allergies can occur alone or along with other allergy symptoms, such as a runny or stuffy nose, a scratchy throat, sneezing, and dark circles under the eyes.

Watery Eyes Can Be Dry, Too

Surprisingly, both allergies and dry eye syndrome can cause watery eyes at times. In the case of dry eye syndrome, poor-quality tears typically have decreased water content. What few tears get produced are quickly blinked away. When this happens, tears don’t stay in your eyes long enough to keep them feeling moist and comfortable. Inadequate moisture disrupts the normal tear chemistry and alters tear comfort. Eye irritation may prompt a temporary flood of tears from the large lacrimal glands, which overflow your eyes and start rolling down your cheeks.

When you have dry eye syndrome, these episodes of excessive watering follow periods of dry, scratchy, gritty-feeling eyes. In contrast, when you have allergies, your eyes may start watering after exposure to something you’re allergic to.

Guidelines are helpful. But telling eye allergies apart from dry eye syndrome can be tricky. See your physician to make sure you get the right diagnosis and appropriate treatment for you.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Sep 22
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Eye Allergy. American Academy of Allergy, Asthma, and Immunology.
  2. Rhinitis (Hay Fever). American Academy of Allergy, Asthma, and Immunology.
  3. Eye Allergy Symptoms and Signs. American Academy of Allergy, Asthma, and Immunology.
  4. What is Dry Eye? American Academy of Ophthalmology.
  5. Causes of Dry Eye. American Academy of Ophthalmology.
  6. Facts About the Cornea and Corneal Disease. National Eye Institute.