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Conjunctivitis - allergic - Management
What are the adverse effects of topical ocular antihistamines?
- In the unlikely event that topical ocular antihistamines cause transient changes in vision, advise the person to wait until these changes resolve before driving or performing other skilled tasks such as operating machinery.
- Azelastine — occasionally mild transient irritation is experienced [ABPI Medicines Compendium, 2006].
- Emedastine — the most common ocular adverse reaction is discomfort in the form of transient burning or stinging upon instillation [ABPI Medicines Compendium, 2002a].
- Ketotifen — eye irritation, burning or stinging, and punctate corneal epithelial erosion are the most commonly reported adverse effects [ABPI Medicines Compendium, 2007a].
- Antazoline/xylometazoline (Otrivine-Antistin®) combination — should only be used short term, as overuse of vasoconstrictors may lead to rebound hyperaemia, irritation, and systemic adverse effects [Bielory et al, 2005]. Otrivine-Antistin® should be used with caution in people susceptible to close-angle glaucoma, as prolonged use can increase intraocular pressure and precipitate glaucoma [BNF 53, 2007].
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