Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 4 Issue 2

Comparative Efficacy of Olopatadine 0.2%, Bepotastine 1.5% and Alcaftadine 0.25% in Treatment of Allergic Conjunctivitis

Upasna Ajmani1, Anand Aggarwal2*, Karamjit Singh2, Prempal Kaur2, Monisha SP1 and Shivani1

1Junior Resident, Department of Ophthalmology, Govt. Medical College, Amritsar, India
2Professor, Department of Ophthalmology, Govt. Medical College, Amritsar, India

*Corresponding Author: Anand Aggarwal, Professor, Department of Ophthalmology, Govt. Medical College, Amritsar, India.

Received: December 19, 2020; Published: January 22, 2021



Objective: To compare the efficacy of 0.2% olopatadine, 1.5% bepotastine and 0.25% alcaftadine in treatment of allergic conjunctivitis.

Design: This was a prospective study conducted on 90 consecutive patients who presented to out-patient department with signs and symptoms of allergic conjunctivitis from December 2018 to July 2020 i.e. 20 months. Randomization was done by envelope method in which randomly generated treatment regimens were sealed within opaque envelopes and allocated to the patients after obtaining their informed consent.

Results: Out of 90 patients, 55 (61.11%) patients were males. Overall mean age was 16.67 ± 10.59 years. 74.44% patients resided in rural areas. 38(42.22%) patients had symptoms of allergic rhinitis such as running nose and sneezing. The mean time for beginning of itch relief after instilling eye drops at first visit was 6.35 ± 1.99 minutes with no significant difference between Group A, B and C (p = 0.58). Paired analysis of median itch scores showed significant improvement in median itch score (p< 0.05) at each follow-up visit when compared to the previous visit in all groups. On comparing the median symptom scores and sign scores, there was no statistically significant difference (p > 0.05) between the scores of group A, B and C at the time of presentation as well as at follow-up visit on day 1, day 3, 1 week, 1 month and 3 months. All the symptoms were completely resolved in group A, B and C by the end of 1 month. Papillary reaction persisted in 35(38.89%) of patients at the end of 3 months. The average cost of treatment for 1 month was 280.00 INR, 495.00 INR and 450 INR in Group A, Group B and Group C respectively which shows that olopatadine 0.2% was most cost-effective.

Conclusion: Olopatadine 0.2%, bepotastine 1.5% and alcaftadine 0.25% are comparable in treating symptoms and signs of mild to moderate allergic conjunctivitis. None of these drugs are effective as monotherapy in treating severe allergic conjunctivitis. Olopatadine 0.2% is most cost-effective and equally effective as bepotastine 1.5% and alcaftadine 0.25% in treating allergic conjunctivitis. Olopatadine 0.2% may be prescribed to patients as initial therapy considering the low socio-economic status of majority of patients in our country.

Keywords: Allergic; Conjunctivitis; Olopatadine; Bepotastine; Alcaftadine



  1. Leonardi A., et al. "Allergic conjunctivitis: a cross‐sectional study”. Clinical and Experimental Allergy6 (2015): 1118-1125.
  2. La Rosa Mario, et al. "Allergic conjunctivitis: a comprehensive review of the literature”. Italian Journal of Pediatrics1 (2013): 18.
  3. Leonardi Andrea., et al. "Immunopathogenesis of ocular allergy: a schematic approach to different clinical entities”. Current Opinion in Allergy and Clinical Immunology5 (2007): 429-435.
  4. Bielory Brett P., et al. "Management of seasonal allergic conjunctivitis: guide to therapy”. Acta Ophthalmologica5 (2012): 399-407.
  5. Geraldini Marcos., et al. "Conjunctivitis: 359 prevalence of allergic conjunctivitis in childhood”. The World Allergy Organization Journal2 (2012): S132.
  6. Kahol Payal., et al. "Prevalence, morbidity and treatment seeking behavior for allergic conjunctivitis in children in a North Indian community”. Clinical Epidemiology and Global Health2 (2019): 239-245.
  7. Rosario Nelson and Leonard Bielory. "Epidemiology of allergic conjunctivitis”. Current opinion in allergy and clinical immunology5 (2011): 471-476.
  8. Thong,Bernard Yu-Hor. "Allergic conjunctivitis in Asia”. Asia Pacific Allergy2 (2017): 57-64.
  9. Bielory Leonard. "Allergic conjunctivitis and the impact of allergic rhinitis”. Current allergy and asthma Reports2 (2010): 122-134.
  10. Ben-Eli Hadas and Abraham Solomon. "Topical antihistamines, mast cell stabilizers, and dual-action agents in ocular allergy: current trends”. Current Opinion in Allergy and Clinical Immunology5 (2018): 411-416.
  11. Abelson Mark B., et al. "Efficacy of olopatadine ophthalmic solution 0.2% in reducing signs and symptoms of allergic conjunctivitis”. Allergy and Asthma Proceedings 4 (2007):427-433.
  12. Carr Warner W., et al. "Efficacy of bepotastine besilate ophthalmic solution 1.5% for seasonal allergic conjunctivitis: A randomized, placebo-controlled, natural exposure, clinical trial”. Allergy and Asthma Proceedings3 (2013):247-254.
  13. Ciolino Joseph B., et al. "Effect of alcaftadine 0.25% on ocular itch associated with seasonal or perennial allergic conjunctivitis: a pooled analysis of two multicenter randomized clinical trials”. Clinical Ophthalmology (Auckland, NZ)9 (2015): 765.
  14. Ackerman Stacey., et al. "A multicenter evaluation of the efficacy and duration of action of alcaftadine 0.25% and olopatadine 0.2% in the conjunctival allergen challenge model”. Journal of Asthma and Allergy6 (2013): 43.
  15. McCabe Craig F and Shannon E McCabe. "Comparative efficacy of bepotastine besilate 1.5% ophthalmic solution versus olopatadine hydrochloride 0.2% ophthalmic solution evaluated by patient preference”. Clinical Ophthalmology (Auckland, NZ)6 (2012): 1731.
  16. Bergmann Mark T., et al. "Treatment of allergic conjunctivitis with bepotastine besilate ophthalmic solution 1.5%”. Clinical Ophthalmology (Auckland, NZ)8 (2014): 1495.
  17. Mah Francis S., et al. "Efficacy and comfort of olopatadine 0.2% versus epinastine 0.05% ophthalmic solution for treating itching and redness induced by conjunctival allergen challenge”. Current Medical Research and Opinion6 (2007): 1445-1452.
  18. McLaurin Eugene B., et al. "Alcaftadine 0.25% versus olopatadine 0.2% in prevention of ocular itching in allergic conjunctivitis”. Journal of Allergy and Clinical Immunology2 (2014): AB278.
  19. Dudeja Lakshey., et al. "Observer-masked trial comparing efficacy of topical olopatadine (0.1%), bepotastine (1.5%), and alcaftadine (0.25%) in mild to moderate allergic conjunctivitis”. Indian Journal of Ophthalmology9 (2019): 1400.
  20. Li Zhiwei., et al. "Comparative evaluation of topical pranoprofen and fluorometholone in cases with chronic allergic conjunctivitis”. Cornea5 (2013): 579-582.


Citation: Upasna Ajmani., et al. “Comparative Efficacy of Olopatadine 0.2%, Bepotastine 1.5% and Alcaftadine 0.25% in Treatment of Allergic Conjunctivitis".Acta Scientific Ophthalmology 4.2 (2021): 15-21.


Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

Indexed In

News and Events

Contact US