Are Allergy Eye Drops Safe for Kids?

Have your kids been rubbing their eyes and whining “I’m itchyyyyy” all season? Well my friend, you’ve come to the right place. It’s allergy season, and tiny eyes (and noses!) everywhere are affected. First, a quick background lesson for any allergy newbies. (Feel free to jump ahead if you’re well-versed in the seasonal allergy rundown.)  In a nutshell, allergies are the body’s abnormal response to a normal thing.

With seasonal allergies, a normal substance in the environment that comes around yearly in the same season, such as tree pollen in the late spring, is recognized by the body as an invader that must be destroyed.

The immune system overreacts to the allergen and releases a ton of histamine and other invader fighting molecules. The end result for kiddos is sneezing, runny nose, itchiness, eye discomfort… all around misery! 

Where I live, April through June is always tough with tons of pollen raining down! My kids actually really enjoy “finger painting” in the pollen dust that accumulates on our cars. Ragweed hits us in the fall. Sigh. Allergic conjunctivitis is the official scientific term for inflammation of the conjunctiva (the lining covering the eyes) that occurs in response to an allergic reaction.

Allergic Conjunctivitis or Red Itchy Eyes

This year, allergic conjunctivitis - red itchy eyes - was actually my first clue that my kids were dealing with seasonal allergy onset vs. the 27th cold of the season. My older two kids were able to tell me that their eyes were itchy, but for my toddler, the itchiness presented as eye rubbing. He also rubbed his eyes in his sleep, leading to sad little scratches and dark circles the following morning! 

I’ve been down the allergy road before, so I got my kiddos started on a treatment plan and spruced up my home environment and routine with some good allergen avoidance habits.

We added in allergy eye drops for a few weeks, and 1000 tissues later we seem to be in a better spot. If this is the first season you’re dealing with allergies or if you’re unsure, give the pediatrician a call.

Typically, seasonal allergies are diagnosed by a doctor when a patient has long lasting cold symptoms that are seemingly caused by exposure to something.

Eye drops for Allergies

If first-line treatments are optimized but tiny eyes are still bothered, parents may consider the addition of an allergy eye drop.

It’s worth noting here that allergy eye drops usually aren’t used as the only drug to alleviate seasonal allergies & red and itchy eyes, but that they are often added to a daily dose of oral antihistamine or nasal steroid when the other medications aren't enough.

However, there could be some exceptions to this… i.e. if allergic conjunctivitis is the main symptom and you’ve confirmed with your pediatrician that it’s definitely allergy related and not something else, then the doc may perhaps recommend using only eye drops. Less drug therapy in children is generally better than more!  

Are Allergy Eye Drops Safe for Children?

Allergy eye drops are safe for children, and there are some appropriate options for toddlers as well! But first, a safety note. Allergic conjunctivitis can be easily confused with viral or bacterial conjunctivitis.

The addition of an allergy eye drop may be inappropriate if the red itchy eyes are actually caused by a bacteria or virus. Bacterial conjunctivitis in particular needs an antibiotic eye drop. One clue that you may be dealing with bacterial conjunctivitis? “The goop.”

For those parents not lucky enough to have experienced “the goop” - it’s basically what it sounds like. Eyes will be itchy and red, but also produce copious amounts of mucous and may even be caked shut after sleep. Bacterial conjunctivitis is also very contagious and tends to spread through a family like wildfire. So that’s fun. 

Choosing an Allergy Eye Drop for Children:

There are several allergy eye drop options available on the market to consider. Most are available over-the-counter. When shopping, keep in mind that the same common ingredients may be found under different branded names.

Usually the drops will say “allergy” on the box to help clue you in, but take a look at the active ingredients and use section on the back of the box to be sure that the drops are actually for allergic conjunctivitis! Here are some common options: 

The products listed in the table above should be available at most drug stores or major retailers. They all share the same common side effects: temporary blurry vision, eye discomfort, etc. Headache or cold symptoms can also occur.

