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How to Choose the Best Drops for Dry Eye

Views: 54572
Reviewed by Nymark M, PhD on February 26, 2016

Do you frequently suffer from itchy, swollen eyes, as well as blurred vision? It is possible that you are suffering from dry eye syndrome. This is a serious eye problem that has a variety of causes and symptoms, as well as possible treatment options.

If you want to deal with your dry eye problem effectively, there are many important things to consider. The purpose of this article is to identify the critical issues surrounding dry eye, what causes it, treatment options, types of products and much more. Armed with extensive information about dry eye, then you can choose the best treatment program for your needs.

To begin, it is necessary to understand what dry eye is, what causes it, and more. Once you have a solid understanding of the problem and treatment options, you then can make a decision about how to move forward with treatment.

What Is Dry Eye?

Dry eye is a condition where the person does not naturally produce enough tears to both nourish and lubricate the eye with each blink of the eyelid. When this process is working properly, tears spread across the cornea and provide lubrication. Tears also reduce the chance of eye infection and wash away bacteria and contaminants from the eye. Any excess tears that are produced flow into very small drainage ducts on the inside corners of the eyelids.

When dry eye occurs, redness, itching, swelling and blurred vision may occur. Along with dry eye, it is common to experience inflammation around the surface of the eye. If this is left untreated, the condition may lead to ulcers, pain, or scars across the cornea, as well as the potential for some vision loss.

Fortunately, vision loss associated with dry eye is uncommon. Dry eye often makes it difficult to perform certain activities, such as reading or using a computer, and it can make living in dry environments highly uncomfortable. Other names for dry eye syndrome include dysfunctional tear syndrome, keratoconjunctivitis sicca, lacrimal keratoconjunctivitis, aqueous tear deficiency, evaporative tear deficiency, and LASIK-induced neurotrophic epitheliopathy.

What Are the Symptoms of Dry Eye?

The signs and symptoms of dry eye, which typically stretch to both eyes, regardless of the condition, may include:

  • Eyes that are constantly stinging or burning
  • A feeling of sand or grit in the eyes that will not go away
  • Periods where your eyes produce a lot of tears and then not enough tears
  • Stringy discharges from one or both eyes
  • Pain and redness in the eyes
  • Blurred vision that does not go away
  • Eyelids that feel heavy
  • Eyes feel and look swollen
  • Inability to produce tears to cry
  • Contact lenses that never feel comfortable
  • Difficulty reading, working on the computer or anything that requires longer periods of visual attention
  • Eyes feel tired and fatigued

If you are feeling these symptoms for long periods of time on a regular basis, you should talk to an eye care professional to get a proper diagnosis as well as possible treatment options.

What Causes Symptoms of Dry Eye?

It is important to understand what is the cause of dry eye symptoms, and also the specific possible physiological causes of those symptoms. The reasons that some people cannot produce an adequate supply or the proper quality of tears are:

  • Poor quantity of tears: Tears are made by several tiny glands that are in and around the upper and lower eyelids. Tear production can decline with age, as well as from a variety of medical problems and conditions. Side effects of some drugs also can cause this problem. Other causes may be windy and dry climates, as tear volume can evaporate from such weather conditions.
  • Poor tear quality: Tears are made of oil, water and mucus. Each part of the tears both protects and nourishes the frontal area of the eye. A smooth layer of oil prevents the water layer from evaporating, and the layer of mucus helps the tears to be spread in an even fashion over the eye surface. If tears tend to evaporate too fast, or fail to spread properly over the cornea due to lack of proper tear ingredients, dry eye can occur.

The most common type of dry eye is where the water part of the tears is too low. This is known as keratoconjunctivitis sicca or KCS, and is referred to as ‘dry eye syndrome.’

What Are the Underlying Causes of Dry Eye?

