Best allergy medicine for itchy eyes

Best Allergy Medicine for Itchy Eyes
Medically reviewed by Dr. Mavra Farrukh


As allergy season sweeps in, affecting around 60 million U.S. adults with allergic rhinitis, attention turns to the often-neglected eye symptoms. Beyond the familiar sneezing and nasal congestion, itchy, red, watery eyes become a focus. This blog addresses allergic conjunctivitis, providing a comprehensive guide to the various types of allergy medications. From understanding the urgency of fast relief to navigating the multitude of over-the-counter and prescription options, keep reading to choose the most effective remedy for your itchy eyes. Expert advice rounds out the discussion, offering guidance on personalized treatment to make this allergy season more manageable for you and your family.

Which allergy medicines are best for itchy eyes?

When it comes to addressing itchy eyes caused by seasonal allergies, a variety of allergy eye drops flood the market. Over-the-counter (OTC) brands such as Clear Eyes, Visine, and Refresh offer different types of drops, often concealing similar active ingredients under multiple brand names. Here is the list of allergy medications available over the counter as well as upon prescription: 

Decongestant Eye Drops

The American Academy of Ophthalmology designates decongestant eye drops as the primary defense against itchy eyes induced by seasonal allergies. Functioning as topical vasoconstrictors, these medications narrow blood vessels in the eyes, alleviating irritation and redness. Typically available over-the-counter and often combined with antihistamines, decongestant eye drops provide quick relief, necessitating administration approximately four times a day. Several OTC decongestant eye drops, including tetrahydrozoline and naphazoline, are available under different brand names. These brands work efficiently, but caution is advised due to potential side effects.

Potential Side Effects

While effective, some eye specialists caution against prolonged use of decongestant eye drops due to possible side effects. Doctors say extended use may worsen redness and ocular surface injury. Limiting their use to the short term is recommended, as most side effects occur with prolonged usage. Decongestant eye drops often act by narrowing blood vessels and may include additional medications like zinc or glycerin for enhanced relief or moisture.

Guidelines for Usage

For optimal results, it’s advisable to use decongestant eye drops for a maximum of three consecutive days. If the need persists beyond this period, consulting with a healthcare provider is recommended to ensure proper eye care and address any lingering concerns.

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Anti-inflammatory eye drops 

In allergic conjunctivitis, irritation is often caused by inflammation, bringing forth symptoms like redness, dryness, and itching. To combat these discomforts, anti-inflammatory eye drops emerge as a recommended solution. This category encompasses two types: NSAID eye drops, requiring four-times-a-day application, and corticosteroid eye drops, reserved for a brief two-week duration.

Anti-inflammatory eye drops offer diverse options to alleviate allergic conjunctivitis symptoms. Over-the-counter (OTC) Acular (ketorolac) stands out, while prescription-only choices include Alrex (loteprednol 0.2%) and Lotemax (loteprednol 0.5%). Acular provides accessible relief, whereas Alrex and Lotemax require a prescription.

Side Effects and Considerations

As with any medication, awareness of potential side effects is crucial. NSAID eye drops may lead to a burning or stinging sensation, prompting users to consult their healthcare provider for potential alternatives. Long-term use of corticosteroid eye drops raises concerns about infections, cataracts, and glaucoma, emphasizing strict adherence to the recommended two-week duration. Additionally, compatibility with contact lenses varies among eye drops, highlighting the importance of discussing potential interactions with an eye doctor to determine the safest and most effective choice for individual needs.

Artificial tears and moisturizers

Frequently hand in hand with red and itchy eyes, dry eye is a prevalent concern. In such cases, eye drops mimicking natural tears become a viable solution to restore eye moisture.

Artificial tears come in various forms—eye drops, gels, and ointments. While gels and ointments offer prolonged eye coverage, reducing the frequency of application, they may momentarily cause blurry vision. Examples of brand-name artificial tears include Clear Eyes Advanced Dry and Itchy Relief, Clear Eyes Natural Tears, Refresh Classic, Refresh Liquigel, Systane Balance, Systane Ultra, TheraTears Liquid Gel Nighttime, and Visine Dry Eye Relief Tired Eye.

