Arming your patients against allergies: Popular OTC options for drops

Seasonal allergies are a common complaint in optometric practice, with patients frequently presenting with itching, redness, tearing, and eyelid swelling triggered by airborne allergens such as pollen, mold, or pet dander. For many patients with mild to moderate allergic conjunctivitis, OTC ophthalmic medications can provide effective relief. Several antihistamine and mast cell–stabilizing drops are currently available without a prescription, giving optometrists multiple options to recommend based on symptom severity, dosing preferences, and patient lifestyle.

One of the most widely used OTC options is olopatadine, a dual-action antihistamine and mast cell stabilizer available in multiple strengths. Products such as Pataday Once Daily Relief (0.2%) and Pataday Extra Strength (0.7%) are designed for once-daily dosing, while Pataday Twice Daily Relief (0.1%) offers a twice-daily regimen. Olopatadine works by blocking histamine receptors while also stabilizing mast cells to prevent the release of inflammatory mediators, helping to control itching and redness throughout the day.^1-3

Another long-standing OTC therapy is ketotifen fumarate 0.025%, available in products including Zaditor, Alaway, and several store-brand equivalents. Ketotifen also combines antihistamine activity with mast cell stabilization and is typically dosed twice daily. Because of its accessibility and clinical history, ketotifen remains a common first-line recommendation for patients experiencing seasonal itching.⁴

Alcaftadine 0.25% (Lastacaft) is another OTC antihistamine and mast cell stabilizer designed for once-daily dosing. The drop has demonstrated extended duration of action in clinical testing and is often considered for patients who prefer a simplified dosing schedule or require longer-lasting symptom control.⁵

For patients with milder symptoms or those seeking supportive relief, lubricating artificial tears may also help by diluting allergens and flushing them from the ocular surface.⁶ While not a primary allergy treatment, preservative-free artificial tears can be used in combination with antihistamine drops to improve overall comfort during peak allergy season.

When recommending OTC allergy drops, optometrists often consider factors such as symptom frequency, convenience of dosing, contact lens wear, and cost. Patients should also be advised to avoid rubbing their eyes, limit allergen exposure when possible, and consider complementary measures such as cold compresses or preservative-free tears.^6,7

With multiple OTC antihistamine and mast cell–stabilizing options now readily available, eye care professionals can help guide patients toward treatments that provide effective relief while supporting comfortable vision throughout allergy season.

References:

1. Pataday Once Daily Relief. Pataday. Accessed March 10, 2026. https://pataday.myalcon.com/products/pataday-once-daily-relief/

2. Extra Strength Pataday. Pataday. Accessed March 10, 2026. https://pataday.myalcon.com/products/pataday-once-daily-relief-extra-strength/

3. Pataday Twice Daily Relief. Pataday. Accessed March 10, 2026. https://pataday.myalcon.com/products/pataday-twice-daily-relief/

4. Ketotifen (ophthalmic route). Mayo Clinic. Updated February 1, 2026. Accessed March 10, 2026. https://www.mayoclinic.org/drugs-supplements/ketotifen-ophthalmic-route/description/drg-20064429

5. Alcaftadine (ophthalmic route). Mayo Clinic. Updated February 1, 2026. Accessed March 10, 2026. https://www.mayoclinic.org/drugs-supplements/alcaftadine-ophthalmic-route/description/drg-20074407

6. Pagan-Duran, B. Lubricating eye drops for dry eyes. American Academy of Ophthalmology. February 9, 2022. Accessed March 10, 2026. https://www.aao.org/eye-health/treatments/lubricating-eye-drops

7. Artificial Tears. Cleveland Clinic. Updated February 21, 2023. Accessed March 10, 2026. https://my.clevelandclinic.org/health/treatments/24804-artificial-tears