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    How to approach the management of seasonal allergies



    Topical antihistamines

    Both ophthalmologists said topical antihistamines are excellent first-line therapy, especially when used by a patient who is following the tips mentioned here for reducing exposure to allergens.

    “Most patients will get good relief from topical antihistamines,” Dr. Raizman explained. “There are some that are quite effective that are available over the counter. Some of the prescription options can be more convenient because they are once-a-day dosing and they may be more effective, although there aren’t many good head-to-head trials comparing them to one another.”

    Dr. Raizman is okay with patients exceeding the recommended dose for short time periods when their symptoms are at their worst. “If a patient is having a really bad allergy day, I am fine with letting them use them at will,” he added.

    Dr. Donnenfeld noted that some of the newer allergy medicines can last 18 to 24 hours, helping patients avoid the peaks and troughs that can come with more frequent dosing regimens.

    Both doctors suggest patients, who need a little more relief than what their antihistamine drops are providing, should put the bottle in the refrigerator–using them cold can enhance their effect. Rinsing out the eyes with water first can help too, as patients can apply cold compresses as needed, Dr. Donnenfeld added.

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