From the Guidelines
For individuals with glaucoma, the safest option for allergy eye drops is a dual-action agent such as olopatadine (Pataday, Patanol) or ketotifen (Alaway, Zaditor), which combines antihistamine and mast cell stabilizer properties without significantly affecting intraocular pressure. These medications, as noted in the study by 1, work well for acute and longer-term treatment of allergic conjunctivitis symptoms and have a rapid onset of action, typically within 30 minutes. It's crucial to avoid using vasoconstrictor eye drops, such as those containing tetrahydrozoline (Visine) or naphazoline (AK-Con, Albalon), as they can increase eye pressure and potentially worsen glaucoma, as indicated in the same study 1.
When considering treatment options, several key points should be taken into account:
- The potential for rebound hyperemia or conjunctivitis medicamentosa with prolonged use of ocular decongestants, making limited use (up to 10 days) advisable if they are used at all 1.
- The effectiveness of mast cell stabilizers for chronic ocular allergies, although they may require several days to achieve optimal symptom relief 1.
- The role of topical NSAIDs, like ketorolac (Acular), in reducing prostaglandin production involved in mediating ocular allergy, suitable for temporary relief of ocular itching caused by seasonal allergic conjunctivitis 1.
- The importance of reserving ocular corticosteroids, such as loteprednol etabonate (Alrex), for more severe symptoms due to their potential for vision-threatening side effects, including cataract formation, elevated IOP, and secondary infections 1.
Given these considerations, consulting with an ophthalmologist is essential to determine the most appropriate eye drop for an individual's specific condition, ensuring that the treatment does not exacerbate glaucoma while effectively managing allergy symptoms. They may recommend preservative-free formulations to minimize irritation, especially if the patient is using multiple eye medications. Adherence to the prescribed dosing schedule and continuation of prescribed glaucoma medications alongside any allergy treatments are also critical.
From the FDA Drug Label
Directions adults and children 2 years of age and older: put 1 drop in the affected eye(s) twice daily, every 6 to 8 hours, no more than twice per day if using other ophthalmic products while using this product, wait at least 5 minutes between each product replace cap after each use children under 2 years of age:consult a doctor Directions Adults and children 3 years of age and older: Put 1 drop in the affected eye(s) twice daily, every 8-12 hours, no more than twice per day. Children under 3 years of age: Consult a doctor.
Neither of the provided drug labels for Olopatadine (OPHTH) 2 or Ketotifen (OPHTH) 3 directly addresses safety for use in patients with glaucoma.
- The labels do not mention glaucoma.
- No conclusion can be drawn about the safety of these eye drops for patients with glaucoma.
From the Research
Safe Eye Drops for Glaucoma and Allergies
- When considering eye drops for allergies, it's essential to choose ones that are safe for use with glaucoma.
- Studies have shown that certain eye drops can be effective in treating allergic conjunctivitis without exacerbating glaucoma.
Recommended Eye Drops
- Olopatadine is a topical antihistamine and mast cell stabilizer that has been shown to be effective in treating allergic conjunctivitis 4, 5, 6, 7.
- It has been found to be more comfortable and efficacious than other eye drops, such as ketotifen and azelastine 4, 8.
- High-concentration olopatadine (0.77%) has been shown to have a longer duration of action and better efficacy on ocular itch than low-concentration olopatadine (0.1%) 5.
Key Considerations
- Patient preference and comfort are important factors in determining the effectiveness of eye drops 4.
- Olopatadine has been found to be well-tolerated and safe for use in patients with allergic conjunctivitis, with no significant adverse events reported 4, 8.
- It's essential to consult with a healthcare professional before using any new eye drops, especially if you have glaucoma or other underlying eye conditions.