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Spring's Dry, Itchy Eyes Can Hang Us Up the Most

Friday, March 08, 2019

Even though snow is still falling, and old man winter has been a gracious host, we decided to get an early jump on spring allergy season and dry, itchy, gritty eyes, since ongoing climate changes seem to now move us from winter to spring in the blink of an eye.

The etiology of a common form of dry, itchy eyes is a mast cell-located immunoglobulin (IgE) antigen-antibody structure / function overreaction.

Unfortunately, most clinical settings do not have the ability to test tears for IgE antigen-antibody overreactions, therefore allergic dry eyes are still too often misdiagnosed as other forms of dry, itchy eyes and treated thusly.

Treatment for dry, itchy eyes is traditionally evaluated in clinical settings with a group of subjects who test the comfort of a proposed therapy with daily use and who return to the eye care professional for regular appointments to evaluate parameters of ocular surface health.

Given that spring's morning's kiss wakens trees and flowers, in the allergic patient, ever-changing environmental conditions can greatly influence problematic ocular surface signs and symptoms, making proper diagnose without adequate diagnostic tools far more difficult.

The good news: Tests are now available for tear film proteins and IgE antigen-antibody overreactions linked to ocular signs and symptoms.

It has also been suggested in Current Opinions in Allergy and Clinical Immunology that better controlling ocular surface inflammation may help in the symptom management of ocular allergies.

Other studies suggest that antioxidants and essential fatty acid dietary deficiencies may stimulate overreaction of immune system functions linked to improper tear film disruption during allergy seasons. 


Eye care professionals and researchers rely on various clinical and laboratory tests to diagnose dry eyes and determine its underlying etiologies including inflammation and allergies. The most common tests at this time are:

A.  Ocular surface staining
B.  Shirmer's

C. Tear break-up time
D. Tear film osmolarity
E. Tear protein assay
F.  Tear IgE levels

It's important to be aware that objective test results indicating the presence or absence of dry, itchy eyes does not always correlate with subjective dry eye symptoms (what the patient is personally experiencing); therefore we can still expect the continued disconnect and frequent dissatisfaction of the dry eye patient with their eye care professional when dry and gritty eye complaints are not taken seriously.


Ellen Troyer, Spencer Thornton, MD, David Amess and the Biosyntrx staff

PEARL: Lack of attention to these complaints and the lack of a successful treatment plan, is still the most common reason patients change eye care professionals. Given that more than 20 percent of patients who visit ophthalmic clinics report dry, itchy, gritty symptoms, it's now considered a public health problem. 

Those who suffer spring allergies, those who treat them, and our Friday Pearl readers who adore jazz standards will no doubt love Marsha Bartenetti's soon-to-be-released version of "Spring Can Really Hang You Up the Most" the classic 1950s jazz tune based on T.S. Eliot's poem, April is the Cruellest Month. 

Marsha's latest CD titled I Believe in Love is scheduled for release in early May and will be available from iTunes and Amazon.