For many people, spring is a welcome relief – longer days, warmer air, the return of colour and light. But if you have dry eye disease, and particularly if Meibomian Gland Dysfunction (MGD) is the underlying cause, spring can feel like a betrayal.
The pollen arrives, the histamine response kicks in, and suddenly the eyes that were just about manageable are in a full flare. This post explains why that happens – and why treating the allergy alone is rarely enough.
Mr Neo says, "As a consultant ophthalmic surgeon specialising in corneal and ocular surface disease, it is a pattern I have seen throughout my career – and one that is already emerging in my clinics here at Clinica London. Patients who have been managing their dry eye reasonably well through the colder months come in struggling as spring arrives – their symptoms are flaring, their drops are no longer enough, and they want to understand why."
The answer lies in the relationship between seasonal allergic conjunctivitis and the underlying mechanisms of dry eye disease. These are not the same condition – but in patients with MGD, they compound each other in a way that antihistamine drops from the chemist cannot fully address. Understanding that interaction is the first step to managing it properly.
Both conditions share a common thread: inflammation on the ocular surface. In allergic conjunctivitis, the trigger is airborne – pollen, dust, pet dander – and the response is immediate: histamine release, mast cell activation, itching and redness. In MGD-related dry eye, the inflammation is chronic and structural, driven by blocked or dysfunctional meibomian glands that can no longer produce a stable tear film.1 When the two overlap, as they so often do in spring, each makes the other significantly worse.
Meibomian Gland Dysfunction (MGD) before (left) and after treatment (right) — image courtesy of Consultant Oculoplastic Surgeon, Miss Jane Olver, Clinica London.
In dry eye disease, and particularly in Meibomian Gland Dysfunction (MGD), the tiny oil-producing glands along the eyelid margins become blocked or dysfunctional. Without a healthy oil layer, the tear film evaporates too quickly, leaving the surface of the eye exposed, irritated, and inflamed. That inflammation is a constant background state.
When airborne pollen arrives, it lands on an ocular surface that is already compromised. The allergic response – histamine release, mast cell activation, increased inflammatory mediators – adds a second wave of inflammation onto a system that was already struggling to cope. The result is a significant worsening of symptoms: more grittiness, more redness, more light sensitivity, more reflex tearing that paradoxically still leaves the eye dry.
"Patients often tell me they assumed their dry eye had suddenly become much worse, or that they had developed a new allergy. In reality, the two conditions are amplifying each other, and neither can be properly addressed without understanding the interaction."
It is worth knowing what to look out for as we head into spring, particularly if you already have a diagnosed dry eye condition or have noticed recurring symptoms at this time of year. The signs that your dry eye and seasonal inflammation may be compounding include:
If any of this sounds familiar, it is worth seeking a proper assessment rather than simply increasing your drop use. Artificial tears treat the symptom, not the cause, and at some point the underlying inflammation needs to be addressed directly.
There is a tendency to think about dry eye treatment reactively – reaching for drops when the discomfort becomes too much. But the evidence increasingly supports a proactive approach, particularly for patients with underlying MGD.
MGD is a chronic condition. The inflammation that drives it does not resolve on its own, and without treatment, the meibomian glands can undergo structural changes that reduce their function over time.2,5 Starting spring with inflamed, partially blocked glands means that pollen season is going to be significantly harder to tolerate.
The good news is that there is now strong evidence for treatments that address the inflammation and gland dysfunction directly – not just the symptoms. More recently, TFOS DEWS III has further expanded the definition of dry eye disease and the therapeutic options available, with a particular focus on symptom improvement. At Clinica London, our approach to dry eye is built around four principles: treat the acute flare and symptoms; maintain patients symptom-free; protect the eyelids and ocular surface; and prevent or reduce further inflammation and damage.
This philosophy – Preventive Ocular Care – underpins everything we do, and it shapes the range of treatments we offer.
Effective dry eye management rarely comes down to a single treatment. Depending on the underlying causes and severity, a comprehensive plan might combine lid hygiene, attention to sleep and diet, in-clinic procedures, and where appropriate, prescription therapies.
At Clinica London we offer the full range, including BlephEx, a precise micro-exfoliation of the eyelid margins that removes the biofilm and debris that accumulates with blepharitis and contributes to MGD.
The treatments below are those that are particularly relevant for patients heading into spring with active or worsening dry eye.
OptiLight is an Intense Pulsed Light (IPL) therapy developed specifically for the periocular area, and the first and only FDA-approved IPL device for the management of dry eye disease due to MGD.3 What makes it particularly relevant for patients struggling at this time of year is that it targets inflammation directly – the same inflammatory pathways that spring allergens aggravate.
Rather than adding another layer of symptom management, it works to calm the underlying condition that makes the eyes so reactive in the first place.
For patients who know from experience that spring is their worst season, completing an initial course or booking a maintenance session before pollen levels peak can make a meaningful difference to the months ahead. Full details of the treatment, what it involves, and what to expect are on our OptiLight treatment page.
OptiLight IPL at Clinica London is performed by Consultant Oculoplastic Ophthalmologists Miss Jane Olver and Miss Lisa Jagan, and the Ophthalmic Technicians, all of whom have completed specialist Lumenis training. Together, they all work alongside Mr Johnson Neo, our consultant corneal expert.
