Ask the Allergist: Eyes Wide Open On Dry Eye

EyeQ: I experience a dry, burning sensation in my eyes and they turn red and painful during winter months. Is this an allergic reaction? What can I do? 

Leonard Bielory, MD: If your eyes bother you in the winter months, then you may have a form of tear dysfunction known as dry eye, or “keratoconjunctivitis sicca.” This is not an allergic reaction – it happens when your eyes either do not make enough tears or the tears they make go away very quickly. This causes your eyes to feel dry and irritated.

Many people have dry eye, including about one-third of older adults. It’s commonly found in people with eye allergies as well.

DR_BielorySome medications, including oral antihistamines, sleeping pills and anti-depressants, can cause dry eye symptoms or make them worse. Symptoms are also sometimes worse when it’s cold or windy outside, after you turn on the heat in your home, or if you’re in a dry environment. 

What You Can Do

Artificial tears – lubricant eye drops – are the main treatment for dry eye. They can keep the eye moist and help reduce symptoms.

You can buy artificial tears at a drug store or grocery store without a prescription. They come in liquid, gel or ointments. Artificial tears do not cure the condition – they soothe the eyes and work only as long as you keep using them. Preservative-free artificial tears are best for long-term use, but these are more expensive.

Other things you can do to help improve your symptoms:

  • Try to blink a lot, especially when you are reading or using a computer. This helps keep your eyes moist.
  • Avoid excess air conditioning or heating as much as you can. Also avoid sitting directly in the flow of cold or hot air.
  • Use a humidifier in your bedroom and any other space where you spend a lot of time.
  • Use swim goggles or “moisture chambers” if your doctor or nurse suggests them. Moisture chambers are special devices that fit on your glasses. They can help keep your eyes moist. You can buy moisture chambers at most stores that sell glasses.

If dry eye symptoms do not get better within 3-4 weeks, you may want to schedule an appointment with your allergist, especially if you also have allergies. 

Additional treatments include prescription eye drops and anti-inflammatory medicines. If these are not successful, tear duct plugs or surgery that requires the assistance of an ophthalmologist may be recommended.

Q: Would it help to not wear contact lenses
in winter?

Dr. Bielory: Contact lenses require the proper amount of tear fluid to “float over the cornea” to provide proper vision. The decrease in tears or poor quality of tears due to dry eye can cause the contact lens to irritate the surface of the eye. Most patients with difficult-to-control dry eye will need to stop wearing contact lenses for 1-3 months.

Leonard Bielory, MD, FACAAI, is a board-certified allergist and immunologist, professor of medicine at Thomas Jefferson University Kimmel School of Medicine, adjunct professor at Rutgers University, and past director of the Immuno-Ophthalmology Service.

Have a medical question? Email or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.


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