Understanding Eye Allergies and Dry Eyes: How They're Connected

Allergic Conjunctivitis and Dry Eyes: A Double Trouble

Both AC and DES are among the most common inflammatory eye disorders today—and they’ve been described as epidemics of the 21st century. ³ Studies estimate that:

• Up to 40% of people report symptoms consistent with allergic conjunctivitis.³
• Between 5% and 42% of the population may suffer from dry eyes.  ^{1 3}

What's even more surprising is that most patients with itchy eyes also experience dryness and redness, suggesting a significant overlap between these two conditions. ³

The Role of Allergies in Eye Discomfort

Allergic conjunctivitis is caused by an overreaction of the immune system to allergens such as pollen, pet dander, and dust mites. This results in a type I hypersensitivity reaction, which activates mast cells in the conjunctiva. These mast cells—particularly those containing both tryptase and chymase—are found in increased numbers in allergic eye diseases, and they show a different distribution pattern in affected eyes.²

Symptoms typically include:

• Itchiness (the hallmark of AC) ²
• Redness ²
• Watery or tearing eyes ²
• Swelling of the eyelids ²

In more severe cases, such as Giant Papillary Conjunctivitis (GPC), patients may develop a bumpy, cobblestone-like appearance inside the eyelids. This form is commonly associated with long-term contact lens wear or ocular prosthetics, and it worsens during spring due to high pollen counts.³

Shared Symptoms and Misdiagnosis

Historically, AC and DES have been seen as distinct conditions. But more recent research shows they often share similar symptoms—and in many cases, they occur together in the same patients. ³

In a study of 689 patients, researchers found:

• 35.8% reported dry eye symptoms
• 28.2% reported itchiness

The majority of these symptoms overlapped, especially among those who also reported redness  ³

This makes diagnosis tricky. For example, itchiness is a strong indicator of allergies, but it’s often accompanied by dryness and redness, which are also signs of dry eye disease. ³ This overlap has led to increased awareness of "mixed symptom" eye conditions in modern optometry.

Dry Eye Disease in Africa: A Growing Concern

While DES is a global issue, recent research shows it’s especially widespread across African populations:

• A systematic review and meta-analysis found an overall prevalence of 42.0% for dry eye disease in Africa, with South Africa reporting 54.9%—among the highest on the continent.¹
• In Nigeria, a community study of adults aged 40+ found a 32.5% prevalence, identifying older age as a major risk factor.¹
• Another study from Southwest Nigeria reported a 28.2% prevalence, noting that women were four times more likely to have DES than men, and that people aged 31–40 were most affected. ¹

Dry eye may be exacerbated in Africa due to factors such as sun exposure, urban air pollution, underdiagnosis, and lack of access to specialized eye care. ⁵

Why It Matters: Quality of Life Takes a Hit

Whether you’re struggling with AC, DES, or both, the impact on your life can be significant:

• Studies have found that dry eye disease and allergic conjunctivitis can negatively affect quality of life as much as moderate angina (chronic chest pain). ³
• 46% of patients with AC report a significant drop in their daily comfort and performance during flare-ups. ³
• People often struggle with screen use, driving, reading, and exposure to outdoor environments.
• These conditions are more than just an inconvenience—they’re chronic and disruptive.

What You Can Do

If your eyes are constantly irritated—especially during allergy season or after long hours on screens—you may be experiencing a combination of allergies and dryness.

Helpful Tips:

• See an optometrist or ophthalmologist for proper diagnosis and treatment.
• Try lubricating eye drops like OPTIVE™ FUSION or OPTIVE™ PLUS to hydrate and soothe dry, irritated eyes.
• Consider preservative-free drops if you use them multiple times a day.
• Reduce exposure to common allergens like pollen, dust, or pet dander.
• Use a cool compress to reduce swelling and itching during flare-ups.

Final Thoughts

The line between eye allergies and dry eyes is blurrier than we once thought. If your eyes are itchy, red, and dry, it may not be one or the other—but both conditions at once.

The good news is that with proper diagnosis and the right eye care products, you can manage the symptoms effectively. The OPTIVE™ range of eye drops offers advanced hydration and protection, helping you stay comfortable through allergy seasons, screen time, and daily life.