Experts Recommend the Best Eye Drops for Dry Eyes

Not all eye drops are created equal—here's what to look for to find the most relief.

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Anyone who's ever dealt with dry eye—a common condition in which your eyes don't produce enough tears or enough quality tears—knows the issue is more than just a minor annoyance. The scratchy or gritty sensation, the light sensitivity, and the blurred vision all make for an unpleasant experience.

Fortunately, there are options that can help alleviate discomfort from dry eyes, per MedlinePlus, such as eyewear or the use of tiny plugs in tear drainage ducts to keep the eyes moisturized. One treatment that many people with dry eyes tend to find relief from is eye drops; however, choosing the right eye drops is often not an easy decision.

To help you navigate the dozens of solutions available, we've talked with three optometrists who shared their tips on how to choose the best kind of eye drops for your dry eyes—including what you need to know about prescription, over-the-counter (OTC), preservative, and preservative-free eye drops.

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Considerations When Using Eye Drops for Dry Eyes

Eye drops are one of the most popular and effective OTC medications used today, William T. Reynolds, OD, trustee for and former president of the American Optometric Association, told Health. For many people, they can be a good option for managing dry eye. In fact, they're usually the first line of defense for combatting dry eye symptoms, according to MedlinePlus.

That said, improperly using or overusing drops can sometimes worsen eye conditions, Dr. Reynolds said. It's also worth noting that the type of eye drop that's right for you will depend on the severity and cause of your dry eye. Severe dry eye, for example, might need prescription eye drops, while more mild or moderate cases may benefit from OTC drops.

If you have dry eye, that's why it's important to discuss your options with an eye doctor for a more personalized recommendation and follow the safety instructions as directed by the eye drop packaging or an eye doctor.

Additionally, while the type of eye drop you'll need is based on your own specific needs, there is one type of eye drop that experts recommend everyone with dry eyes steer clear of—eye drops that promise to clear up red eyes.

These drops (like Visine or Clear Eyes) constrict the blood vessels in your eyes so that they appear white, Tom Cruse, OD, an optometrist with Insight Vision Group in Denver and site residency director for the Illinois College of Optometry, told Health. But they're not very effective at treating dry eyes, and if the blood vessels are constricted for too long (which can happen when these products are used regularly) you can get "rebound redness," Dr. Cruse added.

OTC Eye Drops

If you have mild to moderate dry eyes, your healthcare provider will likely recommend OTC drops to start. This is the easiest and most economical choice, Arti Shah, OD, a fellow of the American Academy of Optometry and optometrist at Elander Eye Care in Santa Monica, told Health. But there's a catch: With more than 35 different brands of OTC eye drops, "they're not all created equal," Dr. Shah warned.

For many patients, Dr. Shah has typically recommended lipid-based moisturizing drops as a first option. These drops can strengthen the outer lipid or oily layer of your tear film (which helps prevent evaporation of the eye's protective tear film) and help support the watery or aqueous layer. But this is also where a more personalized recommendation comes in handy. If your dry eye is caused by a problem with the sticky or mucous layer of the tear film (the layer that essentially helps tears stick to the eye), then you may find more relief from a different type of eye drop.

People with more severe dry eyes may need to use a lubricating ointment or gel, which you can also buy OTC. These options, which are thicker than regular drops and stay in your eyes longer, may blur your vision temporarily, so most people use them just before bedtime, Dr. Reynolds said.

While Dr. Shah recommended that everyone talk directly with their eye doctors to find the eye drops that will work best for their specific type of dry eye, some of her favorite options for both eye drops and lubricating ointments or gels included:

Prescription Eye Drops

Some people with moderate-to-severe dry eye may do better with a prescription eye drop that is ordered by their doctor. As of September 2022, there are three major prescription eye drops on the market for dry eyes: Restasis, Cequa, Xiidra, Eysuvis, and Tyrvaya.

The drawback to prescription medications is that you have to keep using them; otherwise, your dry eye will come back. Also, they can take time—weeks or even months—before you notice a difference. For faster relief, doctors sometimes prescribe steroid eye drops, Dr. Shah added. These can quickly relieve irritated, inflamed eyes, but they are not a medication you would use long-term.

For moderate to severe cases of dry eye, doctors may prescribe biologic eye drops, which help reduce inflammation. For severe dry eyes, they sometimes recommend autologous serum eye drops, which are created using your blood. "You're basically using your own body to heal your own body," Dr. Shah explained.

Eye Drops With Preservatives

Preservatives are included in eye drops to maintain the sterility of the drops, per a Clinical Ophthalmology article published in August 2019. "Eye drops with preservatives have chemicals that are designed to keep bacteria from growing in the bottles once they are opened," Dr. Reynolds explained. Preventing bacteria growth is, of course, a good thing. But on the flip side, these preservatives can actually cause dryness and exacerbate irritation in some people. Many eye doctors recommend using eye drops with preservatives no more than four times a day, Dr. Reynolds said.

Preservative-Free Eye Drops

Preservative-free eye drops, on the other hand, have fewer additives and are usually recommended for people with moderate to severe dry eye, Dr. Reynolds said. They are often best for people who use artificial tears more than four times a day, Dr. Reynolds added.

"In general, if it comes in a bottle, it's preserved," Dr. Shah said, estimating that about 90 percent of bottled eye drops have preservatives. Most preservative-free eye drops come in single-use, tear-off capsules, but there are a few manufacturers who offer preservative-free drops in the convenience of a bottle, including Clear Eyes for Dry Eyes.

Overall, the best eye drops for dry eyes really depend on the severity of your dry eye and what's causing them—that's why it's always a good idea to chat with your eye doctor. With their help, you can find the best treatment option for your dry eyes.

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