Eye Drops

By Peter Galvin, MD

There are many types of over the counter (OTC) eye drops available to treat various eye conditions, for example eye allergies, aka allergic conjunctivitis. In reaction to allergens like pollen or pet dander, your eyes may become itchy and red. Let’s look at the types of OTC drops available to treat these eye symptoms. Remember, however, that like all OTC medications, eye drops are not regulated or evaluated and tested by the FDA. Also, remember that just because a medication is OTC, does not mean that it is without side effects.

Ocular lubricants (artificial tears) are drops, gels, or ointments that flush allergens from the eyes and decrease the symptoms of dry eyes. Most lubricants contain either or a combination of glycerin, polyethylene glycol, or carboxymethylcellulose. Preservative-free lubricants are recommended if they are going to be used more than four times a day. Ointments and gels provide longer symptom relief but should be used at bedtime because they are more likely to cause blurry vision. Different types may be combined, for example,  drops during the day and ointments at night. The most common side effects are minor eye irritation and temporary blurry vision.

Ocular antihistamines decrease eye itchiness by blocking histamine, a substance released by the body in response to an allergen. Most of these types of eye drops will contain the word “allergy” in the brand name. Side effects may include headache, burning or irritation of the eyes, and temporary blurry vision. Ocular decongestants are eye drops that decrease eye redness by constricting blood vessels in the eye. Most people are familiar with Visine eye drops, which is an ocular decongestant. Individuals with diabetes, heart disease, high blood pressure, or thyroid disease should speak to their doctor before starting an ocular decongestant. Common side effects include dilated pupils and burning or irritation of the eyes. Most decongestants contain tetrahydrozoline, aka tetryzoline, which should never be taken orally. A common urban myth is that putting Visine in someone’s drink as a joke will cause them to have diarrhea, when in fact it does not cause diarrhea but rather severe nausea and vomiting, coma, and possibly death. In 2018, a South Carolina woman was indicted for murdering her husband. His body had high levels of tetrahydrozoline.

Eye allergy symptoms often improve in minutes after using these drops. The three types of drops may be used in combination. Some brands of drops contain a mix of lubricants, antihistamines, and decongestants. Those with glaucoma, macular degeneration, or other eye diseases should not use these drops before consulting with their eye doctor. When using these products, those with contact lenses should wash their hands and remove the lenses. To instill the product into the eye, look up, pull down your lower eyelid, gently squeeze the recommended amount of medication into your eye, and hold your finger over your tear duct (inside part of the lower eyelid next to the nose) for one minute. Avoid touching the tip of the container to your eye, eyelid, or any other surface. Do not use these medications at higher than recommended dosages or for longer than recommended. For more information go to the National Library of Medicine at: www.dailymed.nlm.nih.gov/dailymed/

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