As optometrists, we often encounter several frequently asked questions regarding eye irritation:
Before we start, definitely try to avoid using any “red eye relief” or “redness relief” eye drops, such as Visine and Clear Eyes, as they do not effectively address the issue at hand.
Allow us to introduce eye lubricants! They serve as the primary approach to managing dry eyes, aiming to lubricate the eyes, replenish moisture, and supplement your natural tears.
Selecting a preservative-free lubricant for the eyes can diminish the potential adverse effects on the eyes and has demonstrated improvement in the signs and symptoms of the patient’s dry eye disease.
However, in cases where a preservative-containing eye drop is necessary, alternative preservatives such as polyquad, polyhexamethylene biguanide (PHMB), and oxidized complexes have been found to cause less disruption to the ocular surface.
Some eye lubricants contain phosphate and can be harmful for the eye only in certain cases.
Phosphate is a mineral that is naturally found in the body. However, when it is used in eye drops, it can bind to calcium in the tears and form calcium phosphate crystals. These crystals can deposit on the cornea, the clear front part of the eye. This can lead to corneal calcification, which can cause blurred vision, pain, and sensitivity to light.
The risk of corneal calcification is highest in people who have corneal epithelial defects or pronounced corneal damage, such as corneal erosions or ulcers. These defects allow calcium to leach into the cornea, which makes it more likely that phosphate will bind to it and form crystals
These are commonly recommended as the initial choice for treating dry eyes due to their easy application and minimal residual blur. It is suggested to use them up to six times a day. However, if the frequency exceeds four times a day, it might be advisable to switch to a more viscous option, such as a gel or ointment.
💡 Administer 1 drop in each eye up to 4 times daily.
| Pros | Cons |
| Less stickiness feeling | Only keeps the eye lubricated for a short period of time |
| Less visual blur after instilling eye drop | |
| Can be used throughout the day | |
| Many preservative-free options |
Depending on the type of dry eyes you suffer from, you may need to supplement the moisture, oil or both to achieve relief! All our recommendations are preservative-free and compatible while wearing contact lenses.
They provide lubrication and viscosity to the tears and can be important for those with aqueous deficient dry eyes.
A meta-analysis published in 2021 showed a superiority of hyaluronic acid containing artificial tears compared to non-hyaluronic acid eye drops.
Helps to supplement abnormal lipid production, as they closely mimic the oil layer of the tear film that is secreted from the meibomian glands. This can be important for those with evaporative dry eye/MGD.
💡 Our favourite dry eye lubricating cocktail is using a drop of Hyloforte and then adding another drop of NovaTears!
Eye gel formulations are the preferred option when liquid eye lubricants prove insufficient or are administered more than four times a day. They prove beneficial for patients experiencing moderate to severe dry eye or lagophthalmos, effectively covering the exposed part of the eye during sleep.
| Pros | Cons |
| Can be used during the daytime or at night time | Most eye gels on the market have preservatives |
| More viscosity means that it will last longer on the cornea | Many people do not like the consistency of gel drops as they blur the vision slightly |
| Doesn’t need to be instilled as often |
All our recommendations are preservative-free.
If you’ve already experimented with liquid lubricants, preservative-free lubricants, and eye gels without finding relief from dry eyes, it is advisable to consider transitioning to an ointment. Typically, ointments are reserved for individuals with moderate to severe dry eyes.
Ointments can also be beneficial for lagophthalmos patients, offering protection for their eyes during sleep.
| Pros | Cons |
| Stays on the cornea for a lot longer | Causes blurry vision for a long period of time |
| Only used once at night time before sleep due to it’s thicker formulation | Causes eyelids to stick together |
| Easier to know when you’ve applied it as you physically see the ointment being applied. Giving you reassurance that it went into the eye | Need to clean eyelids/eyelashes in the morning |
All our recommendations are preservative-free.
💡 Ointments are best used before bedtime
They have both antibacterial and anti-inflammatory properties that help with both aqueous deficient and evaporative dry eye.
Do not use if there is a history of hypersensitivity or sensitive to honey, food gums or benzoate preservatives (only applicable to the eye drops formulation).
💡 Use twice daily
Certain over-the-counter (OTC) artificial tears and lubricants are marketed as homeopathic. Individuals may be enticed to purchase these homeopathic artificial tears, believing they are a “healthier” and chemical-free choice for eye care.
Typically, these homeopathic eye drops incorporate plant-based ingredients such as euphrasia and calendula. It’s important to emphasize that the ingredients in these eye drops lack scientific support and may potentially harm the eyes instead of providing benefits.
If you encounter someone using homeopathic dry eye drops, kindly advise them to discontinue use immediately. Take the opportunity to educate them on the importance of relying exclusively on scientifically researched and proven artificial tears for optimal eye care.
Contact lens solutions are specifically formulated for cleaning, disinfecting, and storing contact lenses. They are not intended to be used as eye drops. While some contact lens solutions may contain ingredients that are similar to those found in artificial tears or eye drops, they can also contain other components that might not be suitable for direct application to the eyes.
Using contact lens solution as eye drops can potentially cause discomfort, irritation, and even more serious issues such as corneal damage. If you’re experiencing dry or irritated eyes, it’s best to use lubricating eye drops that are specifically designed for soothing and moisturising the eyes.
Yes, eye drops do expire. The expiration date is usually printed on the label of the bottle. Unopened eye drops usually expire 1-2 years after the manufacturing date. Once you open a bottle of eye drops, you should use it within 30 days. This is because the preservatives in the eye drops start to break down after they are opened, which can lead to contamination – unless stated otherwise!
Yes, you can use eye drops with contact lenses, but not all eye drops are safe to use with contacts. It is important to check the label of the eye drops to see if they are safe to use with contacts or check out the list above to see options that are suitable for contact lenses.