There are many potential, underlying medical reasons why the symptoms of dry eye can develop. The most common causes of dry eye include:

  • Age: Dry eye can be part of the general aging process. People who are over the age of 65 may develop various symptoms of dry eye.
  • Gender: Women tend to develop dry eye with greater frequency than men. This is because they undergo hormonal changes due to pregnancy, menopause and the use of birth control pills.
  • Drugs: There are a variety of over the counter and prescription drugs that may cause dry eye. Some of these include antihistamines, decongestants, blood pressure drugs and antidepressants. The pharmacological actions of these drugs can lead to the reduction of tear production in some patients.
  • Medical problems: Some people with serious medical problems may be more likely to have dry eye. Some of these conditions include rheumatoid arthritis, diabetes and problems with the thyroid gland. Further, some eye problems make dry eye more likely. These include eyelid inflammation or blepharitis, inflammation of eye surfaces, and turning of eyelids in or out.
  • Contact lens use: Using contact lenses for a long period of time can lead to the possibility of dry eye
  • Environmental factors: Being exposed to smoke, dry and windy climates and simple failure to blink enough when staring at a computer screen can cause dry eye.
  • Lasik: Refractive eye surgeries such as LASIK can reduce the amount of tears produced and cause dry eye.

Treating Dry Eye with Eye Drops

The best way a person can help to relieve their own symptoms of dry eye is to utilize gels, artificial tears, ointments, and eye drops that are available either on a prescription basis, or as over-the-counter remedies. These solutions offer a way to replace tears in patients with a deficiency, and offer temporary relief.

The eye drops available to people suffering from dry eye syndrome can frequently be categorized into two: the first category is for prescription eye drops, and the second is for over the counter (OTC) eye drops. OTC eye drops can be an appropriate solution in many cases, and are also far more convenient and cheaper for the patient involved. However, if symptoms persist or get worse, then it is crucial to visit an eye doctor.

Did you know the prevalence of dry eye syndrome increases with age. According to the American Academy of Ophthalmology, an estimated 3.2 million women age 50 and over and 1.68 million men age 50 and over are affected by dry eye syndrome. Eye industry experts estimate that 25 million Americans are already affected by symptoms of dry eye and don’t even know it!

Below is more about OTC and prescription eye drops.

Over the Counter Eye Drops

OTC drops, or lubricating artificial tears, can offer short-term relief for dry eyes when the cause of the problem is related to temporary issues such as strain from overuse of a computer, being outdoors in particularly dry or windy conditions, or dealing with excessive tiredness. Most OTC eye drops work by supplementing the tears with elements that should already been in your eyes already in order to make the eye more moist, and feel more comfortable.These eye drops are available in various viscosities and with different ingredients.

Eye drops with a low viscosity are generally watery and light, and capable of providing quick or even immediate relief to individuals with dry eyes, while allowing them to avoid the side effect of blurred vision. Unfortunately, low-viscosity eye drops usually have a short-lived effect, and sometimes patients must use the drops frequently to get any relief.Alternatively, artificial tears with a higher viscosity offer a more gel-like consistency, and can provide lubrication that lasts for a much longer period.

Typically, however, these drops cause a great deal of blurring in the vision for a number of minutes after being applied. For this reason, the drops may not be a good choice if you need to continue working throughout the day, or if you need clear vision immediately for tasks such as driving. High viscosity drops are generally recommended more for use at bedtime.When choosing the best over the counter eye drops, in some cases, the ingredients used can determine the kind of eye condition they are best suited for.

For example, examination of the packaging may indicate that one brand works more effectively for people suffering with evaporative dry eye syndrome, while another is better suited to people with aqueous deficiency. It’s often a good idea to avoid eye drops that contain decongestants, and you can recognize these as they are often advertised as offering relief for red eyes.

Although decongestants can help to reduce the appearance of redness around the eyes, they can also cause the dry eye symptoms to become worse for the long-term. If the problems you are suffering from in regards to dry eye are more severe, you may need to utilize an ointment or lubricating gel.

Eye Drops with Preservatives

Many eye drops come in two distinct formats: those without preservatives and those with preservatives. When a brand adds preservatives to their eye drops, they do so to help prevent the growth of bacteria, however some people can find that these particular eye drops are irritating to their eyes, or make their eyes more sensitive. These drops are not recommended for people with serious eye dryness, or those with significant eye conditions.

