It must be that time of year or is it?

The question “does dry eye have a season?” is often posed. The answer is “yes” and “no.” 

The seasonality of dry eye disease is driven in large part by environmental and pharmacological changes. Patients may report an uptick in symptoms during winter months due to heat within their homes and offices.

Forced heat with low humidity can cause an increase in symptoms not unlike a controlled adverse environment chamber (CAE). CAE’s have been employed in studies to evaluate the efficacy of ophthalmic pharmaceuticals designated for the treatment of dry eye disease. 

In addition to heat, artificially cooled environments may cause similar symptoms. Ceiling fans are notorious offenders for driving patient symptoms.  While they may run year-round in some homes, others use them strictly for relief from the summer heat.  Fans may cause an increase in patient discomfort during both waking and overnight hours especially if the patient suffers from nocturnal lagophthalmos. 

Spring is the most common season for complaints.

While summer and winter seasonality are classically driven by environmental changes, spring may be a rooted in pharmacological changes. While allergy may occur at different times of the year depending on the source of the allergen, spring is the most common season that patients complain of symptoms. 

They may seek care with a primary care physician or allergist, but many will choose to self-medicate with products found at the pharmacy. Use of over-the-counter antihistamines and decongestants designed to ameliorate systemic symptoms can trigger dry eye complaints in an otherwise asymptomatic population. 

While one may think that the new ocular symptoms are strictly driven by the medication, further investigation is warranted to be certain those patients weren’t already experiencing dry eye to some degree which made them more susceptible to complain when they started the allergy medication.

Overall for many dry eye disease patients, there are good times and there are bad times.  There is no true seasonality to evaporative or aqueous-deficient dry eye disease. Patients tend to suffer in some form or fashion year round. With that in mind, follow up visits are critical to allow both doctor and patient to keep their finger on the pulse of the condition and make therapeutic adjustments as needed.