Over-the-counter eye drops come in various types and categories for treatment of dry eye disease (DED).
There are so many lubricating eye drop options that it is hard to choose the one that is right for you. There are six categories of lubricating (artificial tears) drop that can be purchased over the counter.
- Preserved Artificial Tears
- Preservative-Free Artificial Tears
- Oil-Based Artificial Tears
- Artificial Tear Gel
- Artificial Tear Ointment
- Eye Sprays and Mists
Preserved Artificial Tears contain preservatives to combat bacterial growth once the bottle has been opened. The preservatives may cause minor irritation to your eyes when you first use the drops. Avoid preserved artificial tears if they cause lasting irritation and do not use them more than 4 to 6 times a day.
Preservative-Free Artificial Tears typically come in single-use vials. They won’t irritate your eyes because there are no chemical preservatives in them, so they are great for those with sensitive eyes. Some of the vials can be recapped to allow for a second application, but you should use the remaining drops within 24 hours to prevent any bacterial growth.
Oil-Based Artificial Tears are available in both preserved and preservative-free versions. These eye drops are thicker than other artificial tears. The oil in them helps prevent the watery portion of the drop from evaporating too quickly. The oil is typically castor oil or mineral oil. These types of eye drops are not recommended for use with contact lenses because the oils may adhere to the surface of the lenses.
Artificial Tear Gel is somewhat thicker than artificial tears and may blur your vision temporarily until they spread evenly across the surface of your cornea and thin out a bit. They do provide extended relief for both moderate and severe dry eyes.
Artificial Tear Ointment is thick and coats the corneal surface. These ointments are applied to the inside of the eyelid. Always wash your hands before applying them and do not apply them when you are wearing contact lenses. These ointments are best for bedtime use because they blur your vision.
Eye Drop Spray or Mist is suitable for people who have difficulty putting drops in their eyes. You spray them onto your closed eyelids and when you blink the lubricating mist will enter your eyes. But don’t spray them when you have makeup or lotions on your eyelids because that will cause the makeup or lotion to also enter your eyes.
There are also antimicrobial sprays that can be used for dry eyes caused by blepharitis (inflammation of the eyelids). Blepharitis is caused by an overgrowth of bacteria around the eyelids that clogs the tiny oil glands near the base of the eyelashes and causes eye irritation, redness, and dry eyes.
Antimicrobial sprays contain hypochlorous acid which also naturally occurs in your immune system and is released to fight off infections. Hypochlorous acid can reduce the bacterial load around the eyes by more than 90% and when the bacterial growth is reduced the symptoms of chronic dry eyes are improved.
REMEMBER: Eye drops don’t address the root cause of your dry eyes. Only an eye examination can determine the underlying causes, such as autoimmune diseases, diabetes, allergies, hormonal changes, medications, etc. An eye exam enables your eye doctor to diagnose the cause and will allow your eye doctor to treat the underlying causes or recommend you to a specialist who can.