Aim: To evaluate the efficacy of tear substitute in patients with chronic seasonal allergic conjunctivitis i.e. spring catarrh and analysis of the outcome results. Design: Prospective randomized study. Patients and method: 240 patients with seasonal allergic conjunctivitis complicating with dry eye are randomized in 3 groups. Group I received antihistaminic in the form of Epinastine hydrochloride 0.5 mg per mL while group II received tear substitutes in the form of carboxymethylcellulose and glycerin; group III received combination of the two drugs. The outcome measures were the eye comfortability and relieve of eye burning and blurring vision. Results: Complete comfortability in 46.5% of patients and partial comfortability in 33.8% of patients. These percent to 60.6% and 21.3% respectively if antihistaminic were added to tear substitutes. Conclusion: At a time, allergy may fade away but dry eye persists. Patients should continue tear substitutes during the attack. Dry eye disease is the missing already present disease in chronic allergy. This study proved that tear substitutes prescription in chronic allergy not only achieve eye relieve but also improve the quality of vision. Till now, the chronic allergy-dry eye complex is still an unfinished business and further studies are needed to solve the chronic allergy-dry eye puzzle.
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