If you’ve experienced dry or red eyes, chances are you reached for eye drops in your medicine cabinet for some relief. It’s important to know that not all over-the-counter eye drops are created alike, so you should make sure you’re using the right ones for the issues you’re experiencing. Eye drops or artificial tears are intended to lubricate the eye and come in a few varieties. There are eye drops with preservatives, preservative-free artificial tears, lipid-based artificial tears and more. The right type will depend on your eye health and issues.
It can be overwhelming to walk into the eye care aisle at your local pharmacy since there are many eye drops for sale with different purposes. Remember to always consult with your eye doctor when in doubt. We spoke to various experts to narrow down their top choices in eye drops based on different needs. Below are their top eye drop picks for when you’re in a pinch.
Best eye drops of 2023
How we evaluated the best eye drops
We consulted with ophthalmologists and optometrists who prescribe eye drops to patients regularly and are familiar with the many OTC brands on the market.
How to pick eye drops
Before buying any type of eye drops, it’s important to speak with your doctor so they can evaluate your issue. In some cases, OTC eye drops are sufficient, but in other situations you may need prescription medicated drops.
If your issue can be resolved with OTC eye drops, you should know that there are drops with preservatives and others without them. The preservative-free eye drops are generally safe for most people — including pregnant people — and can be used every hour or as directed. Drops with preservatives should be used more conservatively because they can worsen some cases. The same is true for other drops, such as the ones for redness relief.
“Poor-quality artificial tears, or ones that tout the red out, often have chemicals that can cause problems including rebound redness, dilation of the eyes, corneal toxicity, blurred vision and worsening of dry eye disease,” Koetting warned.
Dr. Edmund Farris, an associate clinical professor of ophthalmology at Mount Sinai, added that these preservatives have the ability to change aspects of the eye. He said, “the preservatives in most drops can alter the corneal surface and cause loss of these superficial corneal cells, which may eventually lead to more symptoms.” So if you’re using these types of drops too often, this can become an issue.
Some signs to look out for if you think you’re having a negative reaction to eye drops include redness that gets worse, irritation, blurred vision and a burning or grittiness sensation. Oftentimes this occurs due to the preservatives found in some drops. Koetting said that if these symptoms don’t improve, it can indicate an allergy or sensitivity to the drops. “However, if a person notices that they are having an increase in itching, swelling around the eye or the whites of the eyes become swollen and red, they should immediately discontinue the drop and call an eye care professional,” she added.
When eye drops aren’t enough
In some cases you may need steroids or other medicated treatments if OTC eye drops are not doing their job.
“Oftentimes, dry eye disease has multiple causes, and will take multiple treatments to see improvement,” Lighthizer said. He added that a patient with mild to severe dry eye may require multiple treatments, including OTC artificial tears (usually preservative-free) along with a prescription dry eye drop.
According to Koetting, a good rule of thumb to follow is if the symptoms have minimal improvement over two weeks or if you find yourself using over the counter artificial tears more than twice a day. “We know that dry eye disease is a chronic problem that can flare depending on the season and the patient will likely need to be evaluated for appropriate care and then monitored,” she said.