Some common eye drops that contain preservatives include:

  • Computer Eye Drops
  • Moisture Eyes
  • HypoTears

Generally, eye drops that do not include preservatives may be recommended for people suffering from severe to moderate dry eyes. These drops are sometime sold in single-use containers, and are often more expensive. Examples of eye drops that do not contain preservatives include:

  • NanoTears MXP
  • Refresh Optive Advanced
  • Sooth XP
  • Systane Balance

If the dryness that you are experiencing in your eyes is caused by a lower level of oil within your tears, chances are that your doctor will recommend eye drops that contain extra oil. Some of the most effective eye drops that include oil are:

  • Sooth XP
  • Refresh Optive Advanced
  • Systane Balance

Types of Preservatives

As you consider which eye drops to try, it is very important to be aware of the specific types of preservatives used in many eye drops today. Some patients may be much more sensitive to some preservatives than others. Those who have problems with preservatives may wish to choose preservative-free eye drops.

The two major types of preservatives in eye drops are:

  • Chemical
  • Oxidative

Chemical preservatives are much older in terms of the science, and can be more irritating and toxic to the eye. Still, they are found in many modern over the counter artificial tears.

Some of the most common types of chemical preservatives used in artificial tears are benzalkonium chloride or BAK, and chlorobutanol. Of these two preservatives, experts say that the latter is easier on the eye surface. Chlorobutanol is based upon alcohol; it works by disorganizing the lipids of the microbial cell membranes, and increases the permeability.

BAK is called a cationic surfactant quaternary ammonium detergent. It works by breaking open the cell membranes and disrupting intracellular structures.

Other common chemical preservatives are sorbate and Polyquad. The latter is a newer ammonium preservative, and is found in Tears Natural II produced by Alcon.

Oxidative preservatives are a newer science and are generally less toxic to the ocular surface. One of them is sodium perborate. It is called a ‘vanishing preservative’ because on the eye surface, the preservative turns into hydrogen peroxide, and that breaks down into harmless salt and water. GenTeal made by Novartis is one product that contains this preservative.

Another popular oxidative preservative is stabilized oxychloro complex or SOC. It has strong antimicrobial activity and is more likely to kill fungi than some other preservatives. It is believed to be safer than chemical preservatives, even when it is used four time per day. Refresh Tears made by Allergen contains SOC.

Products containing oxidative preservatives are generally considered friendlier to the eye surfaces, experts contend. However, it is worth noting that preservatives may be fine for many patients for short-term use. But patients with chronic dry eye may wish to use preservative-free eye drops if they need to treat their symptoms for a long period.

Prescription Eye Drops Vs Over the Counter Eye Drops

There are a good number of eye drops that can be obtained over the counter (OTC). These products are often a good choice to help to moisten your eyes and to provide temporary relief of dry eye symptoms. These OTC products often are excellent for many people who suffer from short term, mild to moderate dry eye symptoms.

However, people who suffer from severe, long term dry eye may feel they need a prescription drug to correct the problem. Prescription eye drops for dry eye can increase the ability of the eye to produce natural tears but side effects can outweigh the benefits.

For example, many doctors prescribe eye lubricating medications such as Lacrisert, which is an artificial tear insert similar to a contact lens that can be placed on the eye one or two times a day.

The insert includes cellulose, which helps to thicken and stabilize the film of tears that sit naturally over the eye, prolonging the soothing effect and reducing the feeling of soreness and discomfort.Some doctors may recommend the daily use of a prescription eye drop either alongside over the counter artificial tears, or instead of them.

The most commonly used prescription eye drops are Restasis or Xiidra and they are beneficial because they are capable of doing far more than simply lubricating the eye surface. Instead, these prescription medications include agents that are responsible for reducing the inflammation that is commonly present in dry eye syndrome, and they can be used as a way of helping your body to produce more tears naturally.

