Optimization the treatment of seasonal allergic conjunctivitis: the clinical efficacy of olopatadine and ways to reduce preservative-induced toxicity
DOI: 10.32364/2311-7729-2026-26-3-5
Optimization the treatment of seasonal allergic conjunctivitis: the clinical efficacy of olopatadine and ways to reduce preservative-induced toxicity
E.A. Drozdova, A.M. Bogomolova, E.V. Yadykina
South Ural State Medical University, Chelyabinsk, Russian Federation
Aim of the review: based on current scientific publications, to review the key aspects of the efficacy and safety of olopatadine, a dual-action anti-allergic agent, in the treatment of seasonal allergic conjunctivitis (SAC), with particular emphasis on preservative-induced ocular surface toxicity. SAC affects up to 30–40% of the population during the pollen season, substantially reducing quality of life. The pathogenesis of SAC is based on an IgE-mediated reaction with mast cell degranulation. Clinically, SAC is characterized by intense ocular itching, burning or foreign body sensation, tearing, conjunctival hyperemia, edema, and papillary hypertrophy of the conjunctiva. Owing to its dual mechanism of action — selective H1-receptor blocade and mast cell membrane stabilization — olopatadine rapidly relieves itching, hyperemia, and conjunctival edema. It has demonstrated superior efficacy compared with ketotifen and systemic antihistamines while maintaining an excellent safety profile. However, multidose formulations of olopatadine eye drops contain benzalkonium chloride, a preservative with cytotoxic, oxidative, and pro-apoptotic effects on the corneal epithelium and conjunctival goblet cells, potentially exacerbating dry eye disease and keratopathy. Polyquaternium-1 (PQ-1; polydronium chloride) represents a less cytotoxic alternative preservative. Olopatadine 0.1% preserved with PQ-1 may therefore be considered the preferred option for prolonged seasonal treatment of SAC because of its lower risk of ocular surface damage.
Keywords: seasonal allergic conjunctivitis, olopatadine, benzalkonium chloride, polyquaternium-1, toxic ocular surface damage, eye drop preservatives.
For citation: Drozdova E.A., Bogomolova A.M., Yadykina E.V. Optimization the treatment of seasonal allergic conjunctivitis: the clinical efficacy of olopatadine and ways to reduce preservative-induced toxicity. Russian Journal of Clinical Ophthalmology. 2026;26(3):250–254 (in Russ.). DOI: 10.32364/2311-7729-2026-26-3-5
About the authors:
Elena A. Drozdova — Dr. Sc. (Med.), Professor, Head of the Department of Ophthalmology, South Ural State Medical University; 64, Vorovskogo str., Chelyabinsk, 454092, Russian Federation; ORCID iD 0000-0002-1799-211X
Anna M. Bogomolova — Assistant of the Department of Ophthalmology, South Ural State Medical University; 64, Vorovskogo str., Chelyabinsk, 454092, Russian Federation; ORCID iD 0009-0007-9630-8227
Elena V. Yadykina — C. Sc. (Med.), Assistant of the Department of Ophthalmology, South Ural State Medical University; 64, Vorovskogo str., Chelyabinsk, 454092, Russian Federation; ORCID iD ORCID iD 0000-0001-7362-367X
Contact information: Elena A. Drozdova, e-mail: dhelena2006@yandex.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 30.06.2026.
Revised 17.07.2026.
Accepted 28.07.2026.
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