Consumer guide to eye lubricants:

Over-the-counter artificial tears, gels, ointments, sprays and specialty prescription-only lubricants for dry eye

Please note: The list below is outdated. For CURRENT information, please visit:

Drops, Gels and Ointments: Ingredients Reference List

0.3% Glycerin
1.0% Propylene glycol

Bion Tears

HOMEOPATHIC
mercurius sublimatus 6x, belladonna 6x, euphrasia 6x

Soothe Xtra Hydration (new 2010)

SUBJECT TO RECALL! CLICK HERE FOR DETAILS

Systane Free

SUBJECT TO RECALL! PLEASE CLICK HERE for details.

Bion Tears

Light mineral oil, mineral oil

HOMEOPATHIC
mercurius sublimatus 6x, belladonna 6x, euphrasia 6x

Systane Free

SUBJECT TO RECALL! PLEASE CLICK HERE for details.

EDITOR'S NOTE: At The Dry Eye Zone we are not fond of ointments and recommend caution in any long-term use of them. Think of the tear film as a delivery vehicle for important nutrients to the entire cornea and conjunctiva. Grease applied directly to those surfaces is going to interfere with tears reaching them, so our concern (bear in mind this is coming from laypeople not medical professionals) is that while helping to temporarily protect the cornea it may be making it more vulnerable. In our community forums we get frequent reports of worsening of symptoms with long-term use of ointments. So please discuss with your doctor other options too. Check out our night dry eye page for suggestions about other ways to protect eyes at night.

Frequently Asked Questions

Is it okay to use preserved lubricants?

Don't use a product with benzalkonium chloride (BAK) unless specifically directed by your doctor - and even then, please ask him/her about alternatives.

Do follow your doctor's instructions. If you've been told to avoid all preservatives, for example for a period following an eye surgery, do so. Your doctor may also have particular views on which preservatives are safer than others.

For a more detailed discussion of the use of preservatives in artificial tears, see our article on preservatives.

How often should I use artificial tears?

This is controversial. Please remember that this is just a patient-run website - when in doubt, go with your doctor's advice. The following is JUST MY OPINION and I am NOT a medical professional.

There are some cases - particularly in severe aqueous deficient dry eye from primary auto-immune disease - where keeping the eyes wet with tear supplementation is a must, period, because otherwise the eyes would be at risk of abrasions or even ulceration.

But for the rest of us....

I think personally that if you are using artificial tears more often than every 2-3 hours, you should (if you haven't already) try alternative lubricants, and if you've exhausted those, then investigate some additional treatments to improve your tear film (particularly those related to meibomian gland dysfunction if applicable) and also look into eyewear and other strategies for managing pain and discomfort.

Many patients with moderate to severe dry eye symptoms from other causes (including a destabilized tear film, meibomian gland dysfunction etc) end up using artificial tears more as a means of controlling pain than as a protectant against imminent damage. It seems clear to me that in at least some of these cases, patients can do themselves harm by over-using artificial tears. Your naturally tears have substances intended to protect and nourish the eye surfaces. When your natural tear film is destabilized, overloading it constantly with watery or oily supplements can further destabilize it by basically washing the good stuff right out.

There's no magic answer for everyone of course. Some patients do seem to fare best when they use supplements whenever needed. Others have shown a distinct pattern of getting worse when they use more tears, and getting better when they use fewer.

Which products are best?

While there are definitely some perfectly useless products on the market (sorry... I'm not going to name names), there is also definitely not a "Best" product.

Take a look at our current poll results for artificial tear favorites to get a general idea how varied the responses are amongst our community members. Bear in mind that some of the products listed are actually families so it's not clear which product(s) exactly are preferred - for example, among the Genteal line, the gel is almost certainly the preferred product in our online community, but you can't tell from the poll itself. Likewise, with Systane, Systane Free (currently subject to recall) has been favored, and with Refresh, it's probably Refresh Plus by a fairly wide margin.

Taking it to a personal level for a moment... For those not familiar with my history (and the history of this website), the truth of the matter is, all of the over-the-counter eyedrops were so far from "best" for me that when I finally found some little known formulations (not in commercial production) that worked well for me and for a bunch of my dry eye cronies, I rustled up some cash and hired a contract sterile ophthalmics manufacturer to make them just to make sure none of us would ever run out. (No exaggeration! That's the story of Dakrina, Dwelle and Nutratear in a nutshell.)

But I don't want to bore you with an infomercial. The fact remains that different products work best for different people. There are no shortcuts... you need to experiment. For suggestions, perhaps start with the poll results or read patients' comments in our Drops & Goop forum. Don't forget to post about your own experiences for others' benefit.

What are gels useful for?

Gels are best for night-time use. They are thicker than artificial tears — though "liquid gels" may be somewhere in between — and theoretically last longer on the eye. For those whose dryness puts them in danger of corneal erosions at night, eye protection is critical and may doctors recommend gels for that protection. Putting a gel in both eyes and covering the eyes with an eye guard or plastic may be a useful way to keep the eyes lubricated at night. We have some concerns about build-up from gels, but we know that sometimes you gotta do what you gotta do.

When are ointments useful?

If you are a frequent ointment user because nothing else protects you long enough, I would strongly recommend reading our pages on night eye protection and on eyewear to get some fresh ideas about more natural ways to protect your eyes.

Again... this is just a layperson's opinion and NOT medical advice or science. I don’t think that classic ointments (comprised of petrolatum and mineral oi) are good for us, period. Frankly, no matter what some doctors say I am pretty much altogether against use of this stuff other than as an emergency measure to prevent abrasions at night. It basically amounts to putting vaseline in your eye. Petroleum products are good for a lot of things, but in eyes? Truth be told, the big-time eye surface wetting theorists, the PhDs of tears, all have endless very persuasive arguments why putting greasy stuff in your eye, though it may keep off tonight’s abrasion, will actually be bad for your eye longer-term because it will make it that much harder for your eyes to stay wet. While we don’t have the background or the patience to wend our way through the scientific arguments the fact is we have seen this in practice with a great many LVC patients, which makes us much more inclined to think it’s true. — Personally, I was never all that crazy about having to wipe grease out of my eyes in the morning so I was secretly relieved to find that it was thought to be a bad idea anyway.

Key

CMC = carboxyl methylcellulose sodium

HPMC = hydroxypropyl methylcellulose, hypromellose

PF = preservative free

PVA = polyvinyl alcohol. Editor's note: PVA, like methylcellulose and most other artificial tear active ingredients, is a polymer, NOT an "alcohol" in the sense of an astringent. If your eye doctor objects to an eyedrop with PVA on the basis that it "contains alcohol", flee and don't look back, because s/he clearly missed some very basic chemistry lessons.

BAK = Benzalkonium chloride (AVOID LUBRICANTS WITH THIS PRESERVATVE)

Prices: Prices are approximate and (where available) based on Drugstore.com pricing or as indicated.

Sizes: Eyedrops usually come in one of the following sizes: 15mL (0.5 fl oz), 30mL (1.0 fl oz), or single-use vials. Gel type products usually come in a 10mL tube. Ointments usually come in a 0.125 mL tube.

Notes

(1) Proprietary products available from our parent,The Dry Eye Company. See The Dry Eye Shop for details.

(2) Some people were familiar with these as part of the Dwelle/Dakrina/Freshkote "family" in past years. Freshkote is now sold as a prescription drug (Focus Laboratories). Please see the Freshkote website for more details.