What are the best eye drops for dry eyes?

There is no single “best” eye drop for dry eye, as treatment depends on the underlying cause. According to the TFOS DEWS III framework, dry eye is a multifactorial disease involving tear film instability, inflammation, and ocular surface damage. For many patients, preservative-free lubricating eye drops are recommended as first-line therapy, particularly for frequent or long-term use. An optometrist can help select drops based on tear quality, evaporation rate, and ocular surface findings.

How often should I use eye drops for dry eyes?

The frequency of eye drop use depends on symptom severity and the type of drop used. Preservative-free drops may be used multiple times per day, whereas preserved drops should be used less frequently to avoid ocular surface irritation. If drops are needed more than 4–6 times daily, clinical guidance generally recommends preservative-free formulations and a dry eye assessment.

Can you use eye drops too often?

Yes. Overuse of preserved eye drops can worsen dry eye symptoms by disrupting the tear film and irritating the ocular surface. DEWS III emphasises minimising preservative exposure and addressing underlying causes—such as meibomian gland dysfunction or inflammation—rather than relying solely on frequent lubrication.

What is the difference between Polytears, Systane, and Hylo eye drops?

Polytears, Systane, and Hylo are lubricating eye drops, but they differ in formulation, viscosity, and preservative status. Some are better suited for mild, intermittent dryness, while others are designed for more persistent symptoms or contact lens wear. Brand name alone does not determine suitability; clinical evaluation does.

Are preservative-free eye drops better for dry eyes?

For many patients, yes. Preservative-free eye drops are commonly recommended for moderate to severe dry eye, frequent use, contact lens wear, and sensitive eyes. DEWS III highlights that long-term preservative exposure can contribute to ocular surface irritation in some people.

Can contact lens wear make dry eye worse?

Contact lenses can exacerbate dry eye symptoms by disrupting tear film stability and increasing evaporation. However, with appropriate lens materials, care systems, and compatible eye drops, many contact lens wearers can remain comfortable. Drops labelled as safe for use with contact lenses are typically preferred during lens wear.

How do I know which eye drops are right for me?

Dry eye is not a single condition. Effective management requires identifying whether symptoms are driven by evaporation, aqueous deficiency, inflammation, or eyelid disease. A dry eye assessment—including tear stability, ocular surface staining, and meibomian gland evaluation—helps guide targeted treatment rather than trial-and-error.

Are thicker eye drops better than watery ones?

Not always. Thicker drops may provide longer relief but can blur vision and may not be ideal for daytime use. Thinner drops may be better tolerated but may require more frequent application. DEWS III supports matching drop viscosity to symptom pattern and lifestyle needs.

Can dry eye be treated without eye drops?

Yes. While lubricating drops are commonly used, DEWS III emphasises a stepwise approach that may include eyelid hygiene, heat therapy, management of meibomian gland dysfunction, environmental modification, and lifestyle changes such as reducing prolonged screen use. Eye drops often remain part of treatment when symptoms affect comfort or visual quality.

When should I see an optometrist for dry eyes?

Seek professional assessment if symptoms are persistent, worsening, or affecting activities such as reading, screen use, or driving. Ongoing reliance on eye drops without improvement suggests an underlying issue that may require targeted treatment.

Lid Hygiene: The Foundation of Dry Eye Management

Author: Jacqueline Rowe, BSc Chemistry, BOptom. Partner Optometrist, Rose Optometry; New Zealand Eye Research Centre.

Published by the New Zealand Eye Research Centre. General information only — not a substitute for a personalised assessment.

If there is one habit that underpins nearly every dry eye and blepharitis treatment plan, it is lid hygiene. It is simple, inexpensive and evidence-based — and yet it is the step people most often skip. Here is why it matters and how to do it properly.

Why your eyelids need cleaning

The eyelid margins host oil glands (meibomian glands) and lashes. When debris, makeup, bacteria and thickened oil build up along the lid margin, they clog the glands and trigger inflammation — driving blepharitis, meibomian gland dysfunction and evaporative dry eye. Cleaning the lids clears that build-up and lets the glands work.

The TFOS evidence

The Tear Film and Ocular Surface Society (TFOS) Lifestyle Report highlights how everyday factors — cosmetics, contact lenses, screen use and environment — affect the ocular surface, and reinforces lid hygiene as a foundational management step. It is not a fringe idea; it is mainstream ocular-surface care.

How to do lid hygiene well

Warmth first — a warm compress softens hardened oil in the glands.
Clean the lid margin — use a purpose-made lid cleanser (foam, gel or spray) rather than improvising with soap, which can sting and dry the skin.
Be gentle and consistent — daily is better than occasional deep-scrubbing.

A note on choosing products — and a NZ colleague we admire

Modern lid cleansers are formulated to cleanse without stripping moisture or clogging pores. One range we stock is Elin Eyes, created by New Zealand optometrist Adele Jefferies, founder of Illume Eye Care in Auckland and past President of the Cornea and Contact Lens Society of New Zealand. Adele developed Elin Eyes with reference to the TFOS Lifestyle Report, and we are glad to support a fellow NZ optometrist making genuinely well-formulated products. You can learn more at elineyes.co.nz. For lid-margin bacterial load, hypochlorous acid sprays such as SteriLid and OcuSoft HypoChlor are another well-tolerated option; for demodex, tea-tree-based cleansers like OcuSoft Oust Demodex are used.

Talk to us

Lid hygiene is simple but the details matter, and the right product depends on what is driving your symptoms. At Rose Optometry, backed by the New Zealand Eye Research Centre, we will show you the technique and match the cleanser to your eyes.

References

Craig JP, Alves M, Wolffsohn JS, et al. TFOS Lifestyle Report Executive Summary. Ocul Surf. 2023;30:240–253.
Sabeti S, Kheirkhah A, Yin J, Dana R. Management of meibomian gland dysfunction: a review. Surv Ophthalmol. 2020;65(2):205–217.

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