From the Guidelines
For itchy eyes due to pollen allergies, dual-action antihistamine and mast cell stabilizer eye drops like olopatadine (Pataday) are typically most effective, as they provide quick relief and can prevent symptoms when used before exposure 1. These over-the-counter options can be used up to twice daily as directed on the packaging. Some key points to consider when using these eye drops include:
- Artificial tears can also help flush allergens from the eyes and provide additional comfort when used as needed throughout the day.
- Cold compresses applied to closed eyes for 5-10 minutes can reduce inflammation and itching between eye drop applications.
- These antihistamine drops work by blocking histamine receptors in the eye, preventing the chemical reaction that causes itching, redness, and tearing when pollen contacts the eye surface.
- If symptoms persist beyond 72 hours of treatment or worsen, consult an eye care professional as prescription-strength options may be necessary. It's also important to note that:
- Vasoconstrictors can provide temporary relief but may lead to rebound hyperemia with prolonged use 1.
- Mast cell stabilizers can be used for chronic conditions but have a slower onset of action 1.
- Topical NSAIDs like ketorolac can reduce prostaglandin production but are generally less effective than dual-action agents 1.
- Ocular corticosteroids should be reserved for severe symptoms due to the risk of vision-threatening side effects 1.
From the FDA Drug Label
CLINICAL PHARMACOLOGY Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. Seasonal Allergic Conjunctivitis: A placebo-controlled clinical study demonstrated that loteprednol etabonate was effective in reducing the signs and symptoms of allergic conjunctivitis during peak periods of pollen exposure.
The best eye drops for allergic conjunctivitis due to pollen are loteprednol etabonate and ketotifen.
- Loteprednol etabonate has been shown to be effective in reducing the signs and symptoms of allergic conjunctivitis during peak periods of pollen exposure 2.
- Ketotifen temporarily relieves itchy eyes due to pollen, ragweed, grass, animal hair and dander 3.
From the Research
Treatment Options for Allergic Conjunctivitis
- Olopatadine 0.1% and ketotifen 0.025% are two common eye drop options for treating allergic conjunctivitis 4, 5.
- Olopatadine has been shown to be more effective than ketotifen in reducing symptoms of allergic conjunctivitis, with a significantly greater percentage of patients preferring olopatadine 4.
- Olopatadine has also been compared to cromolyn sodium 2% and levocabastine 0.05%, with olopatadine showing greater efficacy in controlling ocular signs and symptoms of seasonal allergic conjunctivitis 6, 7.
Efficacy of Olopatadine and Ketotifen
- A study comparing olopatadine and ketotifen found that both treatments were effective in reducing symptoms of seasonal allergic conjunctivitis, but olopatadine was more effective in reducing tearing and itching 8.
- Another study found that ketotifen was effective in reducing the signs and symptoms of seasonal allergic conjunctivitis, and was well tolerated 5.
- Olopatadine has been shown to be effective in reducing the expression of cell adhesion molecules and inflammatory markers in conjunctival surface cells, which may contribute to its efficacy in treating allergic conjunctivitis 8.
Patient Preference and Comfort
- A study found that patients preferred olopatadine over ketotifen, citing greater efficacy and comfort 4.
- Another study found that olopatadine was well tolerated and effective in controlling ocular signs and symptoms of seasonal allergic conjunctivitis in children 7.
- Patient preference and comfort are important factors to consider when selecting an eye drop treatment for allergic conjunctivitis 4, 7.