The more that Restasis can reduce inflammation within the surface of the eye, the more your eye should be able to maintain a naturally healthy tear film.

However, it is important for patients to keep in mind that the therapeutic effects associated with the use of over-the-counter eye drops such as Restasis may not be immediate. In fact, many doctors suggest that patients must continue to use the drops on a daily basis for at least a period of ninety days in order to experience the true benefits of the treatment.

What’s more, a large percentage of people who use Restasis to combat the effects of dry eye syndrome will suffer from side effects. These can include  burning and discomfort during the first weeks of their treatment.

What Should You Do About Dry Eye?

While certain products can work to relieve the symptoms of dry eye, they will not treat the underlying causes of dry eyes. If your goal is to treat dry eyes, then you should typically avoid products that promise to reduce redness, such as Clear Eyes and Visine.

In most cases, the causes of mild eye dryness can be treated with over the counter eye drops, but it’s important to remember that dry eyes can sometimes occur as a result of serious health problems, which is why you should have your eye health regularly evaluated. People who suffer from chronic dry eye should talk to their doctor; they may need a prescription eye drop.

Experts also recommend wearing glasses or sunglasses that fit very close to the face, such as wrap around shades, or ones that feature side shields that can reduce tear evaporation. Indoors, experts recommend a good quality air cleaner to filter dust and other contaminants to prevent dry eye. Some people also use a humidifier to add moisture to the air.

It also is recommended to review the eye drop products listed below; some of these products could really help you with your dry eye syndrome.

Top 25 Best Rated Eye Drop Products

Now that you have a thorough understanding of dry eye and what types of products are available, below is a list of the 25 best eye drops available on Amazon.com:

Rank Product Name Size and Count Product Features Preservative Free
#1 Systane Ultra Lubricant Eye Drops 2-count, .33 fl ounce bottle ●      Offers high performance eye therapy for moderate to severe dry eye symptoms.

●      Delivers long-lasting protection with just one drop.

No
#2 TheraTears Dry Eye Therapy – Lubricant Eye Drops 1 fluid ounce ●      Immediate, long-lasting relief of dry eye

●      Restores natural balance

●      Hypotonic, electrolyte balance formula replicates natural tears

●      Multi-use bottle

No
#3 Ocusoft Retain MGD Ophthalmic Emulsion, Milky White Solution 30 single 30 single use containers ●      Preservative-free ophthalmic emulsion that lubricates moderate/severe dry eyes

●      Long-lasting relief

●      Cationic oil emulsion science delivers moisturizing ingredients via electrostatic attraction

Yes
#4 Alcon Zaditor Eyedrops Twin pack, .34 ounce ●      Works as antihistamine; relieves severe eye itching in minutes

●      Mast cell stablizer to prevent itching for up to 12 hours

●      Late-phase reactions stopped by preventing release of chemical mediators (eosinophils)

No
#5 Theratears Eye Nutrition – Omega 3 Supplement 90-count ●      Promotes healthy tears

●      Features Omega-3 supplement with vitamin E

●      Easy to swallow soft gels

●      Preservative free

Yes
#6` Clear Eyes Maximum Strength Redness Relief .5 fluid ounce ●      Contains maximum strength redness relief

●      Provides as much as 12 hours of itching relief

●      Soothes and moisturizes to relieve redness, burning and mild dry eye

●      Preservative free

Yes
#7 Systane Ultra Lubricant Eye Drops 60-count ●      Delivers highly soothing relief so that eyes feel moist and refreshed for hours

●      Uses the original formulation that has made Systane products #1 recommended by doctors for dry eye

●      Preservative free

Yes
#8 Systane Balance Restorative Formula .33 ounce ●      Clinical strength intensive therapy

●      Restorative formula that provides hours of dry eye relief

●      Supports natural tears by restoring your lipid layer

●      Designed to work on all three layers of tear film

No
#9 Systane Gel Drops Lubricant Eye Gel Anytime Protection .33 ounc ●      Long lasting relief for severe dry eye symptoms