Despite their similarity to natural tears, it’s prudent to consult with a healthcare provider before prolonged use of artificial tears. While generally considered safe, chronic usage can sometimes exacerbate dry eye.

How do artificial tears assist allergic itchy eyes?

Artificial tears prove beneficial for allergic itchy eyes through a dual mechanism. 

  • Firstly, they wash allergens out of the eyes. 
  • Secondly, moisturizing the eyes alleviates redness and dryness, common contributors to eye itchiness. 

Some doctors say oral allergy medications can induce dryness, making it harder for the eyes to flush out allergens naturally.

Side Effects and Considerations

While generally well-tolerated, there is a potential for allergic reactions to artificial tears, marked by symptoms like skin rash, shortness of breath, wheezing, and a runny nose. Consultation with a healthcare provider is crucial if these symptoms arise. To enhance safety, experts recommend opting for preservative-free artificial tears.

Antihistamine/mast cell stabilizer eye drops

Ranked second and third most recommended treatments for itchy eyes caused by seasonal allergies; antihistamines and mast cell stabilizer drops play a pivotal role, according to the American Academy of Ophthalmology. These two medications are frequently amalgamated into a single-eye solution, offering a comprehensive approach. Antihistamines block histamine receptors, reducing allergy symptoms, while mast cell stabilizers prevent the release of histamine and other allergy-triggering chemicals, effectively reducing the allergic reaction at its source.

Prescription-based Elestat (epinastine) and over-the-counter options like Zaditor (ketotifen), Alaway (ketotifen), and Pataday (olopatadine) are examples of combination antihistamine/mast cell stabilizer eye drops. Elestat requires a healthcare provider’s prescription, while the others are available without one.

Side Effects and Considerations

While these eye drops are effective for symptomatic relief, caution is advised regarding their preventive use. Antihistamine or mast cell stabilizer eye drops contain preservatives that may not be gentle on the ocular surfaces and can lead to dry eyes with long-term use. In case of dryness, the concurrent use of artificial tears alongside antihistamine/mast cell stabilizers is recommended to mitigate this effect.

How they work to relieve symptoms

Antihistamine/mast cell stabilizer eye drops operate on a dual front to alleviate allergic conjunctivitis symptoms. By blocking histamine, these drops counteract its effects, providing relief from red and itchy eyes. Simultaneously, mast cell stabilizers reduce the likelihood of mast cells releasing histamine, offering a multifaceted solution.

Several brands fall under the category of antihistamine/mast cell stabilizer eye drops, including Alaway (ketotifen 0.025%), Clear Eyes Once Daily Eye Allergy Itch Relief (olopatadine 0.2%), Extra Strength Pataday Once Daily Relief (olopatadine 0.7%), Pataday Once Daily Relief (olopatadine 0.2%), Pataday Twice A Day Relief (olopatadine 0.1%), and Zaditor (ketotifen 0.025%).

Prescription-only mast cell stabilizer eye drops, including Alocril (nedocromil 2%), Alomide (lodoxamide 0.1%), and Cromolyn sodium 4%, offer an alternative for those seeking long-term relief from allergic conjunctivitis. However, their effectiveness may take days or weeks to manifest, making them a secondary option after exploring other allergy eye drops first, as recommended by experts.

Itchy eyes can be triggered during allergy season Get your antihistamines to walk itch free this spring

Oral Antihistamines

Oral antihistamines provide a comprehensive solution to allergy symptoms by blocking the release of histamine throughout the body. While not the primary treatment for itchy eyes, they prove effective when accompanied by other allergy indicators, such as itchy skin, sneezing, and a runny nose. The optimal effectiveness of oral antihistamines is realized when taken before the onset of allergic reactions.

When seeking relief for itchy eyes, the choice between oral antihistamines like Zyrtec (cetirizine), Claritin (loratadine), Allegra (fexofenadine), Xyzal (levocetirizine), Clarinex (desloratadine), and Benadryl (diphenhydramine) depends on individual response. The efficacy varies among individuals, and it may take trying several options before finding the most suitable one. All the mentioned oral antihistamines are available over the counter, providing accessibility for users seeking relief from allergic symptoms.

