After comparing dexamethasone intracanalicular optic nerve insert (DEX) versus topical loteprednol (LOT) or olopatadine (OLO) in a recent real-world study of allergen exposure, DEX exhibited strong effectiveness in relieving symptoms and more preference by the patients with allergic eye diseases due to its ease of self-administration.

This study released in the Clinical Ophthalmology journal by Shani Reich et al. included 30 adults with testing-confirmed bilateral allergic conjunctivitis. All received DEX in the more symptomatic eye (30 adults) and either LOT 2 twice every day (15 adults) or OLO once every day (15 adults) for 30 days in the other eye. The patient's preference was the main outcome. Itching in the eyes and hyperemia, swelling of the eyelid, and watering/tearing were all clinical outcomes. Intraocular pressure (IOP) was considered as the safety outcome.

Ten out of 15 adults (66.7%) patients favoured DEX over LOT (4 out of 15 adults; 26.7%), with 1 patient with no preference. Patients had no preference between DEX and OLO, with 1 patient with no preference. Itching and hyperemia improved more with DEX compared to LOT, whereas DEX eyes showed greater improvement in conjunctival hyperemia but not itching.

There were no between-group changes in eyelid swelling or tearing/watering in either of the groups. The mean change in safety outcome was similar between the DEX and LOT eyes, with higher mean IOP in the eyes treated with DEX compared to the OLO.