By Dr. Romie Dhaliwal
If your eyes have been feeling unusually dry, itchy, watery, or irritated lately, you’re not alone. As we head into fall, changing temperatures, seasonal allergens, and drier air can all contribute to uncomfortable eye symptoms. But how do you know if it’s allergies or dry eye?
What’s tricky is that two common eye conditions – dry eye syndrome and eye allergies – share overlapping symptoms but require different treatments. And to complicate matters even more, many people experience both conditions at the same time.
What’s the difference?
While both dry eye and eye allergies can cause burning, redness, watery eyes, and blurry vision, there are a few key differences. Itchiness, for example, is the hallmark of eye allergies. If your eyes are itchy enough that you feel the urge to rub them constantly, you’re likely dealing with an allergic reaction. Swelling of the eyelids, puffiness under the eyes, and even dark under-eye circles – sometimes called “allergic shiners” can also be signs of eye allergies.
Dry eye, on the other hand, is more often described as a scratchy or gritty feeling, like an eyelash in the eye. People with dry eye may experience tired eyes, light sensitivity, and intermittent blurry vision, particularly at the end of the day or after screen time.
Ironically, dry eyes can also produce excessive tearing – the eyes trying to compensate for dryness by flooding with tears that don’t actually soothe or hydrate the eye surface.
Why it’s so common right now
Fall can be tough on your eyes.
Seasonal allergens, cooler temperatures, wind, and drier indoor air can all contribute to irritation. For some people, these factors trigger itchy and watery eyes associated with allergies, while for others they can worsen dry eye symptoms. Knowing the difference can help you find the right relief.
For those over 55, the situation can be even more frustrating. As we age, our eyes naturally produce fewer tears, and the tears we do make can be of poorer quality. Hormonal changes, certain medications (like antihistamines, decongestants, or antidepressants), and underlying conditions such as thyroid disease or arthritis can all contribute to dry eye.
At the same time, environmental allergies to pollen, dust, mould, and even pet dander or fragrances can cause the immune system to react with eye inflammation. This results in histamine release, which increases swelling and itchiness. The treatments for one condition can sometimes make the other worse. For example, antihistamines for allergies can reduce tear production, intensifying dry eye symptoms.
What you can do
The most important step is getting the right diagnosis. Trying to guess whether it’s dry eye or allergies can lead to using the wrong drops and worsening symptoms.
If allergies are to blame, antihistamine drops or oral medications can help. Cold compresses and avoiding known triggers – like going outside when pollen or smoke levels are high – can also provide relief. Artificial tears can help flush allergens from the eyes, especially if used frequently throughout the day.
For dry eye, treatment focuses on restoring moisture and improving tear quality. Preservative-free artificial tears are often the first step. For more chronic cases, we offer in-office treatments like Intense Pulsed Light (IPL) and Radio Frequency (RF), which help treat underlying eyelid inflammation and Meibomian gland dysfunction – one of the most common causes of dry eye.
When to seek help
If your eyes are red, burning, or watering persistently – and especially if you’re unsure what’s causing it – it’s time to book an eye exam. Left untreated, both dry eye and allergies can interfere with vision and quality of life. In rare cases, untreated dry eye can even lead to long-term damage.
At Academy Optical, we use advanced diagnostic tools to determine what’s really going on and build a treatment plan tailored to your needs. Whether you need relief from allergies, dry eyes, or both, we’re here to help you see clearly and comfortably again!
Dr. Romie Dhaliwal, B. SC., O.D. is the owner and optometrist at Academy Optical.