June 19, 2018
Young woman putting in eye drops

An Eye on Eye Drops

by Berkeley Wellness  

If you have dry, red, or itchy eyes and are looking for over-the-counter relief, there are many eye drop products to choose from—so many, in fact, that the choice can leave you bleary-eyed. Here’s what you’ll find on drugstore shelves.

For dry eye relief: With names like Bion Tears, Refresh, Visine Tears, TheraTears, GenTeal, Systane, and Tears Again, so-called artificial tears lubricate and moisturize dry eyes caused by dry air, wind, smoke, medications, prolonged computer use, or reduced tear production. They come in different formulas and viscosities, but some common ingredients are hydroxyethyl cellulose, methylcellulose, polycarbophil, glycerin, and polyvinyl alcohol. Thinner drops provide fast—but short-term—relief. More viscous products (which may also come as gels or ointments) provide greater moisturizing ability, but because they cause temporary blurring they are best used at bedtime and should not be used before driving.

To get the red out: Clear Eyes, Visine Original, and other drops marketed for red eyes typically contain a decongestant (such as naphazoline or phenylephrine), which, by constricting blood vessels, makes the whites of eyes look less red. But regular or frequent use can cause in­­creased irritation and redness, called a rebound effect. You should not use decongestant products if you have narrow-angle glaucoma, and should use them with caution if you have high blood pressure, heart disease, diabetes, hyperthyroidism, or difficulty urinating due to an enlarged prostate.

For itchy eyes due to allergies: Naphcon-A, Opcon-A, and Visine-A, among other allergy drops, contain an antihistamine (pheniramine or antazoline phosphate) and a decongestant (like naphazoline) to temporarily relieve itchiness and redness caused by pollen, pet dander, or other allergies, though they may not be as effective as prescription drops. Because they contain decongestants, the same cautions apply as with drops used for red eyes. Some antihistamines may raise ocular pressure slightly, so if you have glaucoma, talk to your doctor before using allergy eye drops. Over-the-counter prescription-strength ketotifen fumarate contains a longer-lasting antihistamine and no decongestant; its anti-allergy effects last up to 12 hours, compared to about four hours for other antihistamine eye drops.

General advice on OTC eye drops

Over-the-counter eye drops are generally safe for regular use, but follow directions carefully, particularly if the drops contain a decongestant. Most products, including store brands, contain the same basic ingredients within their category—and more expensive brands are not necessarily better. A simple lubricating product is often a good first treatment for dry eyes, allergies, and other minor eye complaints. If you develop any irritation with eye drops, stop using them immediately.

If symptoms persist or worsen after three days of using eye drops, or if you have vision changes or eye pain or develop other eye problems, see an optometrist, ophthalmologist, or your regular doctor. You may need stronger drops or other treatment. Red, itchy eyes, for example, are a common symptom of allergies, but could also indicate a bacterial infection that requires antibiotics.

How to apply eye drops

With your head tilted back, pull your lower eyelid down and put the drops in that space; close your eyes gently for about five seconds. Don’t let the tip of the bottle touch your eye, and don’t touch the tip with your fingers. If you wear contacts, wait at least 10 minutes before putting the lenses in. Some drops shouldn’t be used with certain types of contacts, so talk to your eye doctor.

Most eye drops contain preservatives—sodium perborate, methyl-paraben, sorbic acid, EDTA, benzalkonium chloride, and others—which can cause inflammation and worsen symptoms in some people. If you have sensitive eyes or severe dry eyes, look for preservative-free artificial tears, usually available in single-use vials. Some drops are considered preservative-free upon contact—that is, the preservative dissipates quickly after application.

Some eye drops need to be refrigerated, so check the label. Many people find that refrigerating them, even if not required, makes them more soothing.

Also see Should You Take Vision Supplements?