Nonsteroidal anti-inflammatory drugs (NSAIDs) are eye drops used to treat eye allergies, which include perennial or seasonal allergic conjunctivitis, giant papillary conjunctivitis, atopic keratoconjunctivitis, vernal keratoconjunctivitis, and contact allergic conjunctivitis. Of these, allergic conjunctivitis is the most popular, with an estimated 50 million Americans affected. Generally, eye allergy symptoms include red eyes, itching, tearing, and burning eyes, often accompanied by nasal symptoms like sneezing and runny nose. Outdoor allergens can trigger eye allergies, and they include pollen from weeds, trees, and grass. Mold, pet dander, and dust mites constitute indoor allergens. Irritants have also been known to cause allergies and include perfume, diesel exhaust, and cigarette smoke.
Allergic conjunctivitis or pink eye is an eye disease that affects the conjunctiva, a thin layer of tissue covering the inside of the eye and a section of the eye's front part. Although rare, allergic conjunctivitis can lead to blurry vision. Vernal keratoconjunctivitis mainly affects the male gender and is more serious. It may be seasonal or occur all year round, although a patient's symptoms worsen during certain seasons. Besides having the eye allergy symptoms of itching, feeling of something in the eye, sensitivity to light, excessive tearing, and thick mucus production, these patients often have asthma or eczema. Atopic conjunctivitis mostly affects older men with a history of allergy and presents similar vernal keratoconjunctivitis symptoms. Contact allergic conjunctivitis results from contact lens wear, while giant papillary conjunctivitis refers to a severe type of contact allergic conjunctivitis.
NSAID eye drops affect certain nerve endings to relieve itchiness. An example includes Ketorolac, which causes the itchiness to go away only an hour after use. When first placed in the eyes, Ketorolac will cause burning or stinging. Steroids can be used but may be contraindicated, hence the choice of NSAIDs. Topical NSAIDs are a useful short-term treatment option to relieve a patient of pain associated with inflammation. NSAIDs help to inhibit an enzyme (cyclooxygenase) responsible for converting arachidonic acid into lipid inflammation mediators. Although they relieve itching, they do not block histamine from being produced. NSAIDs can effectively treat allergic conjunctivitis, the other types mostly treated by corticosteroids and antihistamines/mast cell stabilizers. However, moderate or severe atopic keratoconjunctivitis cases can be treated with NSAIDs if the patient cannot tolerate corticosteroids. Nevertheless, because of NSAIDs' limitations indirectly decreasing the release of histamines from the mast cells, they are not as effective as corticosteroids. When used together with a mast cell stabilizer/antihistamine combination, NSAIDS can be an effective therapy.
Administration & Dosage
NSAIDs’ administration depends on the condition being treated but is usually administered four times daily. However, the dosage and frequency of administration depend on how severe the inflammation is. Sometimes the NSAIDs are administered together with cold compresses (for one week) to grant the patient more comfort.
Potential Side Effects & Interactions
The potential side effects may include itching, stinging, or burning eyes soon after instilling the drops. The more severe symptoms include bloody eyes, facial or eye swelling, foreign body sensation, eye crusting or discharge, teary eyes, blurry vision, eye pain, and sensitivity to light. Should these occur, the patient should immediately contact a doctor.
Some NSAID eye drops can interact with other drugs leading to less effective treatment and increasing side effects. The patient should inform the doctor if s/he is taking herbal products or other medications like different NSAID types, prescription medications, and non-prescription drugs. Some patients may be allergic to other NSAIDs such as nepafenac, ibuprofen, naproxen, and tolmetin. Other medications that should be declared include aspirin and blood thinners such as warfarin and corticosteroid eye drops like prednisolone. Some conditions may affect treatment and they include diabetes, dry eye syndrome, rheumatoid arthritis, and other eye diseases. Diclofenac eye drops are not recommended for pregnant women or breastfeeding mothers. A patient may also need to stop using soft contact lenses while on treatment.
Symptoms of Overdose
If taken in excess, this medication can cause severe symptoms such as breathing problems and passing out. In the case of overdose, the patient should immediately call 911 or the poison control center at 1-800-1222.
The drug should be kept away from children and pets. It should be kept tightly closed in its original container. The eye drops should also be stored at room temperature and in conditions with no excess heat and moisture.