# Allergic conjunctivitis - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: AAO Preferred Practice Pattern: Conjunctivitis 2018 · Opatanol 1 mg/ml eye drops SmPC sections 4.2 and 4.4 (eMC product 6768) · eMC SmPC, Zaditen 0.25 mg/ml eye drops solution (Thea Pharmaceuticals), sections 4.1 and 4.2 · Allergic Conjunctivitis - disease-level clinical article (allergic-conjunctivitis-clinical.txt) · Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) - Verified date: 2026-08 ## Verified against - Opatanol 1 mg/ml eye drops SmPC sections 4.2 and 4.4 (eMC product 6768) - eMC SmPC, Zaditen 0.25 mg/ml eye drops solution (Thea Pharmaceuticals), sections 4.1 and 4.2 - Allergic Conjunctivitis - disease-level clinical article (allergic-conjunctivitis-clinical.txt) - Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) ## Treatment metadata - Olopatadine — eye - Ketotifen — eye - Referral & safety-netting (no drug therapy) - Loratadine — 10 mg — oral.solid ## Complete treatment card ```text ALLERGIC CONJUNCTIVITIS Sources: AAO Preferred Practice Pattern: Conjunctivitis 2018 · Opatanol 1 mg/ml eye drops SmPC sections 4.2 and 4.4 (eMC product 6768) · eMC SmPC, Zaditen 0.25 mg/ml eye drops solution (Thea Pharmaceuticals), sections 4.1 and 4.2 · Allergic Conjunctivitis - disease-level clinical article (allergic-conjunctivitis-clinical.txt) · Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) Review status: REVIEWED against 4 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (8) - Itching along with widespread redness of the white and inner-lid surface of the eye is the most typical complaint [itching · redness] - A clear, watery discharge affecting both eyes, with mild morning crusting, marks the simple form [crusting] - Pain or blurred vision is not typical of the simple form and should raise suspicion of another diagnosis [blurred vision] - Episodes often come with sneezing and a runny nose, the usual companions of allergic rhinitis [allergic rhinitis · runny nose · sneezing] - The vernal form flares worst in spring, with thick mucus, pain, light sensitivity, and blurred vision [blurred vision · photophobia] - A foreign-body sensation with frequent blinking is typical of the vernal form [foreign body] - The atopic form tends to be year-round, with pain, blurred vision, light sensitivity, and a foreign-body feeling [blurred vision · foreign body · photophobia] - Worsening itch and a switch from watery to thick mucus discharge signal progression to the papillary form, often tied to contact lens wear [itching] SIGNS - what you find (8) - Pronounced eyelid swelling and chemosis (conjunctival swelling) are common in the simple form [eyelid swelling] - Giant papillae on the upper tarsal conjunctiva are a universal exam finding in the vernal form - Flat-topped, cobblestone-like macropapillae under 1 mm appear early in the palpebral vernal form - White cellular deposits at the limbus, Horner-Trantas dots, are a hallmark of the limbal vernal form - Superior punctate corneal erosions with mucus are typical of vernal keratopathy [corneal changes] - Absent outer eyebrows (Hertoghe sign) and lower-lid skin creases (Dennie-Morgan folds) are seen in the atopic form - In the atopic form the lower lid conjunctiva is affected more than the upper, the reverse of the vernal pattern - Contact-lens papillary disease shows mobile, protein-coated lenses and hyperemia of the upper tarsal conjunctiva with papillae TESTS (4) - Fluorescein staining can rule out a corneal abrasion when that is a concern - Skin-prick or blood allergy testing can pin down the specific triggers when needed - Scraping the conjunctiva and finding eosinophils supports the diagnosis in the simple form, though skin testing is rarely required - Abundant eosinophils on conjunctival scraping are typical of the vernal form IF NOT THIS - what else fits (5) - Viral or bacterial conjunctivitis needs to be distinguished from the allergic type - Trachoma and chlamydial or neonatal conjunctivitis are infectious look-alikes - Nonallergic eosinophilic conjunctivitis and contact allergic blepharoconjunctivitis mimic the allergic picture - Severe blistering conditions such as mucous membrane pemphigoid or Stevens-Johnson syndrome belong on the differential - Superior limbic keratoconjunctivitis is another differential to consider Source StatPearls "Allergic Conjunctivitis" - disease-level clinical article Status traced to the source above 1. OLOPATADINE [1st line] Adult 1 drop into the affected eye(s) twice daily, 8 hours apart - as required Peds Age restriction: minimum 36 months Over 3 years: 1 drop into affected eye twice daily. (Children >3 years: 1 drop twice daily into affected eye(s)) Source Opatanol 1 mg/ml eye drops SmPC sections 4.2 and 4.4 (eMC product 6768) Why Combines direct antihistamine blockade with mast cell stabilization, calming the immediate itching and redness of allergic conjunctivitis while also reducing further histamine release on continued allergen exposure. Caution Soft contact lenses take up the preservative and discolour: out before the drop, back in no sooner than 15 minutes after. Transient burning or stinging may occur upon drop instillation. Licensed from 3 years at the adult dose, and may be continued up to four months where needed. Olopatadine has dual antihistamine and mast cell stabilizer action. Egypt PATADOLINE 0.1% EYE DROPS 5 ML GLOBAL ADVANC... 