Case-Allergic conjunctivitis

GR is a 28-year-old man who comes to the pharmacy in April complaining of itchy eyes. He explains that his eyes have been itchy for the past few weeks. He says they have been tearing more than usual as well. GR is not on any medications and has no medical conditions. Upon questioning, he says that he has been affected by seasonal allergies over the past few years. GR owns a lawn cutting company and is outside for most of his day. He has taken loratadine 10 mg in the past, but only when he had systemic symptoms. At this time, he has no other symptoms besides his itchy eyes. What would you recommend for GR?

Answer

GR is experiencing allergic conjunctivitis. The treatment goal for allergic conjunctivitis is removal or avoidance of the allergen. Because his job requires him to be outdoors, it would be difficult for GR to avoid the allergen; therefore, symptomatic relief is recommended. It is usually recommended that patients with allergic conjunctivitis be treated first-line with ocular lubricants. If symptoms continue, GR could then switch to an antihistamine/ mast cell stabilizer product. There are currently 2 such products on the market, Zaditor (Novartis) and Alaway (Bausch Lomb). Either can be recommended for use twice daily. If symptoms persist, you can suggest adding loratadine 10 mg as a second regimen.