What are the recommended eyedrops for allergic conjunctivitis?

From the Guidelines

For allergy eye symptoms, I recommend using dual-action antihistamine and mast cell stabilizer eye drops, such as olopatadine (Pataday, Patanol) or ketotifen (Alaway, Zaditor), as they have been shown to be effective in preventing and treating ocular itching and other symptoms of allergic conjunctivitis 1. These medications work by blocking histamine receptors and stabilizing mast cells, reducing itching, redness, and tearing.

• They are available over-the-counter and can be used 1 drop in each affected eye twice daily or as directed on the package.
• For more severe symptoms, prescription-strength options like olopatadine 0.7% (once daily) or azelastine may be more effective.
• It's also important to note that oral antihistamines are generally less effective in relieving ocular allergy symptoms than topical ophthalmic agents and have slower onset of action 1.
• Additionally, artificial tears can help flush allergens from the eyes and provide additional relief when used between antihistamine doses.
• Cold compresses applied to closed eyes for 5-10 minutes can temporarily reduce swelling and discomfort.
• If symptoms don't improve within a week, or if eye pain, vision changes, or discharge occur, it's essential to consult an eye doctor as these could indicate a more serious condition.
• Preventing symptoms from developing in the first place by avoiding allergen exposure, such as keeping windows closed during high pollen seasons and washing hands after petting animals, can also be beneficial.

From the FDA Drug Label

CLINICAL PHARMACOLOGY Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. Clinical Studies:In two double-masked, placebo-controlled six-week environmental studies of 268 patients with seasonal allergic conjunctivitis, Loteprednol Etabonate Ophthalmic Suspension, 0. 2%, when dosed four times per day was superior to placebo in the treatment of the signs and symptoms of seasonal allergic conjunctivitis. Loteprednol Etabonate Ophthalmic Suspension, 0.2% provided reduction in bulbar conjunctival injection and itching, beginning approximately 2 hours after instillation of the first dose and throughout the first 14 days of treatment.

Eyedrops for allergies can be treated with Loteprednol Etabonate Ophthalmic Suspension, 0.2%. The key benefits of this treatment include:

• Reduction in bulbar conjunctival injection
• Reduction in itching This treatment is effective for seasonal allergic conjunctivitis and starts working approximately 2 hours after the first dose 2.

Another option is Ketotifen which can be used in adults and children 3 years of age and older, with a dosage of 1 drop in the affected eye(s) twice daily 3.

From the Research

Eyedrops for Allergies

• Eyedrops are a common treatment for allergic conjunctivitis, with various mechanisms of action 4, 5, 6.
• Topical antihistamines, such as olopatadine and ketotifen, are effective in relieving symptoms of allergic conjunctivitis, including itching and redness 4, 5, 7.
• These medications have dual action, combining antihistamine and mast cell stabilizer properties, which provides faster and superior relief compared to systemic antihistamines 5, 6.
• Other treatment options include topical vasoconstrictors, mast cell stabilizers, NSAIDs, and corticosteroids, each with their own advantages and disadvantages 6.
• The choice of treatment depends on the severity of symptoms, patient preferences, and potential side effects 6, 7, 8.

Comparison of Eyedrops

• Studies have compared the efficacy of different eyedrops, including olopatadine and ketotifen, in treating allergic conjunctivitis 4, 5, 7.
• Olopatadine has been shown to be effective in reducing itching and redness, with a faster onset of action compared to cromolyn sodium 4.
• Ketotifen has also been found to be effective in relieving symptoms of allergic conjunctivitis, with a higher responder rate compared to olopatadine in one study 7.
• Both olopatadine and ketotifen have been shown to be well-tolerated, with minimal side effects 4, 5, 7.

Treatment Guidelines

• Topical antihistamines with multiple actions are considered the best treatment option for allergic conjunctivitis due to their rapid action, safety, and convenience of use 8.
• Oral antihistamines, preferably second-generation drugs, can also play an important role in treating allergic conjunctivitis, especially when accompanied by nasal symptoms 8.
• Treatment should be individualized based on the severity of symptoms, patient preferences, and potential side effects 6, 7, 8.