The prevalence of allergic diseases is increasing worldwide. Studies suggest that the prevalence of allergic conjunctivitis may range from 15% up to 40%.

Allergic conjunctivitis can present in a number of different presentations, the most common being seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). Symptoms can range from mild to severe. However, even mild cases can significantly affect your quality of life. 3,4

What are the symptoms?

SAC and PAC share the same signs and symptoms. These include conjunctival itchiness, redness and swelling. However, PAC can happen throughout the year due to continued exposure to perennial allergens. SAC is usually an allergic reaction to airborne pollens. As a result, SAC could be the cause of your signs and symptoms around this time of year (spring/summer). 5

What are the treatment options?

Avoidance of the allergen (usually pollen), cold compresses and artificial tears are the first management options of SAC. Cold compresses can help with redness and swelling. Preservative-free artificial tears can provide symptomatic relief by diluting the allergens, histamines and other allergic mediators in the eye. Artificial tears can also be refrigerated for further relief. 6

However, often further treatment is needed. SAC often responds well to a combination antihistamine-mast cell stabilizer. These combination drops provide rapid symptomatic relief by antagonising histamines and provide longer-term allergy control via mast cell stabilization. 7 These drops include ketotifen and olopatadine (Zaditen® and Patanol®). It is best to speak to an optometrist for their recommendation of the best drop for you.

Topical corticosteroid therapy can also be highly effective in the treatment of SAC. However, due to the higher risk of side effects, are usually reserved for refractory or more severe cases, 6 and will need to be prescribed by your therapeutically endorsed optometrist.

What about oral antihistamines?

If other symptoms, like rhinitis are present, or there is an intolerance to topical treatment or an inability to insert eye drops is a problem, oral antihistamines may also be used to treat SAC. However, if only ocular symptoms are present, or ocular itching remains despite the use of oral antihistamines, topical equivalents may provide faster, more direct relief.

How can theOptometrist help me?

If you are suffering from the symptoms of SAC, book an appointment to see us at theOptometrist. Our optometrists are therapeutically endorsed so that we can tailor a treatment plan for you.

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. theOPTOMETRIST has used all reasonable care in compiling the information but make no warranty as to its accuracy. Please consult our optometrists, or other health care professional for diagnosis and treatment of medical conditions.


  1. Pawankar, R 2014, ‘Allergic diseases and asthma: a global health conern and a call to action’, World Allergy Organization Journal, vol. 7, no.12 (
  2. Rosario, N & Bielory, L 2011, ‘Epidemiology of allergic conjunctivitis’, Currently Opinion in Allergy and Clinical Immunology, vol. 11, no. 5, pp. 471-6 (
  3. Leonardi, A 2005, ‘Emerging drugs for ocular allergy,’ Expert Opinion on Emerging Drugs, vol. 10, no.3, pp. 505-20
  4. Manzouri, B, Flynn, T, Larkin, F, Ono, S & Wyse, R 2006, ‘Phamacotherapy of allergic eye disease,’ Expert Opinion in Pharmacotherapy, vol. 7, no. 9, pp. 1191-200
  5. Friedlander, M 2011 ‘Ocular allergy’, Current Opinion in Allergy and Clinical Immunology‘, vol. 11, no. 5, pp. 477-82 (ref 6 from
  6. Bielory, L 2002, ‘Update on ocular allergy treatment’, Expert Opinion on Pharmacotherapy, vol. 3, no. 5, pp. 541-53
  7. Ono, S & Abelson, M 2005, ‘Allergic conjunctivitis: update on pathophysiology and prospects for future treatment’, Journal of Allergy and Clinical Immunology, vol. 115, pp. 118-22