Saline rinses and excess eye drops? Experts debunk common myths about conjunctivitis and dry eyes

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With allergy-related conjunctivitis cases rising 33 percent in spring, eye health is under seasonal threat — but common remedies such as saline rinses and excessive artificial tear use may do more harm than good, experts warn.

This spring, a 43-year-old resident of Cheongju, North Chungcheong Province, found herself stuck at home despite the long holiday weekend. Her second-grade child was suffering from allergic conjunctivitis. “Cold compresses help with the itchiness, but only temporarily,” she said. “We can’t use the prescribed eye drops more than recommended, and rubbing makes it worse — I just hope the pollen season ends soon.”

Spring, despite its clear skies and flowers, is ironically a danger zone for eyes. Pollen, fine dust and yellow dust all irritate the conjunctiva, causing redness, itching and tearing — classic symptoms of allergic conjunctivitis.

According to the Health Insurance Review and Assessment Service, the number of patients treated for conjunctivitis between March and May last year reached 555,952, up 33 percent from winter (416,933). Professor Baek Jin-wook, an ophthalmologist at Incheon St. Mary’s Hospital, said, “The conjunctiva isn’t a protective barrier but a sensitive immune sensor. If symptoms like itching, redness, or foreign body sensation persist, allergic conjunctivitis should be suspected.”

There are two types of allergic conjunctivitis. Seasonal allergic conjunctivitis, triggered by pollen and dust, is more common in spring. Perennial conjunctivitis, on the other hand, is caused by indoor allergens like dust mites, mold, or pet dander and can persist year-round. About 80 percent of perennial sufferers report worsened symptoms in spring.

One widespread myth is that rinsing eyes with saline water can ease symptoms. However, this can actually strip away the eye’s natural antimicrobial components and damage the conjunctiva. “Saline rinses and frequent rubbing can worsen inflammation and harm the eye,” Baek said.

The primary treatment for allergic conjunctivitis is antihistamines, which reduce inflammation by blocking histamine activity. For recurring or chronic symptoms, mast cell stabilizers are often used to suppress the release of allergy-inducing chemicals. In severe cases, steroid eye drops may be prescribed — but should never be used long-term or without medical supervision due to risks like increased intraocular pressure.

Dry eyes are another seasonal concern. They can cause sensations like grittiness, burning, itching, or blurry vision. Ironically, excess tearing can also indicate dry eyes, as the irritated surface reflexively produces more fluid.

People with dry eyes should avoid soft contact lenses, which absorb moisture and worsen dryness. High-moisture lenses may feel comfortable initially but draw water from the eye over time. In contrast, hard lenses contain no moisture and do not contribute to dryness.

Artificial tears — while helpful — can be harmful if overused. Using preservative-free drops more than six times a day may dilute beneficial enzymes and damage the surface of the eye. “Look at preservatives, viscosity and ingredients when choosing artificial tears,” said Dr. Ko Kyung-min from Kim’s Eye Hospital Cornea Center. Thicker drops last longer and better relieve dryness, but may blur vision temporarily.

Left untreated, dry eyes can lead to corneal foreign bodies or, in severe cases, corneal opacity — a condition where the transparent cornea becomes cloudy, permanently impairing vision.

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.