Whether a patient has dry eye or allergy, primarily relies on their symptoms. The hallmark of a patient with allergies is that they really want to itch their eyes, and, in some cases, this can drive them crazy because they want to itch them so bad.
Also with eye allergies, we often see redness around the lids and when pulling down the inside of the lid, there is a specific look with regard to the blood vessels. This is different from dry eye, in the sense that dry eye usually does not have this look to the inside of the lids.
Patients with dry eye will complain of scratchy, sand-paper symptoms. Treating dry eye is also more complicated and is considered a multifactorial disease as it’s caused by so many different things. Dry eye causes are discovered through various diagnostic tests including testing the tears for inflammation as well as osmolarity, which is salt content.
We are also able to take pictures of the oil glands, which are one of the 3 components which make up the tears including mucus and water. By far the most common cause of dry eye diagnosis is the lack of oils in the tear and is known as MGD or meibomian gland dysfunction.
Fortunately, ocular allergies are very easy to address with over-the-counter ocular topical antihistamines including Zaditor, Pataday, and Alaway among others. On the other hand, when we find the cause of the dry eye, we will initiate a specific treatment plan for the dry eye patient.