Many types of eye drops are available for treating dry eyes. Over-the-counter options are often effective. A doctor may recommend prescription options if they aren’t.
Dry eye syndrome, also known as dry eyes, is a common problem estimated to affect 5% to 50% of people. It occurs when the body can’t adequately lubricate the surface of your eyeballs.
The two main types are:
- Evaporative dry eyes: Characterized by a deficiency in the oily layer of your tear film, often due to dysfunction of your meibomian gland. Basically, it means your tears evaporate too quickly.
- Aqueous-deficient dry eyes: Occurs when your tear glands don’t produce enough tears.
Generally, over-the-counter (OTC) eyedrops are the first-line treatment for dry eyes. If these aren’t effective, prescription-strength drops can help reduce inflammation or stimulate the production of tears.
Let’s examine the types of eyedrops available to help manage dry eyes and how to choose which type may be best for you.
The following are types of eye drops available without a prescription.
Allergy eye drops (antihistamine drops)
Dry eyes and allergies from environmental exposures can share similar symptoms. Environmental pollutants can include:
- pollen
- dust mites
- pet dander
- smoke
Antihistamine eyedrops can potentially improve allergy eye symptoms. Some of the OTC antihistamine drops approved in the United States include:
- ketotifen (Zaditor and Alaway)
- pheniramine (Naphcon-A, Visine Allergy, and others)
- olopatadine (Pataday, Patanol)
- cetirizine (Zerviate)
It’s also possible for antihistamines to worsen dry eye symptoms. Speak with a medical professional about which medication may be right for you.
Lubricating eye drops (artificial tears)
Artificial tears are available without a prescription to help moisturize your eyes. The two main types are preservative-containing and preservative-free.
Preservative-free artificial tears may help reduce side effects of preservatives, such as stinging or eye irritation, but have a higher risk of bacterial contamination if used in higher amounts beyond intended individual doses. Products without preservatives are often more expensive.
Many common formulas can be effective. Active ingredients you may find in OTC products include:
- cellulose derivatives:
- carboxymethylcellulose (CMC)
- hypromellose
- hydroxyethylcellulose
- methylcellulose
- dextran 70
- gelatin
- polyols:
- glycerin
- polyethylene glycol (300, 400)
- polysorbate 80
- polymers
- polyvinyl alcohol
- polyvinyl pyrrolidone
Anti-redness drops
Anti-redness eyedrops are designed to reduce irritation and red eyes.
The American Academy of Ophthalmology recommends avoiding red eye relief eye drops since they often contain ingredients that constrict your blood vessels and might make redness worse over time. They particularly recommend staying away from products containing tetrahydrozoline and naphazoline.
If over-the-counter medications aren’t enough to relieve your symptoms, a doctor may write you a prescription for something stronger.
Cyclosporine (Restasis)
Cyclosporine is an immunosuppressant drug that helps your body produce more tears. It’s sometimes prescribed for chronic dry eyes.
Xiidra (Lifitegrast)
Xiidra works by reducing inflammation to help support your eye’s ability to produce tears.
Perfluorohexyloctane (Miebo)
Miebo was the first FDA-approved medication for treating dry eyes by targeting tear evaporation.
Anti-inflammatory eye drops
Ant-inflammatory eye drops might contain steroids. A doctor may recommend these drops if you have an underlying medical condition like an eye infection.
Steroid drops include:
- prednisolone (AK-Pred and others)
- dexamethasone (Dextenza and others)
- fluorometholone (Flarex)
- fluocinolone (Iluvien)
- loteprednol (Eysuvis, Lotemax, and others)
Antibiotic eyedrops
If you have a bacterial eye infection or have an upcoming eye procedure, your doctor may prescribe antibiotic drops. These eye drops are only available with a prescription and include:
- erythromycin (Ilotycin, Romycin)
- azithromycin (AzaSite)
- ciprofloxacin (Ciloxan)
Other treatments for dry eyes include:
- eye masks and moisture goggles
- humidifier for increasing moisture in your home
- wrap-around glasses to reduce weather effects
- scleral lenses, a type of contact lenses that fit over the white of your eye
- medical devices and procedures, such as:
- intense pulsed light
- thermal pulsation therapy
- eye inserts
- punctal occlusion
- eyelid surgery
- radiofrequency
- amniotic membrane grafting
- autologous serum eye drops, which are made from your own blood and more closely resemble real tears than other eye drops
The best eye drops for people with evaporative dry eyes are drops that list oil in the ingredients or mention “evaporative dry eyes.” For people with dry eyes caused by a lack of eye moisture, most types of eye drops can be effective. Preservative-free formulations are considered to have there fewest side effects if they are used according to the product label.
The best preservative-free eye drops for you might depend on factors like your personal preference and your price range. Most common formulas can be effective.
Systane contains the active ingredients polyethylene Glycol 400, Propylene Glycol, and hydroxypropyl Guar. Refresh contains Carboxymethylcellulose sodium 0.5% and Glycerin 0.9%. Both types offer formulations that are preservative-free or have preservatives. Research suggests that both treatments can be well tolerated with similar effectiveness.
The price of Restasis may depend on factors like where you live and whether you buy a brand name or generic drug. It generally costs hundreds of dollars for a 30-day supply without insurance.
Eye drops are generally the first-line treatment for dry eyes. Many formulas are available OTC without a prescription. If these aren’t effective, your doctor may recommend prescription options instead.
The American Academy of Ophthalmology recommends seeing an ophthalmologist and having a comprehensive examination if you’re relying on OTC eye drops more than two or three times per day.