OptiLight IPL treatment for dry eye due to MGD at Clinica London — images courtesy of Jane Olver, from her book: Lacrimal and Dry Eye Disorders: A Complete Guide.
As we age, the periorbital muscles – those beneath and around the eye – gradually lose tone, at a rate of around 3 to 8 per cent per decade. As muscular support reduces, the lower eyelid can become lax, affecting how completely the eye closes during blinking. Incomplete or inefficient blinking disrupts the tear film, accelerates evaporation, and contributes directly to dry eye symptoms.
It is worth being clear that this is distinct from ectropion, where the eyelid physically turns outward and requires surgical correction. OptiLift is designed to address the earlier, more subtle changes in eyelid tone and blinking quality – not structural eyelid malposition.
OptiLift uses a combination of radiofrequency energy (RF) and Dynamic Muscle Stimulation (DMSt) technology to activate the periorbital muscles with gentle electrical impulses, restoring tone and tightness to the lower eyelid and improving blinking quality – without surgery or downtime. The RF component also delivers precise heat to the skin to support collagen formation around the periorbital area.
It is worth noting that OptiLift is not limited to older patients: it is also beneficial for those in their 30s and 40s who experience screen-related partial blinking or early meibomian gland dysfunction, where improving blink mechanics can make a real difference before the condition progresses.
A course consists of four sessions of around 14 minutes, spaced one to three weeks apart, with no downtime. Patients typically notice warmth and a mild eyelid twitching sensation during treatment.
A peer-reviewed clinical study published in Clinical Ophthalmology (Chelnis, 2025) demonstrated an improvement in lid laxity of at least 75 per cent, an improvement in blinking quality of at least 70 per cent, and a 286 per cent increase in tear break-up time – a key measure of tear film stability and dry eye severity.4
OptiLift was launched in the UK in late 2025, and Clinica London is among the first clinics in the country to offer it – giving patients access to this technology at the very forefront of dry eye care.
In appropriate patients, combining OptiLight with OptiLift can address both the inflammatory component of MGD and the mechanical component of impaired blinking – providing a genuinely comprehensive approach to chronic dry eye. Both treatments are delivered by our trained clinical team, with consultant-led assessment and oversight.
OptiLift device (left) in progress at Clinica London. OptiLight IPL device (right) being used to treat dry eye due to meibomian gland dysfunction.
Every patient presenting with dry eye at Clinica London begins with a thorough investigative consultation. We examine the eyelids and eyelid margins, assess meibomian gland function, measure tear film quality, and identify the underlying causes of your symptoms – so that any treatment plan is tailored precisely to what you need.
Not every patient needs OptiLight or OptiLift, and we will always be honest about what the evidence supports for your specific presentation. But for patients with moderate to severe dry eye due to MGD, these treatments represent a meaningful step beyond drops and warm compresses – and the evidence for them is strong.
"For some patients, particularly those with more complex presentations or where inflammation is severe, in-office treatments work best alongside prescription therapies. As a consultant ophthalmologist, I am able to prescribe and manage specialist pharmaceutical treatments – including cyclosporin – that are not available over the counter and which can make a significant difference in cases that have not responded to standard management.
This is especially relevant for children and young people, where early specialist intervention and careful medical management can protect long-term eye health. It is one of the key reasons a consultant-led assessment matters: the full range of diagnostic and therapeutic options is available, not just those on the pharmacy shelf."
This whole-person, preventive approach reflects what we describe as Preventive Dacryology – the belief that long-term ocular surface health is best preserved not by reacting to symptoms when they become unbearable, but by building a care plan that protects the eyelids, tear film, and meibomian glands over time.
Patients who engage with this approach consistently find that their quality of life improves, their reliance on drops reduces, and their eyes are better equipped to handle seasonal triggers like spring pollen.
If you have been struggling with dry eye – whether that is through winter, or you know from experience that spring makes it significantly worse – I would encourage you not to wait until you are uncomfortable before seeking assessment. The best time to treat inflammation is before it escalates.
If spring is making your symptoms worse, a specialist assessment can identify whether dry eye, allergy, MGD or blink dysfunction is driving the problem – and which treatment is most likely to help.
Book a consultation nowMr Johnson Neo is presenting Allergic Eye Disease 101: When Should You Worry? at the Clinica Academy on 19th March 2026 – a CPD-accredited lecture for GPs, optometrists, and allied health professionals. View Academy details
Mr Johnson Neo is a Consultant Corneal, Cataract and Refractive Surgeon at Clinica London, with specialist expertise in dry eye and ocular surface disease. He is a member of the International Tear Health Academy and the European Dry Eye Society. Read more about Mr Neo and his expertise at Clinica London: Mr Johnson Neo on Harley Street.
Our Tears Clinic also includes Miss Lisa Jagan and Miss Jane Olver. Having the corneal ocular surface expert working alongside the oculoplastic eyelid experts provides the MGD and allergy patient optimal care.
Mr Johnson Neo is a Consultant Corneal, Cataract and Refractive Surgeon at Clinica London, with specialist expertise in dry eye and ocular surface disease.
He works as part of Clinica London's multidisciplinary Tears Clinic, combining consultant-led assessment, advanced diagnostics and evidence-based treatment planning for complex dry eye and ocular surface conditions.
To book a dry eye consultation at Clinica London, call 020 7935 7990 or book online.
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