Comparative Efficacy and Safety of Topical Bepotastine Besilate 1.5% Versus Sodium Cromoglycate 4% in Chronic Allergic Conjunctivitis: A Prospective Study

Purpose: To compare the efficacy, safety, and patient satisfaction of bepotastine besilate 1.5% versus sodium cromoglycate 4% eye drops in the management of chronic allergic conjunctivitis. Methods: In this prospective, double-masked comparative study, 100 adult patients with chronic allergic conjunctivitis were assigned to receive either bepotastine twice daily ( n = 50) or cromolyn 4 times daily ( n = 50) for 6 months. The primary outcome was the change in ocular itching severity on a standardized 0–3 scale. Secondary outcomes included changes in redness, tearing, swelling, discomfort, treatment compliance, adverse events, and patient satisfaction. Assessments were conducted at baseline, 2 weeks, 6 weeks, 3 months, and 6 months. Results: Both treatments significantly improved symptoms from baseline after 6 months. Bepotastine showed superior reduction in ocular itching severity (74.4% improvement) compared to cromolyn (63.8%, P < 0.01). Cromolyn was more effective in reducing conjunctival redness (70.0% vs. 59.3%). Bepotastine also showed numerical advantages in tearing, swelling, and discomfort relief. Adverse events were mild and comparable, with slightly more burning sensation reported in the cromolyn group. Compliance and patient satisfaction were higher in the bepotastine group, attributed to its convenient twice-daily dosing. Conclusions: Both bepotastine besilate and sodium cromoglycate are effective and safe for chronic allergic conjunctivitis. Bepotastine offers faster relief of itching and greater convenience, whereas cromolyn provides better control of conjunctival redness. Treatment choice should be individualized based on symptom profile and patient preferences.