From the Guidelines
For mild to moderate allergic conjunctivitis, I recommend starting with over-the-counter antihistamine eye drops like ketotifen (Zaditor, Alaway) or olopatadine (Pataday), used twice daily, as they have been shown to be effective in relieving eye symptoms caused by allergies 1. These medications block histamine receptors and stabilize mast cells, preventing the release of inflammatory chemicals that cause itching, redness, and tearing. Some key points to consider when using eye drops for allergic conjunctivitis include:
- Applying the drops by tilting your head back, pulling down your lower eyelid, placing one drop in the pocket formed, then closing your eyes for 1-2 minutes to allow absorption 1
- Avoiding touching the dropper tip to prevent contamination
- Using artificial tears between medicated drops to help flush allergens and provide additional comfort
- Considering preservative-free formulations for those with preservative sensitivities For more severe symptoms, prescription-strength options like olopatadine 0.7% (Pazeo) used once daily or bepotastine (Bepreve) may be more effective, as they have been shown to provide significant relief from ocular itching and other symptoms of allergic conjunctivitis 1. It is essential to note that if symptoms persist beyond 72 hours of treatment or if you experience vision changes, eye pain, or discharge, you should consult a healthcare provider, as these may be signs of a more severe condition or an adverse reaction to the medication 1. In addition to using eye drops, simple measures such as wearing sunglasses, using cold compresses, and avoiding eye rubbing can also help alleviate symptoms of allergic conjunctivitis 1. Overall, the goal of treatment is to reduce morbidity, mortality, and improve quality of life by providing effective relief from symptoms and preventing complications.
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.
The treatment options for allergic conjunctivitis using eye drops are:
- Olopatadine (OPHTH): 1 drop in the affected eye(s) twice daily, every 6 to 8 hours, no more than twice per day 2
- Ketotifen (OPHTH): 1 drop in the affected eye(s) twice daily, every 8-12 hours, no more than twice per day 3 Key considerations:
- Age restrictions: olopatadine for 2 years and older, ketotifen for 3 years and older
- Dosage frequency: twice daily
- Precautions: wait at least 5 minutes between each product, do not touch dropper tip to any surface 2, 3
From the Research
Treatment Options for Allergic Conjunctivitis
The treatment options for allergic conjunctivitis using eye drops include:
- Topical antihistamines, such as olopatadine, ketotifen, azelastine, and levocabastine 4, 5, 6, 7
- Mast cell stabilizers, such as sodium cromoglycate and nedocromil sodium 5
- Dual-action agents, which combine antihistamine and mast cell stabilizer properties, such as olopatadine, azelastine, and ketotifen 4, 5, 6, 7
Efficacy of Treatment Options
Studies have shown that:
- Olopatadine is more effective than ketotifen in reducing symptoms of allergic conjunctivitis 4, 6
- Olopatadine is more effective than fluticasone furoate nasal spray in reducing symptoms of allergic conjunctivitis 8
- Ketotifen and olopatadine are effective in reducing the expression of cell adhesion molecules and inflammatory markers in conjunctival surface cells 6
- High-concentration olopatadine (0.77%) has a longer duration of action and better efficacy on ocular itch compared to low-concentration olopatadine (0.2%) 7
Safety and Tolerability
Studies have shown that:
- Topical antihistamines and mast cell stabilizers are safe and well-tolerated 5, 6
- No serious adverse events were reported with the use of topical antihistamines and mast cell stabilizers 5
- Ocular discomfort on installation of the drugs was recorded as an adverse event, but no other adverse events were observed 6