From the Guidelines
For mild to moderate allergic eye symptoms, I recommend starting with over-the-counter antihistamine eye drops like ketotifen (Zaditor, Alaway) or olopatadine (Pataday), used twice daily. These medications block histamine receptors and stabilize mast cells, preventing the release of inflammatory chemicals that cause itching, redness, and tearing 1.
Key Considerations
- For more severe symptoms, prescription-strength options like olopatadine 0.7% (Pazeo) used once daily or bepotastine (Bepreve) may be more effective.
- Apply the drops by tilting your head back, pulling down your lower eyelid, placing one drop in the pocket formed, and closing your eyes for 1-2 minutes to allow absorption.
- Avoid touching the dropper tip to prevent contamination.
- If symptoms persist beyond 72 hours of treatment or if you experience vision changes, eye pain, or discharge, consult a healthcare provider.
- For those with chronic allergies, starting eye drops before allergy season begins can provide better symptom control.
Additional Measures
- Wearing sunglasses as a barrier to airborne allergens, cold compresses, refrigerated artificial tears, avoiding eye rubbing, and avoiding allergens can also be helpful 1.
- Hypoallergenic bedding, eyelid cleansers to remove allergens, frequent clothes washing, and bathing/showering before bedtime may also be beneficial.
Medication Options
- Topical mast-cell inhibitors can also be helpful in alleviating the symptoms of allergic rhinitis.
- Mast-cell inhibitors formulated as a nasal spray and aerosols are also helpful in alleviating the symptoms of allergic rhinitis and asthma in some patients 1.
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.
- Olopatadine (OPHTH): For adults and children 2 years of age and older, use 1 drop in the affected eye(s) twice daily, every 6 to 8 hours 2.
- Ketotifen (OPHTH): For adults and children 3 years of age and older, use 1 drop in the affected eye(s) twice daily, every 8-12 hours 3.
- Age restriction: Olopatadine can be used for children as young as 2 years old, while ketotifen is approved for children 3 years and older 2 3.
- Key consideration: Always consult a doctor for children under the specified age limits for each product.
From the Research
Allergy Eye Drops
- Allergy eye drops are used to treat allergic conjunctivitis, an inflammatory condition of the ocular surface characterized by ocular itching, redness, tearing, chemosis, and eyelid swelling 4, 5, 6.
- Topical antihistamines, such as olopatadine, ketotifen, and epinastine, are commonly used to treat allergic conjunctivitis, and have been shown to be effective in reducing symptoms 4, 5, 7.
- Dual-action agents, which combine antihistamine and mast cell stabilizer properties, such as olopatadine and azelastine, are also effective in treating allergic conjunctivitis 7, 8.
- Studies have compared the efficacy of different allergy eye drops, with results showing that olopatadine is superior to ketotifen in terms of patient preference and efficacy 5, and that olopatadine 0.2% is superior to fluticasone furoate nasal spray in reducing signs and symptoms of allergic conjunctivitis 6.
- High-concentration olopatadine (0.77%) has been shown to have a longer duration of action and better efficacy on ocular itch compared to low-concentration olopatadine (0.2%) 7.
- Other treatments, such as epinastine, ketotifen, and fluorometholone, have also been shown to be effective in treating allergic conjunctivitis, although with varying degrees of efficacy and tolerability 8.
Types of Allergy Eye Drops
- Topical antihistamines: olopatadine, ketotifen, epinastine, azelastine 4, 5, 7.
- Dual-action agents: olopatadine, azelastine, ketotifen, epinastine 7, 8.
- Mast cell stabilizers: cromolyn sodium, nedocromil, lodoxamide 4.
- Corticosteroids: fluorometholone 8.
- Vasoconstrictors: naphazoline, antazoline 8.
Efficacy and Tolerability
- Olopatadine has been shown to be effective in reducing signs and symptoms of allergic conjunctivitis, with a high level of patient preference and comfort 5, 6.
- Epinastine and ketotifen have also been shown to be effective in treating allergic conjunctivitis, with comparable efficacy to fluorometholone 8.
- Naphazoline/antazoline has been shown to have lower tolerability compared to other study treatments 8.