Find the right OTC drops for your dry eyes

Thousands of years ago, healers relieved the gritty, parched feeling of dry eyes by rubbing them with everything from onions to oils to the internal organs of yellow frogs.

Today, you’ve got better options. And they come in nice, sterile bottles you can pick up at the pharmacy—not a potion store. Moisturizing over-the-counter (OTC) eye drops can help restore your tear film and ease discomfort.

As a quick refresher, there are many reasons why your eyes get dry in the first place. Age is a biggie: The older you get, the more your natural tear production slows. Those tears are important because, with every blink, they bathe the surface of your eye in a protective film. 

Sometimes, medications or health conditions can also alter your tear production. Wearing your contact lenses for longer than is recommended and working at a computer can make things worse, too.

But with dozens of eye drops boxes begging for your attention (Advanced Protection!, All-Day Comfort!, Complete Relief!), which bottle should you add to your shopping cart? 

If your optometrist has specifically recommended a product for you, go with that one. Otherwise, here’s how to decode eye drops labels like a pro, so you get the relief you need. 

Label Decoder: The Front of the Box

The fancy flags, banners, and bold-faced words on the front label describe the main features and benefits of the drops. 

What to Seek Out

Look for keywords. Drops for dry eyes may be called lubricating drops, artificial tears, or moisturizing drops. They’re all good. You may also find thicker lubricating gels and ointments for more severe dry eyes and for overnight use, too. 

Their aim? “To get your tear volume and composition back to its natural state,” says Laine S. Higa, O.D., an assistant professor at The Eye Institute of the Pennsylvania College of Optometry at Salus University.

According to experts from Ohio State University, Johns Hopkins Bloomberg School of Public Health, and The University of Alabama at Birmingham who reviewed 43 eye drops studies involving 3,497 women and men with dry eyes, all over-the-counter lubricating drops can help. 

If the first one you try doesn’t work for you, choose another. Or ask your eye doctor for a recommendation.

What to Rule Out

Steer clear of products that “get the red out”—even if your dry eyes look red. Redness-relieving eye drops contain ingredients such as tetrahydrozoline and naphazoline, which are decongestants that clamp down on the blood vessels on the white part of the eyes to make them look fresh as snow. But these drops don’t do anything to treat the underlying problem of the tears in dry eyes. Instead, says Dr. Higa, “they provide just a temporary cosmetic benefit.”

Say no thanks to drops for allergic eye reactions, too. Anti-allergy eye drops help decrease itching, redness, and tearing. But the active ingredient in these drops, antihistamines, can actually worsen all of these symptoms if your problem is really dry eye—not allergies. That’s why it’s always a smart idea to have your eyes checked out by an eye doctor for the right call, says Dr. Higa.

Pass on the preservatives. If your eye doctor has told you that you have moderate to severe dry eyes, drops made with fewer additives and preservatives are a good idea. “As a rule, if you are using an eye drop more than four times a day, a preservative-free option is the right choice,” says Dr. Higa. 

Products are usually labeled preservative-free on the front of the package. To double check, flip the box over and read the ingredients list on the back. Common preservatives in eye drops include: 

• Benzalkonium chloride
• Chlorobutanol
• Edetate disodium
• Polyhexamethylene biguanide
• Sodium perborate

Label Decoder: The Back of the Box

Nobody recommends onions and yellow frogs for dry eyes anymore, but you’ll find a bewildering variety of ingredients listed on the back of each box of drops.

Different active ingredients take aim at different aspects of dry eye. But it’s not easy to mirror real tears. That’s why many drops use a combination of ingredients. Your job is to mix and match, according to your most bothersome symptoms.

Know Your Ingredients:

Demulcents

These are the soothers—ingredients that ease discomfort by forming a protective layer over the irritated, inflamed surface of the eyes. 

They mimic the portion of your tear film that forms the foundation of your natural tears. (Its technical name is the mucin layer, and its job is to help tears stick to your eyes’ surface.) 

And some demulcents, such as propylene glycol, pack a bonus. By holding onto extra fluid, they can increase the water content of your tears, too. 

Demulcent ingredients include carboxymethylcellulose sodium, glycerin, polyethylene glycol, polyvinyl alcohol, povidone, carbopol, polyguar, and HP guar.

Hyaluronic acid

This is the tearjerker. This compound, called a polysaccharide, is found naturally in your body’s connective tissue and in some parts of your eyes. It has a clear, stretchy, and slightly thick quality—called viscoelasticity—that, in eye drops, helps tears last longer. 

Hyaluronic acid concentrations in eye drops vary from about 0.1 percent to 0.2 percent, while thicker lubricating gels may contain 0.3 percent.

More may be better. In a 2018 lab study (performed on mice) published in the Journal of Ocular Pharmacology and Therapeutics, a 0.3 percent hyaluronic acid formula was more effective than 0.1 percent and 0.18 percent types for soothing the surface of the eye and for helping tears stay on the eyes longer before they broke up.

Emulsions

These are the protectors. One of the newest arrivals on the lubricating eye drops scene, emulsions typically contain mineral oil and light mineral oil in a variety of concentrations.

These mixtures of microscopic oil droplets in water discourage tear evaporation, bolster the natural oily (or lipid) layer of your tears, and last for a relatively long time on your eyes, according to a recent article in the journal Review of Ophthalmology. This staying power helps restore and protect the surface of your eyes, so they feel and look better.

Double Up on Relief Strategies

In addition to eye drops, there are a number of lifestyle changes you can make to reduce your dry eye symptoms, including:

• Run a humidifier at home during dry weather or when the heat or air conditioning is on. More moisture in the air means more comfort for your eyes. 
• While at your computer, remember to look away frequently so you blink more often. The general rule-of-thumb is to take a 20-second break to gaze off into the distance every 20 minutes.
• Place a warm cloth over your closed eyes for 10 minutes before bedtime and again when you wake up—or as needed. 
• When you’re outdoors, wear sunglasses to shield your eyes from the sun, wind, and dust.