For symptom relief, apply cold compresses and use preservative-free artificial tears as needed. If symptoms persist, antihistamine eye drops (e.g., ketotifen 0.035%) can control itching and redness. Severe or refractory cases may require prescription corticosteroid eye drops, oral antihistamines, or allergen-specific immunotherapy under medical supervision.
January 14, 2025

Allergies with Itchy Eyes: Best OTC Solutions

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

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Itchy eyes (allergic conjunctivitis) is an immune-mediated inflammation of the conjunctiva caused by allergens such as pollen, dust, or pet dander. It presents with itching, redness, tearing, and swelling of the eyes. Treatment aims to alleviate symptoms and prevent recurrence.

First-line recommendations:

  • Avoidance of allergens: Minimize exposure to known triggers by keeping windows closed, using air purifiers, and wearing sunglasses outdoors.

  • Symptom relief: Apply cold compresses to the eyes several times daily to reduce itching and swelling. Artificial tears can flush out allergens and soothe irritation. Use preservative-free drops as needed. Refresh Tears PF Preservative-Free Artificial Tears (FDA M018).

Second-line recommendations:

  • Antihistamine eye drops: To control itching and redness. Use twice daily. Second-generation topical histamine H1-receptor antagonists with mast-cell stabilizing action (e.g. ketotifen 0.035%) are most effective. Zaditor Antihistamine Eye Drops (FDA N021996).

Prescription medications:

  • Corticosteroid eye drops: Short-term use (e.g., loteprednol) for severe cases under ophthalmologist supervision to avoid side effects like glaucoma.

  • Oral antihistamines: Used off-label to help control refractory symptoms. Examples include loratadine or cetirizine. Sometimes may induce or worsen dry eye syndrome, impair the tear film's protective barrier, and actually worsen allergic conjunctivitis, so use in consultation with a doctor.

  • Allergen-specific immunotherapy: Consult an allergist for immunotherapy (e.g., sublingual or subcutaneous) in severe, refractory cases.

Citation

Varu, D. M., Rhee, M. K., Akpek, E. K., Amescua, G., Farid, M., Garcia-Ferrer, F. J., ... & Dunn, S. P. (2019). Conjunctivitis preferred practice pattern®. Ophthalmology, 126(1), P94-P169.

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Levels of evidence considered:

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  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

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