Seasonal and perennial
Pollen drives seasonal flares; dust mites, mold and pet dander keep symptoms going all year.
EyeWikiMedical Eye Care · Allergy
Eye Allergy Guide The most common conjunctivitis, and a steady OTC category.
Allergic conjunctivitis brings patients in every season, and most of them leave with an over-the-counter drop. A clear in-office protocol, the right shelf stock and a path to prescription therapy for the patients who need more make allergy a dependable part of a medical practice.
15 to 40%of the population affected by allergic conjunctivitis
2020year olopatadine 0.7% and 0.2% moved to OTC
2022year alcaftadine 0.25% became available OTC
16 hoursitch relief claimed for once-daily OTC alcaftadine
The basics
What drives allergic eye symptoms
Allergens trigger mast cells in the conjunctiva to release histamine and other mediators. Itching is the hallmark symptom, which helps separate allergy from dry eye and infection.
Itch is the clue
Itching with watery discharge and lid swelling points to allergy; burning and grittiness point more to dry eye.
Dual-action drops
OTC antihistamine and mast cell stabilizer drops such as olopatadine, ketotifen and alcaftadine treat the itch.
Alcon, AbbVieDecongestant drops
Vasoconstrictor combinations whiten the eye quickly; CDC lists antihistamine or vasoconstrictor drops for allergic pink eye.
CDCWhat to keep on the shelf
Most allergy patients can be treated with OTC products the practice can stock and recommend by name.
- Once-daily antihistamine drops
- Lid wipes and cooling masks
- Preservative-free tears to rinse allergens
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Lastacaft (alcaftadine 0.25%)
Switched to OTC in 2022 for ages two and up, dosed once daily; AbbVie cites relief in minutes lasting through 16 hours.
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Pataday (olopatadine)
Alcon's olopatadine 0.7% once daily, 0.2% once daily and 0.1% twice daily moved to OTC in 2020.
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Zaditor (ketotifen)
A long-standing OTC antihistamine and mast cell stabilizer drop, stocked at wholesale.
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Supportive care
Cool compresses, allergy lid wipes and preservative-free tears help remove allergens from the lids and tear film.
In the clinic
An allergy visit in three steps
Separate allergy from look-alikes first, then match the treatment to severity.
Confirm
Ask about itch, triggers and season. Check the tarsal conjunctiva for papillae and rule out infection and dry eye.
Treat
Start a dual-action OTC drop, add cool compresses and lid hygiene, and advise lens wearers to pause or switch to daily lenses.
Escalate
Persistent or severe cases may need a prescription antihistamine or a short course of a soft steroid with pressure monitoring.
Reference details
OTC allergy drops at a glance
| Alcaftadine 0.25% (Lastacaft) | Once daily, ages 2 and up |
|---|---|
| Olopatadine 0.7% (Pataday Once Daily Relief Extra Strength) | Once daily |
| Olopatadine 0.2% (Pataday Once Daily Relief) | Once daily |
| Olopatadine 0.1% (Pataday Twice Daily Relief) | Twice daily |
| Ketotifen (Zaditor) | Antihistamine and mast cell stabilizer |
| Naphazoline and pheniramine (Opcon-A) | Decongestant and antihistamine combination |
Red flags that are not simple allergy
- Pain, light sensitivity or reduced vision
- Purulent discharge or a contact lens wearer with a red eye
- Corneal infiltrates or staining
- Unilateral symptoms with a history of cold sores
Stocking note
Vision Rescue carries Lastacaft, Zaditor, Opcon-A, allergy lid wipes and cooling masks at wholesale. Patients can reorder them between visits through RescueLink, and eligible OTC orders earn the 15% participation credit.
Questions about eye allergy
How do I tell allergy from dry eye?
Itching is the hallmark of allergy. Dry eye more often burns or feels gritty. Many patients have both, so treat the surface as well as the allergy.
Which OTC drop should I recommend first?
A once-daily dual-action drop such as alcaftadine or olopatadine suits most patients and keeps the routine simple.
Are decongestant drops a good choice?
They whiten the eye quickly, and CDC lists vasoconstrictor drops among allergy options. For daily itch control, an antihistamine drop is the more targeted choice.
Can contact lens wearers use allergy drops?
Lenses generally come out before instilling a drop. Daily disposable lenses can help during allergy season.
When is a prescription needed?
When OTC drops do not control symptoms, or when signs are severe. See the allergy Rx drops guide for options.
Can I order allergy products from Vision Rescue?
Yes. Lastacaft, Zaditor, Opcon-A, allergy lid wipes and cooling masks are in the wholesale catalog.
References
Stock the allergy season
Keep once-daily allergy drops and lid care on hand, and send refills to patients with RescueLink.
Written for licensed eye care professionals. Use each product according to its labeling. Product names are trademarks of their owners. The RescueLink participation credit applies to eligible OTC orders on VisionRescue.com; contact lenses and prescriptions are excluded.