What allergy eye drops are recommended for a 91-year-old female with allergic conjunctivitis?

From the Guidelines

For a 91-year-old female with eye allergies, I strongly recommend using preservative-free, over-the-counter antihistamine drops like ketotifen (Zaditor, Alaway) 1-2 drops twice daily as needed, due to their efficacy and safety profile in older adults, as supported by the properties of dual action agents 1. When considering treatment options, it's essential to prioritize the patient's age and potential sensitivity to certain ingredients.

• Preservative-free formulations are preferable to reduce irritation and minimize the risk of side effects.
• Antihistamine drops, such as ketotifen, are generally well-tolerated in older adults and can provide effective relief for ocular allergy symptoms.
• Dual action agents, which possess both antihistamine and mast cell stabilizer activities, like ketotifen, have a rapid onset of action and are suitable for acute and longer-term treatment of allergic conjunctivitis symptoms, as noted in the study 1.
• It's crucial to start with the mildest effective option and monitor for side effects like burning or blurred vision.
• An eye examination before starting any new eye medication is necessary to rule out other conditions that might mimic allergy symptoms, such as dry eye syndrome or glaucoma, which are common in elderly patients.
• Other options, such as olopatadine (Patanol), may be considered for persistent symptoms, but should only be used under physician guidance, taking into account the patient's overall health and potential interactions with other medications, as the study suggests that oral antihistamines are generally less effective in relieving ocular allergy symptoms than topical ophthalmic agents 1.

From the FDA Drug Label

Loteprednol Etabonate Ophthalmic Suspension, 0.2% is indicated for the temporary relief of the signs and symptoms of seasonal allergic conjunctivitis. 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.

For a 91-year-old female, Loteprednol Etabonate Ophthalmic Suspension, 0.2% can be used for the temporary relief of the signs and symptoms of seasonal allergic conjunctivitis 2, 2.

• The dosage is four times per day.
• It is essential to note that corticosteroids are capable of producing a rise in intraocular pressure 2.

From the Research

Allergy Eyedrops for a 91-Year-Old Female

• The choice of allergy eyedrops for a 91-year-old female should be based on the efficacy and tolerability of the medication, as well as the patient's individual needs and medical history.
• Studies have compared the efficacy of different allergy eyedrops, including olopatadine and ketotifen 3, 4.
• Olopatadine has been shown to be more effective than ketotifen in reducing symptoms of allergic conjunctivitis, such as itching and redness 3.
• Olopatadine has also been compared to cromolyn sodium, another allergy eyedrop, and has been found to be more effective in reducing symptoms of allergic conjunctivitis 5.
• Newer antihistamines, such as olopatadine and ketotifen, have been found to be effective in treating allergic conjunctivitis, with fewer side effects than older antihistamines 6.
• When choosing an allergy eyedrop for an older adult, it is important to consider the potential for adverse effects and drug interactions, as well as the patient's individual needs and medical history 7.

Considerations for Older Adults

• Older adults may be more vulnerable to adverse effects and drug interactions due to age-related changes in physiology and the presence of multimorbidity and polypharmacy 7.
• It is important to carefully evaluate the potential benefits and risks of any medication, including allergy eyedrops, in older adults.
• Olopatadine and ketotifen have been found to be well-tolerated in clinical studies, but it is still important to monitor for potential adverse effects, such as ocular discomfort or dryness 3, 4.