Table 2.

Topical ocular allergy medications for the treatment of vernal keratoconjunctivitis

Class	Drug	Indication	Comments
Vasoconstrictor/antihistamine combinations	Naphazoline/pheniramine	Rapid onset of action Episodic itching and redness	Short duration of action Tachyphylaxis Mydriasis Ocular irritation Hypersensitivity Hypertension Potential for inappropriate patient use
Antihistamines	Levocabastine Emedastine	Relief of itching Relief of signs and symptoms	Short duration of action Frequently does not provide complete disease control when used alone
Mast cell stabilizers	Sodium cromoglicate Nedocromil Lodoxamide NAAGA Pemirolast	Relief of signs and symptoms	Long-term usage Slow onset of action Prophylactic dosing Frequently does not provide complete disease control when used alone
Antihistamine/mast cell stabilizers (dual-acting)	Alcaftadine Azelastine Bepotastine Epinastine Ketotifen Olopatadine	Relief of itching Relief of signs and symptoms	Bitter taste (azelastine) No reported serious side effects Frequently does not provide complete disease control when used alone
Corticosteroids	Loteprednol Fluormetholone Desonide Rimexolone Dexamethasone Betamethasone	Treatment of allergic inflammation Use in moderate to severe forms	Risk for long-term side effects No mast cell stabilization Potential for inappropriate patient use Requires close monitoring