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.

Night Ointments for Dry Eye: When to Use Them and How They Differ From Drops

✔ Stock on hand — ships NZ-wide from Rose Optometry, Hamilton.

By Jagrut Lallu — BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Therapeutic Optometrist & Contact Lens Specialist. Founder, New Zealand Eye Research Centre; Partner, Rose Optometry; WCO Asia-Pacific Myopia Ambassador; International Myopia Institute NZ Ambassador; Clinical Senior Lecturer, Deakin School of Optometry; Honorary Teaching Fellow, University of Auckland.

Most patients with dry eye manage their daytime symptoms with drops. But a subset of patients — those with severe dry eye, nocturnal lagophthalmos, exposure keratopathy, or ocular surface damage — need something more than a drop can provide overnight. That is the role of ocular lubricant ointments: a distinct formulation category designed not for comfort during waking hours, but for sustained ocular surface protection across the hours of sleep.

Why Overnight Is Different

During waking hours, blinking replenishes the tear film every few seconds. The lids sweep debris from the surface, mucin and lipid are redistributed, and the ocular surface is kept moist by reflex tearing. At night, blinking largely ceases. In a fully healthy eye with complete lid closure, this is not a problem — the closed lid creates a sealed, humidified environment that protects the cornea through the night.

In dry eye disease, two problems can arise:

Incomplete lid closure (nocturnal lagophthalmos): A surprisingly common condition in which the lids do not fully close during sleep. Patients are typically unaware of it. The exposed cornea desiccates overnight, and patients wake with foreign-body sensation, grittiness, or redness that is worst in the first minutes after waking and slowly improves as blinking resumes. If this pattern describes your symptoms, mention it to your Rose Optometry optometrist.
Severe aqueous deficiency: In moderate-to-severe aqueous-deficient dry eye (Sjögren's syndrome, post-LASIK, graft-versus-host disease, severe meibomian gland dropout), the residual tear volume is insufficient to protect the cornea even across a few hours with lids closed. Drops applied at bedtime disperse within minutes; the ocular surface is unprotected for the remainder of the night.

Ointments address both problems. Their high viscosity and semi-solid formulation means they remain on the ocular surface for hours — not minutes — providing a sustained moisture-retention barrier through the night.

How Ointments Differ From Drops

Property	Lubricant Drops	Lubricant Ointments
Viscosity	Low–medium	High (semi-solid)
Duration of effect	Minutes to ~1 hour	Several hours
Vision blur on instillation	Minimal	Significant (30–60 min)
Appropriate timing	Daytime, as needed	Bedtime only
Contact lens compatible	Depends on product	No
Primary use	Symptom relief during waking hours	Overnight ocular surface protection

The blur produced by ointments on instillation is the principal reason they are not used during the day. Applied at bedtime, however, that blur is irrelevant — the eyes are closed. The same high viscosity that impairs daytime vision is precisely the property that makes ointments effective overnight.

Night Ointments Stocked at Rose Optometry

Vita-POS Eye Ointment

Vita-POS is a preservative-free lubricant ointment based on vitamin A palmitate (retinol palmitate). Vitamin A is a critical component of ocular surface health — it promotes goblet cell survival and mucin secretion, supports corneal epithelial differentiation, and has direct anti-inflammatory effects on the ocular surface. Aqueous-deficient dry eye, Sjögren's syndrome, and other severe dry eye states are associated with ocular surface vitamin A deficiency, making a vitamin A ointment a physiologically rational choice for this patient group.

Vita-POS is packaged in a single-dose tube. The preservative-free formulation eliminates the concern about nightly benzalkonium chloride (BAC) exposure — a significant consideration given that BAC is already the most common preservative on the already-compromised ocular surfaces of severe dry eye patients (see our guide to preservative-free drops).

Application: At bedtime, gently pull down the lower eyelid and instil a 1cm ribbon of ointment into the lower fornix. Close the eye and blink gently to distribute. Vision will be blurred; this resolves on waking.

Poly Visc Eye Ointment

Poly Visc is a paraffin-based lubricant ointment using liquid paraffin and white soft paraffin as its active components. The paraffin base provides an excellent moisture-retention barrier — it is hydrophobic, which means it slows aqueous tear evaporation while retaining the moisture already present beneath the ointment film. This is mechanically different from vitamin A ointments: Poly Visc does not provide vitamin A-mediated epithelial support, but its moisture-barrier effect is robust and well-tolerated.

Poly Visc is indicated for nocturnal lagophthalmos, exposure keratopathy, and severe evaporative dry eye where the primary overnight need is physical moisture barrier rather than vitamin A supplementation. It is also useful post-oculoplastic surgery when the lids are temporarily incompetent.

Application: As for Vita-POS — at bedtime, into the lower fornix, with eye closure. Poly Visc has a slightly firmer texture than Vita-POS; warming the tube briefly between the palms before use makes expression easier.

Which Ointment — Vita-POS or Poly Visc?

The choice depends on the clinical indication:

Aqueous-deficient dry eye, Sjögren's, post-LASIK severe dry eye, ocular surface mucin deficiency: Vita-POS — the vitamin A support is clinically relevant.
Nocturnal lagophthalmos, exposure keratopathy, post-surgical lid incompetence, evaporative dry eye: Poly Visc — the paraffin moisture barrier is the primary need.
Uncertain: Ask your Rose Optometry optometrist. Both can be trialled; switching is straightforward if the first choice is not providing sufficient overnight relief.

In some patients with both severe aqueous deficiency and lagophthalmos, both ointments are used on alternating nights, or Vita-POS is used most nights with Poly Visc reserved for nights when symptoms are particularly severe.

Using Ointments Safely

Bedtime only. Ointments should not be used during waking hours unless specifically directed by your clinician.
Not with contact lenses. Remove all lenses before applying ointment; reinsert lenses only after the ointment has cleared from the surface, typically the following morning.
Don't drive. Significant blur after instillation; never apply and then drive or operate machinery.
Discard after the recommended period. Even in tubes, ointments can become contaminated with repeated use. Follow the in-use expiry on the packaging.

Browse our complete Rose Optometry dry eye product range — all stocked on hand in Hamilton, with free optometrist advice included with every NZ order. Not sure where to start? Our full dry eye drop formulary covers every product category.

References

Jones L, et al. TFOS DEWS III: Management and Therapy. American Journal of Ophthalmology. 2025;279:289-386.
Aragona P, et al. The role of vitamin A in the treatment of ocular surface diseases. Cornea. 2013;32 Suppl 1:S1–7.
Ezuddin NS, et al. Nocturnal lagophthalmos and its management. Eye Contact Lens. 2020;46(5):283–287.

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