Summer brings longer days and warmer weather, but it can also be a difficult season for anyone affected by dry eye disease. Higher pollen levels, heat, wind and air conditioning may all aggravate the ocular surface. If you also experience hay fever, your eyes may become especially itchy, red, watery and uncomfortable.
Why does hay fever affect the eyes?
Hay fever occurs when the immune system reacts to pollen. When pollen settles on the surface of the eye, it can cause allergic conjunctivitis, leading to symptoms such as:
- Intense itching
- Redness
- Watering
- Soreness or irritation
- Puffy or swollen eyelids
Many of these symptoms overlap with dry eye disease. As a result, people may notice increased burning, grittiness or stinging during the pollen season.
It may seem contradictory for an eye to be both dry and watery, but this is very common. Irritation can trigger a sudden production of reflex tears. These watery tears do not necessarily contain the balanced oil, water and mucin components needed to create a stable, protective tear film.
Limit the amount of pollen reaching your eyes
It is difficult to avoid pollen altogether, but reducing your exposure may make symptoms more manageable.
Wrap-around sunglasses can provide a useful physical barrier outdoors, while a hat or cap may offer additional protection. Because pollen easily collects on clothes, hair, skin and household fabrics, it may also help to:
- Keep windows closed when pollen levels are particularly high
- Avoid drying clothes or bed linen outside on high-pollen days
- Change your clothes after spending time outdoors
- Shower and wash your hair before going to bed
- Use an indoor air purifier and replace or clean its filters as recommended
- Check the daily pollen forecast before planning prolonged outdoor activities
Try to resist rubbing your eyes, however tempting it may be. Rubbing may briefly relieve the itch but can make inflammation, redness and swelling worse.
Support the tear film
You may find that you need your usual lubricating eye drops more frequently during the hay fever season. Preservative-free lubricants can help dilute and rinse allergens from the ocular surface while improving comfort and tear-film stability.
A clean, cold compress placed over closed eyelids for several minutes may help reduce itching and puffiness. Some lubricating drops can also be kept in the refrigerator for an additional cooling effect, although you should always check the manufacturer’s storage instructions first.
Non-medicinal allergy drops
Some eye drops designed for allergy-prone eyes contain ectoin, a naturally occurring molecule that helps support the tear film and protect the ocular surface from allergens. Hycosan Dual is one preservative-free example and may be particularly helpful when allergy symptoms occur alongside dry eye disease.
Not every product is suitable for every eye condition. Follow the supplied instructions and speak to your optometrist or pharmacist if you are unsure which type of drop to choose.
Over-the-counter hay fever eye drops
Sodium cromoglicate is commonly used to manage the red, itchy and watery eyes associated with seasonal allergic conjunctivitis. It works best when used regularly as directed and may be more effective if started before or at the beginning of your usual allergy season.
Check the formulation carefully. Some multi-dose bottles contain benzalkonium chloride, also called BAK, as a preservative. BAK can irritate or disrupt the ocular surface, particularly when drops are used frequently or when dry eye disease is already present.
Preservative-free sodium cromoglicate preparations are available, although they may cost more. Your optometrist or pharmacist can help you identify an appropriate option.
When prescription treatment may be needed
If symptoms are persistent, severe or inadequately controlled with over-the-counter products, a healthcare professional may recommend prescription treatment.
Options can include olopatadine or ketotifen eye drops. These have both antihistamine and mast cell-stabilising properties, helping to control the allergic response as well as relieve symptoms. Preservative-free ketotifen is available for seasonal allergic conjunctivitis.
Oral antihistamines may be useful when hay fever is also causing sneezing, nasal congestion or a runny nose. However, some antihistamine tablets can reduce tear production or make existing dry eye symptoms more noticeable. If you have dry eye disease, ask your pharmacist, optometrist or GP which treatment is most appropriate rather than simply increasing medication yourself.
When to seek professional advice
Hay fever typically affects both eyes and itching is usually one of its most prominent features. Arrange an urgent assessment with an optometrist, GP or NHS 111 if you develop:
- Significant eye pain
- Sensitivity to light
- Blurred or altered vision
- Marked or intense redness
- Symptoms that predominantly affect one eye
- Discharge, injury or concern about an eye infection
- Symptoms that persist or worsen despite appropriate treatment
These features are not typical of uncomplicated hay fever and may indicate another eye condition.
If seasonal allergies are making your dry eye increasingly difficult to control, a detailed eye examination can help distinguish allergy from other causes of ocular-surface inflammation and identify the most appropriate combination of treatments.