Many people are familiar with the upper respiratory symptoms that can accompany year-round or seasonal allergies, including runny nose, stuffy nose, sneezing, and postnasal drip. However, it is not uncommon for allergy sufferers to experience eye symptoms as part of an allergic reaction, which nasal sprays and oral medications may be unable to relieve. 

Allergy sufferers may benefit from using eye drops that are specially designed to treat and even prevent eye allergy symptoms. Some of these eye drops are available over the counter, but many are prescription only. 

Which kind of prescription eye drops helps allergies? 

What are allergies?

People are said to have allergies when their body overreacts to the presence of an otherwise harmless substance, known as an allergen. 

Allergens are substances that do not cause symptoms in most people, but can trigger an allergic reaction in others. Allergens commonly include foods, dust, pet dander, medications, latex, pollen, smoke, and other things in the environment.  

Exposure to an allergen can cause a range of symptoms designed to protect the person’s body and flush the allergen out, including hives, sneezing, runny nose, itchy eyes, and more. These symptoms vary from person to person, and can also depend on the allergen.

An allergic reaction begins when the immune system detects the presence of an allergen. From there, the body starts to produce chemicals that direct its cells to mount an attack. These chemicals, which include histamine, send chemical messages to the cells and direct them to start producing the symptoms that patients commonly experience. 

While the best way to avoid an allergy attack is to minimize exposure to an allergen, not everyone has that option. Environmental allergens like pollen, mold, and dust mites are not completely within anyone’s control.

What to know about eye allergies

Some people experience eye allergies, with allergic conjunctivitis being one of the most common results. [1] A patient has allergic conjunctivitis when the tissue that lines the inside of the eyelid and outside of the eyeball, known as conjunctiva, becomes inflamed (i.e. irritated and swollen). 

This inflammation can cause symptoms like itching, swelling, irritation, redness, swollen eyelids, burning, and more. These symptoms can make it hard to see, concentrate, and go about daily activities, particularly when they occur over an extended period of time. They are also uncomfortable and potentially painful.

General eye allergy symptoms include:

• Burning feelings in the eye;

• Itchy eyes;

• Swollen eyelids;

• A feeling of something stuck in the eye;

• Red or bloodshot eyes;

• Tearing or watering.

Among the most common triggers of eye allergies are allergens like pollen, dust mites, mold spores, pet dander, and cockroach droppings. Microscopic particles of these allergens can enter the air and become trapped in the eye, sparking an allergic response. 

It’s also common for people to introduce allergens into their eyes by touching or rubbing their eyes after making physical contact with an allergen. It’s recommended that patients prone to eye allergies wash their hands often with soap and water and avoid touching their eyes as much as possible.

What are prescription eye drops for allergies?

People who experience allergy symptoms in their eyes may benefit from the use of prescription eye drops for allergies. [2] 

Prescription-strength eye drops for allergies differ from over-the-counter eye drops because they typically contain higher concentrations of the active ingredient, which can help relieve more severe symptoms. 

Due to the higher concentrations of active ingredients, a doctor or licensed healthcare provider must prescribe the medication, which is then obtained from a pharmacy. Allergy relief eye drops come in a liquid form that is applied directly to the eye, allowing them to better target and more quickly relieve symptoms compared to oral medications.

What are the different types of prescription eye drops for allergies?

There are five different types of prescription eye drops for allergies, each of which works differently and treats different symptoms. 

While some types of prescription eye drops for allergies treat symptoms more quickly, others provide longer-term relief. 

The type of allergy relief eye drops that will work best depends on factors like a patient’s specific symptoms, the allergen causing the symptoms, and how much the allergy symptoms are impacting a patient’s day-to-day life. 

The five major types of eye drops for allergies include:

• Antihistamines;

• Decongestants;

• Anti-inflammatories;

• Mast cell stabilizers;

• Multiple action.

Antihistamine allergy eye drops

Antihistamine allergy eye drops work to block histamine in the body. Histamine is a chemical released by the body when the immune system detects the presence of an allergen. The chemical causes the cells to start producing allergy symptoms, such as itching, watering, redness, and swelling of the eyes. 

Antihistamines are often recommended as a first line of defense against allergy symptoms because they work quickly. In fact, some doctors may recommend oral antihistamines over antihistamine eyedrops if a patient’s allergy symptoms are causing respiratory or skin issues, too.

Antihistamine prescription eye drops for allergies include:

• Azelastine hydrochloride (sold under the brand name Optivar);

• Levocabastine (sold under the brand name Livostin);

• Emedastine difumarate (sold under the brand name Emadine).

Antihistamine eye drops for allergies are most effective for people who have itchy, watery eyes. Because they work quickly to relieve symptoms, antihistamine eye drops are popular for acute allergy attacks. 

However, they typically provide relief for just a few hours, so they are not a good long-term solution for people who experience allergy symptoms on a regular basis. 

Antihistamine allergy eye drops may also cause dry eyes as a side effect.

Decongestant allergy eye drops

Decongestant eye drops for allergies work by narrowing the blood vessels in and around your eyes that can become swollen during an allergic reaction. Swollen blood vessels contribute to the appearance of red, bloodshot eyes, so people who experience this symptom as a result of their allergies can get short-term relief from decongestant allergy eye drops.

Decongestant eye drops for allergies work quickly to relieve redness and swelling, but they are not intended for long-term use. These types of medications should not be used for more than three days at a time because long-term use can contribute to “rebound redness,” a condition in which the eyes become bloodshot for a longer period of time. In some cases of prolonged use, red eyes may persist even after the symptoms have resolved. 

