Wednesday, August 27, 2008

Photos and Descriptions of Eye Drops for Allergic Conjunctivitis

People with allergic conjunctivitis may have itchy, watery, red, scratchy or dry-feeling eyes. This disease occurs about 90% of the time with allergic rhinitis (hay fever). Note that medications for allergic conjunctivitis are approved on the basis of individual symptoms above. The most important symptoms to reduce in order of importance in my opinion are itching, dry-feeling, then redness. Itch is reduced by mast cell stabilisers and antihistamines, which are listed below. The dry-feeling is reduced by lubricants. Several are available. No studies have shown any superiority. Try one and if no relief, then try another. Redness is reduced by decongestants and astringents. I normally do not recommend these. Overuse can result in conjunctivitis medicamentosa, a rebound condition where the blood vessels have become addicted to the decongestants, as happens to the nose when too much Afrin is used. The eyes can become quite red. My advice is don't go there. It hurts.

I. Over-the-counter (OTC) MEDICATIONS may be tried before moving onto prescription medications. They are usually cheaper than the name-brand prescription meds and may not be any better. The large pharmacy chains produce their own store-label brands of generic medications. Read the labels carefully. For completeness, Similisan is included. This is an herbal-based medication, which in my opinion, has not been effectively proven to work.


Note: which medication a person uses depends as much on the physician prescribing the medication, the patient asking for a medication, and which medication the insurance company will actually pay for. No rhyme nor reason exists for predicting the final result. One piece of advice, patients should try to bring their drug formulary to their doctor visits, so that together physicians and patients may eliminate one step, that of the insurance company denying coverage of a prescribed medication. Prescription medications tend to last longer than OTC eyedrops. In my opinion, there is no uniformly superior medication. For my detailed explanation, go here. Alrex and Lotemax are actually different concentrations of the same corticosteroid eyedrop (made by Bausch and Lomb). I do not use either. I recommend patients using either be under the care of an ophthalmologist, to monitor their intraocular pressure (the pressure inside of their eye). Last, Acular is a non-steroidal anti-inflammatory drug (NSAID) eyedrop. I do not recommend Acular often, based on at best medium effectiveness of symptom relief and the limit of seven days use only per the package insert.

If you have questions, ask your doctor. (Updated 9/4/08)

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