Evaluation of 0.1% Olopatadine Hydrochloride versus 0.5% Ketorolac Tromethamine Solution in the Management of Allergic Conjunctivitis

ABSTRACT

Introduction: The term “allergic conjunctivitis” refers to a group of hypersensitivity disorders of eye. This is a commonocular condition which presents with itching, redness, tearing, swelling, burning, fullness in the eye, leading to rubbing ofthe eye, and blurred vision. Histamine, prostaglandins, and mast cell degranulation are important mediators responsiblefor the signs and symptoms of seasonal and perennial allergic conjunctivitis. Olopatadine is a novel drug with dual actionof mast cell stabilizer with blocking of histamine H1 receptors. Ketorolac tromethamine 0.5% ophthalmic solution is a verypotent nonsteroidal anti-inflammatory drug (NSAID) that inhibits the enzyme cyclooxygenase and decreases the synthesisof prostaglandins.Objectives: The objectives of the study were to compare the clinical efficacy and therapeutic effects of 0.1% olopatadinehydrochloride to that of 0.5% ketorolac tromethamine ophthalmic solution with different pharmacological mechanisms in themanagement of seasonal allergic conjunctivitis.Materials and Methods: This was a comparative study that was conducted on patients with allergic conjunctivitis attendingophthalmology outpatient department in a tertiary health-care center during the study period of 1 year. A total of 100 patientswere chosen by purposive sampling method and randomized into two groups. Group A patients were treated with olopatadineand Group B patients were treated with ketorolac and the drugs were instilled twice daily. Patients were evaluated for clinicalsigns and symptoms at baseline and at 30 min, 2 days, 7 days, and 14 days of application of eye drops.Results: The mean age in our study was 27.81 years and had male predominance. There was a significant reduction in thefrequency of all ocular signs and symptoms of hyperemia and itching following initiation of medication. The percentage of nonresponders was comparable between both the groups. Three patients showed increase in hyperemia signs at 30 min postapplication of ketorolac. Adverse reaction was observed in three patients in the ketorolac group.Conclusion: The topical dual-action drug-olopatadine and NSAID-ketorolac both have an attenuating and equivocal effect onthe clinical signs and symptoms of allergic conjunctivitis.