Eye Drop 101
Eye Drops? Artificial Tears? Lubricants? Whatever you want to call them lubricating eye drops do form the basis of most dry eye management plans. Lubricating eye drops add more lubrication to the eye surface to reduce friction, aid healing and improve the composition of your tears. They have been shown to improve both the symptoms and signs of dry eyes and Dry Eye Disease.
Eye Lubrication can help relieve symptoms of dry, irritated eyes. For moderate to severe symptoms, 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 improve 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?
Tip #1 – 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”.
THE BASICS There are many simple lubricants that have been available for many years that can work well. These include products with hypromellose, carmellose, dextran, carbomers and polyvinyl alcohol. They add more tears to the surface of the eyes and can be beneficial in mild cases. Examples include Refresh and PolyTears.
GETTING MORE ADVANCED While thicker formulas can be helpful for more severe symptoms (Systane Gel), many newer eyedrops can do more than just lubricate the surface – they can have greater meaning they soothe for longer and can have active ingredients that aid in healing the dry eye surface.
Sodium Hyaluronate is a favourite due to its water-retaining and healing properties. Systane Hydration, Blink Intensive Tears, Avizor LacriFresh Ocu-Dry & HyloForte are all great products containing this key ingredient. The Systane Range contains HP-Guar which leads to longer retention times.
LIPID INNOVATIONS As in the majority of Dry Eye Disease, Meibomian Gland Dysfunction (MGD) plays a role, lubricating eye drops with a lipid component can be really beneficial. These can also be great all-round drops for occasional use as they more closely mimic the tear layers. Systane Complete is a good example as is NovaTears.
What about Preservatives?
Preservatives keep things fresh and can make product 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 – HyloFresh, HyloForte, Systane Ultra, Systane Complete, Avizor XXXXX
As a general rule always choose preservative free drop formulations when:
- You need to use lubricating eyedrops more than four times per day
- You also need to use other eye drops for other eye health conditions (eg. Glaucoma)
Other Things to Remember
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 base on your feedback and how the signs of your dry eye is 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.