Decongestant eye drops for allergies are available over-the-counter without a prescription. While anyone can purchase them, they should not be used by people who have glaucoma, as they can make the condition worse. It’s a good idea to check with a healthcare provider before taking any new over the counter medications.

Popular decongestant eye drops for allergies include:

• Naphazoline HCL; 

• Phenylephrine HCL; 

• Oxymetazoline HCL; 

• Tetrahydrozoline HCL.

Anti-inflammatory allergy eye drops

There are two different kinds of anti-inflammatory prescription eye drops for allergies: nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. Both work differently to treat allergy symptoms in the eyes.

NSAID prescription eye drops for allergies include ketorolac, sold under the brand names Acular and Acuvail. These medications work by acting on some of the nerve endings in the eyes that can cause an itchy feeling in response to an allergen. 

When using NSAID prescription eye drops for allergies, itching typically starts to resolve in about an hour. Side effects of NSAID prescription eye drops for allergies include feelings of burning or stinging in the eyes shortly after use.

People who have severe eye allergy symptoms for a prolonged period of time may benefit from using corticosteroid prescription eye drops for allergies. Corticosteroids work by reducing inflammation in the tissues of the eye, helping to relieve swelling. 

Corticosteroid prescription eye drops for allergies include loteprednol (sold under the brand names Alrex and Lotemax), but they may not be suitable for everyone. 

Long-term use of corticosteroid prescription eye drops for allergies can cause problems with eye health, including increased risk of experiencing cataracts, glaucoma, eye infections, and increased pressure in the eye. 

As a result, people who have a history of experiencing these and other eye issues should meet with a physician regularly when using prescription corticosteroid eye drops for allergies.

Mast cell stabilizer allergy eye drops

Mast cell stabilizer prescription eye drops for allergies are among the newest types of eye drops that can be used to treat allergy symptoms. Unlike antihistamines, which work by blocking the action of histamine, mast cell stabilizer eye drops work by stopping the release of histamine and other chemicals before it starts. 

As a result, these types of eyedrops are not intended for use during an allergic reaction but are instead used as a preventive measure.

Mast cell stabilizer eye drops can be used long-term without any side effects, which makes them a good fit for people who may be sensitive to side effects from other medications. These eye drops can be purchased over the counter or with a prescription. 

Prescription mast cell stabilizer allergy eye drops include:

• Cromolyn (sold under the brand name Crolom);

• Lodoxamide (sold under the brand name Alomide);

• Nedocromil sodium (sold under the brand name Alocril);

• Pemirolast potassium (sold under the brand name Alamast).

Multiple-action allergy eye drops

People who have a variety of eye symptoms associated with their allergies may benefit from using multiple-action prescription eye drops for allergies. These eye drops contain two or more kinds of medicine that are designed to treat different symptoms. 

Multiple-action allergy eye drops often come in the forms of antihistamine/decongestant combinations and antihistamine/mast cell stabilizer combinations.

Antihistamine/decongestant eye drops for allergies reduce symptoms like redness, itching, and watery eyes. 

Examples include:

• Pheniramine maleate/naphazoline HCL (sold under the brand names Opcon-A and Naphcon-A);

• Antazoline phosphate/naphazoline HCL (sold under the brand name Vasocon-A).

Antihistamine/mast cell stabilizer combination eye drops for allergies can be used to treat and prevent symptoms like burning, redness, itchy eyes, and tearing. [3] 

People who regularly suffer from eye allergy symptoms can benefit from these medications because they contain both quick-acting medication in the form of the antihistamine as well as preventive medication from the mast cell stabilizer. Examples of antihistamine/mast cell stabilizer combination prescription eye drops for allergies include:

• Epinastine (sold under the brand name Elestat);

• Olopatadine HCL (sold unde the brand names Pataday and Patanol);

• Ketotifen (sold under the brand names Alaway and Zaditor).

What side effects and risks are associated with prescription eye drops for allergies?

Each prescription medication is different, so it is recommended that patients consult with their healthcare provider to learn about specific side effects and risks that may be associated with their eye drops. 

Broadly speaking, the most common side effect of prescription eye drops for allergies is burning or stinging shortly after use.

People with an eye infection or glaucoma should generally not use eye drops for allergies, regardless of whether they are purchased over-the-counter or with a prescription, without a doctor’s approval. 

People who wear contact lenses should ask their healthcare provider about how to use eye drops, as patients may need to remove their contact lenses before using eye drops and then wait for a specific period of time before putting them in. Some patients may not be able to wear contact lenses at all while using eye drops for allergies.

The bottom line

While OTC eye drops are often a go-to for many people, sometimes prescription-strength eyedrops are needed for more persistent, severe symptoms. The most effective type of prescription eye drops for allergies will vary depending on a patient’s specific symptoms, the allergen causing the symptoms, and how much the allergy symptoms impact that person’s day-to-day life. 

It can be helpful for allergy sufferers to consult with a medical professional about available prescription treatments for allergies in order to find the right prescription. 

Fortunately, talking to the doctor doesn’t have to be inconvenient — schedule a visit with a HealthTap doctor today to get the allergy relief you need at an affordable cost, all without leaving the comfort of your home. 

References

1. Eye Allergies (Allergic Conjunctivitis). Asthma and Allergy Foundation of America. https://www.aafa.org/eye-allergy-conjunctivitis/. Reviewed October 2015. Accessed 31 March 2022. 

2. Eye Allergy. American College of Allergy, Asthma & Immunology. https://acaai.org/allergies/allergic-conditions/eye-allergy/. Accessed 31 March 2022. 

3. What Are Eye Allergies? American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/allergies. Updated 11 January 2022. Accessed 31 March 2022.