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EW CORNEA 42 November 2015 by Maxine Lipner EyeWorld Senior Contributing Writer particularly in the spring, according to Anat Galor, MD, staff physician, Veterans Affairs (VA) Medical Center, and associate professor of clinical ophthalmology, Bascom Palmer Eye Institute, Miami. Too often the symptoms and signs of dry eye don't align, so inves- tigators set out to try to understand what was driving the symptoms. Taking a seasonal perspective I f a patient comes in with what appears to be dry eye, another culprit may be responsible. Re- search published in the August 2015 issue of Ophthalmology in- dicates that allergy may be to blame, Is dry eye a cross-pollination with ocular allergy? While it is possible that practitioners are not seeing what's happening on the dynamic ocular surface at any one moment in time clearly enough, there's also another possibility. "An- other hypothesis is that there are other factors that are more related to the symptoms," she said. "We had access to the database that examines dry eye diagnosis over time and over a wide variety of locations within the United States." Investigators reviewed nationwide visits to VA eye clinics that took place over a 5-year span and considered how the allergy index might be affecting the month- ly prevalence of dry eye. Counting pollen peaks This was not the first time the investigators had tapped into this database. "We did a previous study where we looked at factors that we thought were important like environment, atmospheric pres- sure, humidity, and pollution," Dr. Galor said, adding that they looked at all of the VA's data, comparing frequency of dry eye with different atmospheric conditions. One of the surprising findings was that dry eye diagnosis peaked in the spring and winter. "We looked at spring and we thought of pollen," she said. "We then looked at the pollen index and showed a correlation between dry eye symptoms and pollen levels." Investigators determined that in spring, 18.5% of patients were diag- nosed with dry eye, with cases peak- ing in April at 20.9%. Winter was a second peak. Dr. Galor hypothesizes that the dry eye during this chilly season may be stemming from the fact that people stay indoors more. "They have the heat on and it gets very dry and that has a negative impact on dry eye symptoms," she said. The association found between dry eye and allergy in spring, mean-