Side effects of oral antihistamines

One drawback of oral antihistamines is their potential to induce dryness. These medications can lead to insufficient tears to wash allergens out of the eyes, resulting in increased dryness and itchiness. Therefore, doctors recommend concurrently using preservative-free artificial tears while taking oral antihistamines to counteract this effect. This approach ensures a more balanced and comfortable experience for those relying on oral antihistamines for allergy relief.

What is the best OTC for itchy, dry eyes?

For most instances of red and itchy eyes, Over-the-Counter (OTC) allergy eye drops serve as a reliable source of relief. These drops, recognized as safe and effective, are particularly adept at treating allergic conjunctivitis. The FDA occasionally approves prescription allergy eye medications for OTC like Pataday.

When and why to choose prescription allergy eye drops

Prescription allergy eye drops come into consideration when symptoms are more severe or if OTC eye drops prove insufficient. Persistent or excessive symptoms may indicate a condition beyond allergic conjunctivitis, where OTC medications may not be the most appropriate choice.

OTC combination allergy eye drops

Some OTC allergy eye drops combine multiple medications into one solution for convenience. These combinations may include an antihistamine and a decongestant, with lubricants for extra moisture. Reviewing the label is crucial, as it provides a breakdown of active ingredients, guiding users on the medications included in their eye drops. Examples of combination allergy eye drops include

  • Naphcon-A (naphazoline 0.025%/pheniramine 0.3%)
  • Opcon-A (naphazoline 0.02675%/pheniramine 0.315%)
  • Visine Allergy Eye Relief Multi-Action (naphazoline 0.025%/pheniramine 0.3%)
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When to see a doctor

While transient episodes of red and itchy eyes, unaccompanied by other symptoms, typically don’t necessitate immediate medical attention, however, in case of persistent symptoms call your healthcare provider. Eye discharge or crusting, particularly, may signify a bacterial or viral pink eye infection, requiring a professional assessment.

Additionally, in the presence of more serious symptoms such as vision changes or severe headaches, seeking emergency assistance becomes imperative. These indicators may signify underlying issues that require timely evaluation and intervention.

FAQs about medications for itchy eyes

Is Claritin or Zyrtec better for itchy eyes?

When alleviating itchy eyes, Zyrtec (cetirizine) and Claritin (loratadine), prominent antihistamine brands, showcase comparable efficacy. Although these medications contain distinct compounds, their ability to reduce allergy symptoms, including watering eyes, itchy skin, hives, and swelling, appears equally effective.

What are natural eye remedies for itchy eyes?

Several natural remedies can help relieve itchy eyes. Staying adequately hydrated by drinking plenty of water ensures your eyes remain moist and produce healthy tears. Using a humidifier in environments with dry air prevents eye dryness. Consuming omega-3 fatty acids, washing your eyelashes, blinking rapidly, and applying warm or cold compresses are additional strategies. When necessary, eye drops or prescribed medication can provide targeted relief.

What is the best daily allergy medicine?

For daily allergy management, allergists recommend long-acting, non-sedating antihistamines—options that do not induce drowsiness. Examples of such antihistamines include Cetirizine (Zyrtec®, Aller-Tec®, Wall-Zyr®) and Fexofenadine (Allegra®, Aller-ease®, Aller-Fex®, Wal-Fex®). These medications, available in generic versions, effectively address allergy symptoms without causing sleepiness.

How long should itchy eyes last?

The duration of itchy eyes due to allergies can vary widely. Some individuals may experience eye allergy reactions lasting less than an hour, while others may endure symptoms for several days. During pollen allergy season, it’s not uncommon for eye allergies to persist for weeks or longer. The duration depends on individual factors and the specific allergens triggering the reaction. If symptoms persist or worsen, consulting a healthcare provider is advisable for personalized treatment.

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Bielory, L., Lien, K.W. and Bigelsen, S., 2005. Efficacy and tolerability of newer antihistamines in the treatment of allergic conjunctivitis. Drugs65, pp.215-228.

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