Relieving Itchy Eyes

Q:  When my allergies kick up, my antihistamine helps my sneezing and stuffy nose, but my eyes still feel “itchy”. What else can I do? 
Years ago, I bought my “dream” car, a classic jet-black 1985 Jeep CJ7 hardtop. I can still remember that Saturday afternoon in August when my husband Charlie and I took the top off my new Jeep and headed out to the backroads of central Ohio. It was so peaceful: I could smell the damp earth of the fields we cruised by, rows of tall cornstalks alternating with lush, bushy soybeans. 
Saturday’s afternoon was magic, but Sunday’s morning was a nightmare. I woke up to a nose I couldn’t breathe through and eyes that burned like fire.
“What set off my allergies? The only thing I’m allergic to is ragweed, and we drove past corn and soybeans.”
“Honey, we definitely drove past ragweed yesterday. I saw TONS of It, growing thick in the ditches on both sides of the road.”
If you need to soothe the discomfort of itchy eyes from allergies gone wild, you’ll find several eyedrop products available without a prescription. How do you choose the best one to calm your allergies? 
Lubricating eye drops can ease the burning and help relieve dryness. Systane®, GenTeal®, or Refresh® all help reduce the “sand in your eyes” feeling by flushing pesky pollens away, but they can’t shut off an allergic reaction once it starts. 
Decongestant eye drops help your eyes look less red or “bloodshot” by shrinking the blood vessels in the whites of your eyes. They can help reduce puffiness around your eyelids but don’t help reduce allergic reactions. 
Naphazoline is a decongestant. Sold as Naphcon® eye drops, it's also available combined with an antihistamine, such as Visine-A® and Naphcon-A® (the "A" stands for antihistamine). 
Eye drops containing naphazoline can cause trigger dry eyes and aggravate certain types of glaucoma, threatening your vision. Because of this risk, avoid using naphazoline eye drops for more than 3 days at a time. If you have glaucoma, you should avoid using naphazoline eye drops completely.
Antihistamine eye drops help reverse eye itching and swelling from allergies. Pheniramine maleate is an antihistamine available in both Visine-A® and Naphcon-A® eye drops. Because these eye drops also contain the decongestant naphazoline, they should only be used for 3-5 days at a time. 
The most effective eye drop to use when allergies strike is either ketotifen or olopatadine. They help prevent allergic reactions AND calms it down once it starts. 
When you encounter something you are allergic to, it triggers a chain reaction leading to redness, swelling, and itching. This reaction is triggered by a chemical called histamine. 
Your body stores histamine in specialized cells called mast cells. When your body recognizes pollen or cat dander as something you are allergic to, these mast cells open, releasing histamine into your bloodstream, which creates the misery of an allergic reaction.  
Medicines called mast cell stabilizers keep histamine tucked inside your mast cells where it can’t trigger an allergic reaction. Ketotifen and olopatadine are potent mast cell stabilizers as well as antihistamines and are both available as eye drops. Thanks to them, I can drive past ditches full of blooming ragweed without suffering the next day, because they keep histamine safely inside my mast cells.  
Pataday was a popular prescription-only eye drop. It is available without a prescription, in two strengths: Pataday Once Daily 0.2% and Pataday Twice Daily 0.1%. Ketotifen is available as Zatidor® and Alaway® brand eye drops.
Here are 4 Tips on Using Eye Drops for Allergies:
1. Avoid naphazoline eye drops. 
Decongestant eye drops don’t address the allergic reaction and only reduce redness. Limit your use of naphazoline eye drops to three days at a time, and avoid it entirely if you have glaucoma. 
2. Choose Pataday® Once Daily for best results.
Ketotifen and olopatadine work both as antihistamines and mast cell stabilizers to relieve itchy eyes. They are also safe to use in children as young as 2 or 3 years old. Pataday Once Daily 0.2% is more effective than Pataday Twice Daily 0.1% or ketotifen eye drops.
3. Use only one drop in each eye. 
Any more than one drop at a time will just run out and be wasted. Wait a bit before giving yourself another dose.
4. Keep it clean.
Always wash your hands first and avoid touching the tip of the dropper directly to your eye or to any other surface. 
Dr. Louise Achey, Doctor of Pharmacy, is a 42-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Her website has weekly tips with clear answers to your medication questions so you can take your medicine safely.
2021 Louise Achey

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