There are a LOT of products you can try off the shelf to help improve the comfort and appearance of your eyes. They are, however, not all created equally. Your eye care professional can make individualised recommendations as to what will suit your eyes the best. The information here is to give you some insight into what options are available.

Eye Drops.

The term 'artificial tears' is commonly used to describe any drops, solutions and gels designed to be applied directly into the eye. The term is not strictly correct as artificial tears do not accurately mimic the composition of real tears - they mainly act as lubricants.

 Lubricating eye drops add more lubrication to the eye surface to reduce friction, aid healing and improve the composition of your tears. They form a key part of the treatment plan for all patients with dry eyes and have been shown to improve symptoms and signs of dry eye disease when used frequently. However, other treatments are often needed in combination to manage the underlying causes, particularly in moderate to severe dry eye.

To be effective lubricants do need to be used regularly, at least four times per day. When used regularly, lubricating eyedrops have been shown to significantly improvements symptoms after a month of use, and the signs of dry eye that your eye doctor will see after two to three months of regular lubricant use.

There are a variety of products on the market, and newer preparations can have other benefits from simple temporary lubrication. There’s some great technology in eye drops. But when you’re standing in front of the shelf at your average pharmacy what do you choose? 

Use what your Eye Care Professional Recommends

A good optometrist or ophthalmologist will make a specific recommendation based on your needs. They should tailor their advice and recommendations on your individual eyes and tears. The technology available in eye drops now goes far beyond “saline drops”.  

What about Preserved vs Preservative Free?

Preservatives keep things fresh and can make products more affordable for many. Historically some preservatives were found to be toxic to the surface of the eye, particularly when used for prolonged periods but most of these are no longer used. The exception is Benzalkonium Chloride (BAK), which is still commonly used. Many medicated eye drops still use BAK, this is not a reason to stop your medication – the benefit of the medication will outweigh the risk to the surface the eye of BAK.

Other modern preservatives (eg. PolyQuad, OcuPure) are safer for the eye surface and tear health, so choose these if you can.  

Even better are non-preserved formulas. Classically these are products in single-use vials that your need to use over a day and then discard. Technology now also means some bottled preparations are available in preservative-free too.

As a general rule always choose preservative-free drop formulations when you need to use lubricating eye drops more than four times per day or when you also need to use other eye drops for other eye health conditions (eg. Glaucoma).

Other Advice

#1 Always give your eye care professional feedback on the drops they recommend. There are some great options available so they will want to adjust their recommendations based on your feedback and how the signs of your dry eye are improving.

#2 Don’t share your eye drops with others

#3 Once you open an eye drop, always check the expiry date from the day of opening. Some should be thrown away immediately, or 1 month or 3 months after opening.

#4 If you use contact lenses, get advice from your optometrist as to the best drops to use… and remember sometimes an update in your lens or care product technology can mean you don’t get dry eyes with contact lenses.

Ointments.

Eye ointments, often containing paraffin, are a lot thicker than eye drops and gels. They physically lubricate, allow the eye to heal & can protect the eye surface from epithelial erosions on waking. Eye ointments can feel more greasy and blur vision so are best for overnight use. They should also never be used with contact lenses.

Warm Compresses.

As Meibomian Gland Dysfunction (MGD) is a common cause of Dry Eye Disease warm compresses and heat therapies can form a large part of most individual’s treatment plans. Warm compresses can soften debris on the eyelid margins, making it easier to remove but their key role is warming up thickened meibum - think of melting butter.

Studies have shown that treatment with warm compresses leads to improvements in tear film lipid layer thickness and tear film stability in patients with MGD.

You may have been recommended a warm face cloth, and while this is better than nothing, we now know from research that this approach is not as effective, you need to re-heat the facecloth every two minutes for starters.

Wheat bags or specifically designed warm compress bags for the eye area have been shown to be more effective. Warm compresses should be applied for about 10 minutes, four to six times a day to begin with. Generally, once things have improved you will find these are beneficial once or twice a week as part of general self care.

Lid & Lash Hygiene.

Good eyelid and lash hygiene is important for all of us. Eyelid hygiene removes debris, make up, lipid by-products, bacteria & bacterial toxins and biofilms which reduces irritation and inflammation. Depending on if you need just routine care products or management of Blepharitis, Demodex Mites or MGD, there are a range of products available. Most involve gentle cleaning along the lash area and may be recommended from twice daily use to once per week.

Examples of products include Systane Lid Wipes (Alcon), Theratears® SteriLid®, Opti-Soothe Eyelid Wipes (AFT Pharma), Blephadex™ Eyelid Wipes & Foam, i-Lid n Lash Plus® (I-MED Pharma), OCuSoft® Lid Scrubs and Hypocholorous preparations.

OptiMel™

Honey has been used for centuries for its therapeutic affects, including wound healing and as a natural antibacterial. OptiMel™ is a unique honey-based eye drop shown to be an effective treatment for chronic dry eye, MGD and anterior blepharitis. It reduces the bacterial load on the lid margin and it has been shown to be anti-inflammatory improving signs of redness; as well as improving tear osmolarity, tear break up times, staining and meibum quality. It comes in two forms and can sting a little on instillation but can be a natural way to control inflammation.

Cationorm® Eye Drops

Another newer option is the preservative-free, eye drop emulsion, Cationorm. Available in the UK, Australia, Singapore, Vietnam, Philippines and Malaysia this drop has been shown to significantly improve discomfort in those with Dry Eye and Contact Lens associated Dry Eye.

The emulsion, which includes lipids, surfactants and glycerol, replenishes and stabilises all layers of tears. It’s designed to be used up to four-times daily in the affected eye, and is compatible with contact lenses. Eighty-four percent of contact lens wearers in the multicentre study reported that Cationorm reduced ocular discomfort associated with ocular dryness after 15 days of treatment, regardless of lens material, type of lenses, and frequency of eye drop use.

Disclaimer: The opinions on this page are the authors' own. They have received no financial incentive with respect to any products mentioned.