●      Works with just a single drop

●      Thicket gel formula available forces protective shield over the eye

No
#10 Allergan Refresh Plus Lubricant Eye Drops Single-use vials; 100-count ●      #1 doctor recommended

●      Long lasting relief and protection from moderate dry eye

●      Also effective for LASIK dryness

●      Preservative free

Yes
#11 Oasis TEARS PLUS Preservative-Free Eye Drops 30 containers; .01 fluid ounce ●      Contains 30 sterile, disposable containers in each box

●      Works for day or night use

●      Natural blinking makes drops spread across eye surface

●      For moderate to severe dry eye syndrome

●      Preservative free

Yes
#12 Bausch & Lomb Alaway Eye Itch Relief .34 ounce ●      Provides long lasting itch relief in minutes

●      Original prescription strength

●      Up to 12 hours relief

No
#13 Refresh Tears Lubricant Eye Drops 15 ml; 2 bottles ●      Long-lasting dry eye relief

●      Provides relief in minutes

No
#14 Bausch & Lomb Sensitive Eyes Rewetting Drops 1 ounce bottle ●      Ideal for relief of moderate to severe dry eye symptoms

●      Soothes dry eyes for contact lense wearers

●      Gentle and effective thimersosal free solution for those with sensitive eyes

No
#15 Similasan Allergy Eye Relief Eye Drops .33 ounce ●      Provides fast, temporary relief from allergy symptoms

●      Homeopathic ingredients stimulate natural defenses of the body

●      Contains natural active ingredients, including sabadilla and eyebright

●      Preservative free              

Yes
#16 Systane Gel Drops 10 grams; .34 ounce ●      Forms protective shield over eyes to provide long-lasting relief for those with severe dry eye symptoms

●      May be used during day or night

●      Offers convenience of drop with full gel protection

No
#17 Bausch & Lomb Soothe XP Emollient Lubricant Eye Drops .5 ounce ●      Moisturizes your eyes for fast, effective relief

●      Protects your eyes from tear loss

●      Contains Restoryl, an advanced lipid restorative that builds up your lipid tear layer

●      Provides barrier to protect against loss of natural tears

No
#18 Visine Sterile Advanced Redness+Irritation Relief Eye Drops 1 ounce bottle ●      Advanced lubricant and redness relief

●      Features sterile advanced redness and irritation relief

●      Works on contact

No
#19 TheraTears Sterilid Eyelid Cleanser 1.62 fluid ounces ●      Removes oil, debris and other contaminants that may build up on your eyelids and eyelashes

●      Only takes 60 seconds to begin working

●      Multi-use foam pump for convenience

No
#20 Visine Original Redness Reliever Eye Drops 1 fluid ounce ●      Relieves minor eye redness due to irritation

●      Fast acting, proven formula

No
#21 Sodium Chloride 5% Ophthalmic Ointment .12 ounce tube; pack of 3 ●      Ointment to treat symptoms of moderate to severe dry eye

●      Ideal for use at night; last for hours

No
#22 Bausch & Lomb Advanced Eye Relief Rejunvenation Lubricant Eye Drops 1 ounce bottle ●      Moisturizes fast for dry eye relief

●      Safe and gentle formula

●      Effectively moisturizes dry eyes

No
#23 Visine Maximum Strength Redness Relief Lubricant .5 fluid ounce bottle ●      Effective for red, irritated eyes

●      Features hydrating moisturizers for soothing comfort

●      Protects eyes for 10 hours

●      Formula acts fast

No
#24 Can-C Lubricant eye Drops with N-Acetylcarnosine 2×5 ml bottles ●      Provides fast, effective relief for dry eye symptoms with antioxidant N-acetylcarnosine

●      Soothes eyes against wind and sun exposure

No
#25 Genteal Tears Moderate Twin Pack Eye Drops .5 fluid ounce bottle ●      Provides gentle and soothing relief from moderate dry eye

●      Effective, temporary relief for burning and irritation of the eye

●      Contains Polyquad preservative, gentle on sensitive eyes

No

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