In general, these types of drops will cause blurriness for a couple of moments, then are typically well tolerated by most patients. If there are any concerning side effects such as severe eye discomfort or vision changes that aren’t temporary, stop use and get seen by a doctor. Speaking of doctors, there are some newer options available only by prescription that are not included in this review. For example, cetirizine ophthalmic drops were recently approved by the FDA.

Wondering What Eye Drop to Choose?

Here at KidsMedGuide, we don’t think there’s a clear winner. Side effects and effectiveness are pretty similar amongst all of the products. Factors such as cost and availability are probably most important to consider when selecting a product.

Personally, I would probably not choose naphazoline-pheniramine, as it’s an older product with more safety warnings, and there are other options available.

For my own kids, I would lean towards olopatadine 0.2% (Pataday), mostly because it’s a once a day option and can be used in toddlers. Getting eye drops into 6 tiny eyeballs is no easy task, so anything once a day sounds great to me!

Olopatadine eye drops have also been around for awhile, first as a prescription then over the counter, so the safety of the product is pretty well established at this point. If you try one product for several days and you find it’s just not working all that well, switch it up and try a different brand. Some kids may respond better to one drug vs. another. 

Best Health Tips for Allergy Eye Drops

Some other important things to know about eye drops for kids?

• Keep the bottle tip clean.
• Wash your hands before administering a drop, and replace the cap right away.
• Try not to let the tip of the bottle touch the eyeball or any other surface.
• Store them in a cool dark place AWAY from curious toddlers - these aren’t equipped with child safety proof caps and while unlikely to cause harm, you definitely don’t want your kid to drink them!
• Some products may require a gentle shake, others don’t. Double-check the label.
• Also, if your child is taking other eye drops, typically you want to separate administration of different drops by at least 5-10 minutes.
• Lastly, for any older kids who wear contact lenses, you’ll also want to confirm that the drops are safe for lens wear. The usual recommendation is to wait 10-15 minutes or so after drop administration and before putting contacts in, and never to put in contacts if the eyes are still red. 

More Tips on Eye Drops for Kids

So that’s all well and good but.. how the heck do you get eye drops into the eyeballs of a squirmy toddler or unwilling preschooler? Great question. If you find the answer, please let me know. So far bribery and threats haven’t worked for me, and there’s typically a lot of yelling. For a step by step guide on my American Academy of Pediatrics approved not-so-great approach to eye drop administration, check out this post: How to Administer Eye Drops to Kids (and babies).

Keep going with your allergy meds, including eye drops, until the allergy season is over! It’s easier (and advised) to treat throughout the season and keep the allergic response at bay, than to give up on the meds too soon and have symptoms come surging back. Spring allergies often run through June, and fall allergies can start as early as August, but you can check your area’s weather and air quality reports as a guide. Best of luck parents!

The following references were used to compile this information: 

American Association for Pediatric Ophthalmology and Strabismus. (2023, March). Allergic Conjunctivitis. https://aapos.org/glossary/allergic-conjunctivitis 

DailyMed. (2023, December 15). Zaditor - ketotifen fumarate solution.  https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ac66b1e4-c2b0-a4c3-09e3-ebd44a2f7c9f Pataday (olopatadine) Eye Drops

DailyMed. (2023, June 26). Olopatadine hydrochloride ophthalmic solution. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d7bcba63-bfaf-240b-199e-2e42a91c19c9

DailyMed. (2024, March 5). Alcaftadine solution/drops. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b94e071d-421d-48ec-a4ea-254aa8af19ff Lastacaft (alcaftadine) age 2+

DailyMed. (2024, March 27). Naphcon A - Naphazoline hydrochloride and pheniramine maleate solution / drops. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4d8412ff-0e59-4a6a-9f3e-4e6f6204bf58 Zaditor (ketotifen) Eye Drops

Nemours KidsHealth. (2022, January). Kids and Allergies. https://kidshealth.org/en/parents/allergy.html

This article has been reviewed by Andrea Morrissey, PharmD, Board Certified Pediatric Pharmacy Specialist, and Chief Content Officer of Kids Med Guide. The content is for educational and entertainment purposes only and does not replace professional medical advice. Always consult your healthcare provider for medical guidance, and call 911 in an emergency.

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