38.00 EGP 2. KETOTIFEN [1st line] Adult One drop of 0.25 mg/mL solution into the conjunctival sac of the affected eye(s) twice daily - Through the allergen season; the SmPC sets no maximum duration Peds 3 years and over: One drop twice daily, the same regimen as adults (Children aged 3 years and over: the same regimen as adults, one drop twice daily. Safety and efficacy below 3 years have not been established. No mg/kg dosing applies to eye drops.) Choice Alternatives. Availability decides: 6 Egyptian ketotifen products from 6 EGP against a single olopatadine product at 38. Source eMC SmPC, Zaditen 0.25 mg/ml eye drops solution (Thea Pharmaceuticals), sections 4.1 and 4.2 Why 22 live products, and Egyptian ketotifen is sold in both oral and eye-drop form. The SmPC indication is symptomatic treatment of seasonal allergic conjunctivitis, which is this condition exactly, and the row currently holds only olopatadine. Caution Remove soft contact lenses before instilling and wait at least 15 minutes before reinserting - the benzalkonium chloride is absorbed by the lens material and discolours it. Each drop contains 2.6 micrograms of benzalkonium chloride, which can irritate a dry or damaged cornea. Transient blurring and drowsiness after instillation - do not drive until vision has cleared. Leave at least 5 minutes between this and any other eye drop. Pain, photophobia or reduced vision is not allergic conjunctivitis - refer. There are also oral ketotifen products in Egypt with the same generic name; those are a different treatment at a different dose and are sedating. Egypt PROPHALLERGE 0.025% EYE DROPS 5 ML RAMEDA 6.50 EGP TOTISWIX 0.025% EYE DROPS 5 ML CHEMIPHARM 7.00 EGP REDNOTT 0.25MG/ML EYE DROPS 5 ML RAMEDA > PHAR... 12.00 EGP ZADITEN 0.025% EYE DROPS 5 ML EXCELVISION >... 28.80 EGP ORCHAZID 0.025% EYE DPS. 10 ML ORCHIDIA PHAR... 31.00 EGP ORCHAZID 0.025% EYE DROPS 30*0.4 ML SDU ORCHIDIA PHARMACEUTICAL INDUSTRI... 60.00 EGP 3. REFERRAL & SAFETY-NETTING (NO DRUG THERAPY) [1st line] Adult Source Allergic Conjunctivitis - disease-level clinical article (allergic-conjunctivitis- clinical.txt) Why Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen. Caution RED FLAG - Pain and decreased visual acuity are not typical of simple allergic conjunctivitis; their presence should raise suspicion of an alternative (more serious) diagnosis rather than being treated as ordinary allergic conjunctivitis. 4. LORATADINE [add-on - not a substitute] Adult 10 mg once daily - as-needed Peds Age restriction: minimum 24 months 2 to under 6 years: 5 mg once daily 6 years and over: 10 mg once daily (ENDF: 10 mg once daily from 6 years; 5 mg once daily from 2 to 6 years. By weight in children under 12: 5 mg once daily at 30 kg or less, 10 mg once daily above 30 kg.) Source Egyptian National Drug Formulary - Respiratory System 2026 (loratadine monograph) Why The disease article calls for an oral antihistamine in severe symptoms and prefers loratadine over diphenhydramine for its lower sedation. Caution Children under 2 years of age: safety and efficacy have not been established, no data are available. CrCl under 30 mL/minute: 10 mg every 48 hours Severe liver impairment: 10 mg every other day in adults and children over 30 kg, 5 mg every other day at 30 kg or less Egypt HISTALONG 10 MG 20 TAB. JEDCO INT. CO... 17.00 EGP (0.85/unit) UNILORATADINE 10 MG 20 TABS. UNIPHARMA CO.... 17.00 EGP (0.85/unit) SEDCLARIT 10MG 20 TAB. SEDICO 19.50 EGP (0.97/unit) LORATADINE 10MG 10 TAB. MISR 25.50 EGP (2.55/unit) ONY 10 MG 20 TABS. UNIPHARMA 51.00 EGP (2.55/unit) ALLERGETONE 10 MG 20 TABS. MARCYRL PHARM... 66.00 EGP (3.30/unit) CLARITINE 10MG 20 TAB. SEDICO > BAYE... 110.00 EGP (5.50/unit) ALLERGIRAZ 10MG 30 DISINTEGRATING TABS. JEDCO INT. CO. FOR PHARMACEUTICA... 31.50 EGP LORANO 5MG/5ML SYRUP 60ML MINA PHARM 5.00 EGP -> ? strength differs, ? different route - not oral solid UNILORATADINE 5MG/5ML SYRUP 100 ML UNIPHARMA CO. > UNIPHARMA 9.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)