How to choose the right drops for dry eyes
Here’s how to sort through the drugstore shelves and pick the best type of relief for your scratchy, itchy eyes — and know when it’s time for a prescription medication.
We don’t think about our eyes much. Until they start to bother us. So if your eyes feel scratchy, burn, sting or are really watery, you might have a condition called dry eye.
You aren’t alone. “Dry eyes are by far and away the most common condition eye doctors see and diagnose,” says Alexander Solomon, MD. He’s a neuro-ophthalmologist at Pacific Neuroscience Institute in Santa Monica, California.
People develop dry eye for many reasons. It tends to happen to folks over 50, especially women, according to the National Eye Institute. People who wear contact lenses or take certain medications (such as antihistamines or blood pressure medications) are also at higher risk.
Winter can make dry eyes worse, too, says Laine Higa, OD. He’s an optometrist and an assistant professor at Pennsylvania College of Optometry/Salus University in Elkins Park. That’s thanks to low humidity and indoor heating.
Your devices can also contribute to dry eye. When you stare at your phone or computer, you don’t blink as often, so you don’t produce as many tears.
There’s a fix for dry eye: eyedrops. And the store shelves are full of options. We asked the experts to break down those options — and help you figure out when you should see an eye doctor for prescription drops.
The Optum Store carries a variety of eyedrops to fit your needs.
What happens when your eyes get dry
Every time you blink, the tiny glands in your eyes produce tears. Those tears cover your eyeballs, keeping them wet and moist. Tears also wash away dust and pollutants and help you see more clearly.
There are 2 main reasons for dry eyes. It could be that you are not making good-quality tears, which might mean the oil glands in your eyelids are blocked and the tears evaporate too quickly. Or your eyes don’t make enough tears. This is usually because of aging or certain medical conditions.
Here’s a way to unclog the oil glands (besides drops): Use a warm compress on your eyes for 5 to 10 minutes a day.
What drops can do for dry eye
“You really want ones that say ‘artificial tears’ [on the package],” says Dr. Solomon. Artificial tears replace the essentials in tears. Your tears won’t dry up as fast. They’ll also stay longer on the surface of your eyes.
Avoid eyedrops that promise to get the red out of your eye. “These drops only clamp down on the blood vessels in your eyes,” says Dr. Higa. That will make your eyes whiter, but it won’t do anything for your dry eyes. Neither will anti-allergy drops, he adds.
Choosing the right type of artificial tears
“What I’ve told my patients is that it’s a little bit like finding your toothpaste. Everyone’s going to have something slightly different that works for them,” says Dr. Solomon. His advice: Try each kind of artificial tears for a couple of weeks. If they don’t do the trick, make a switch.
Regular artificial tears
These generally come in larger bottles. They contain preservatives, so they last longer.
What you need to know: Limit use to 4 to 6 times a day, warns Dr. Solomon. Otherwise, the preservatives can cause a mild allergic reaction. That can dry out eyes even more.
Best for: People with mild cases. Or those who just began to treat their dry eyes, says Dr. Solomon. Start by putting in the drops 3 times a day (tie them to your meals, he advises). If your eyes feel okay with that, then stick with that routine.
When to switch: When you feel you have to put the drops in more often or your eyes still feel scratchy, says Dr. Higa.
Preservative-free (PF) artificial tears
These drops don’t contain preservatives, so you can put them in more often. They come in small individual vials.
What you need to know: Once you’ve opened the vial, the eyedrops last for 24 hours, says Dr. Solomon. Put the snap-off cap back on and stash the vial in the fridge (if possible), he recommends.
Best for: Anyone who’s using artificial tears more than 3 or 4 times a day. Feel free to put drops in every couple of hours.
When to switch: When your eyes are still bothering you no matter how many times you put in drops. In that case, try thicker drops (such as gels or ointments) or prescription drops.
Gels or ointments
These thicker drops stay longer on your eye, so they keep it hydrated longer, says Dr. Higa. Ointments are thicker than gels, and both come in regular or preservative-free versions.
What you need to know: While both have staying power, they can blur your vision because they’re thick. Use them right before bedtime, especially the ointment.
Best for: People who wake up with dry eyes or whose symptoms are worse in the morning. “The ointment is great at night, because it just sort of sits in there and lubricates the eyes all night long,” explains Dr. Solomon. In the morning, you can wash it away.
When to switch: Not everyone likes something goopy in their eyes. If this bothers you, try another option.
Comfort or rewetting drops
Wearing contact lenses can cause dry eyes or make them worse, especially if you wear them too long.
What you need to know: Preservative-free drops may have the edge over rewetting drops, and they should be fine for people who wear contacts, says Dr. Solomon. Or you can get regular drops that are marketed for contact lens wearers and don’t contain benzalkonium chloride or thimerosal. That’s per a study from the University of Alabama at Birmingham.
Best for: Contact lens wearers
When to make a switch: First, try preservative-free drops. If they don’t work, you can switch to rewetting drops, Dr. Solomon suggests.
When to see a doctor for prescription drops
When over-the-counter brands no longer work, it’s time to see an eye doctor. Prescription eyedrops are anti-inflammatories. “They’re designed to decrease inflammation that could be affecting your tear production,” explains Dr. Solomon.
They don’t work for everyone. But if prescription drops don’t bring relief, your eye doctor can recommend other treatments that will.
Just keep this in mind: Dry eye is “not something that happens overnight. It typically takes months to years to show symptoms,” says Dr. Higa. Do you already have signs of dry eye? Talk to your eye doctor. The earlier you start treatment, the faster you’ll feel better.
Older adults and women: National Eye Institute (2022). “Dry Eye”
Rewetting drops ingredients: Contact Lens & Anterior Eye (2020). “A Review of the Compatibility of Topical Artificial Tears and Rewetting Drops with Contact Lenses”