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.

LinX continuous glucose monitor sensor for tracking blood sugar levels in NZ

Normal Blood Sugar Levels in NZ: HbA1c, Glucose Targets and What They Mean for Your Eyes

By the Rose Optometry optometrist team, Hamilton. General information only — your GP or diabetes team sets your personal targets. Numbered references are listed at the end.

New Zealand reports blood glucose in mmol/L and HbA1c in mmol/mol, which is why numbers from American websites (mg/dL and percentages) look so different. Here are the ranges used here, including the HbA1c thresholds that changed in 2026, and why an optometrist pays attention to them.

Blood glucose levels (mmol/L)

Measure	Value	Source
Fasting glucose, prediabetes range in NZ	6.1 to 6.9 mmol/L	[1]
Fasting glucose, diabetes range	7.0 mmol/L or above	[1,2]
Random glucose with symptoms, diabetes range	11.1 mmol/L or above	[1,2]
Two hours into a glucose tolerance test, prediabetes range	7.8 to 11.0 mmol/L	[1]
Low blood glucose (a hypo), as treated in NZ	Below 4.0 mmol/L	[1]

So in someone without diabetes, fasting glucose is usually below about 6.0 mmol/L. In a study of 153 healthy people wearing a glucose sensor, average glucose was 5.4 to 5.5 mmol/L and they spent a median of 96% of the time between 3.9 and 7.8 mmol/L [3]. One abnormal reading is not a diagnosis; your GP confirms it with proper testing [1].

HbA1c levels in NZ — changed in 2026

HbA1c is a blood test that reflects your average glucose over roughly the past two to three months [2,4]. New Zealand lowered its diagnostic thresholds, with national implementation from 1 July 2026 [5]:

HbA1c (mmol/mol)	What it means
41 or below	Normal [4,5]
42 to 47	Prediabetes (previously 41 to 49) [5]
48 or above	Diabetes (previously 50 or above) [5]

If you have no symptoms, a result of 48 to 52 needs a second confirming test; a result of 53 or above does not [1,5]. If you were told your result under the old ranges, ask your GP what it means now.

Prediabetes: the stage worth catching

Prediabetes means glucose is higher than normal but not yet in the diabetes range. In the Diabetes Prevention Program trial of 3,234 US adults at high risk, a lifestyle programme aiming for at least 7% weight loss and 150 minutes of activity a week reduced the development of type 2 diabetes by 58% over about three years [6]. New Zealand guidance recommends earlier testing for people with risk factors such as Māori, Pacific or South Asian ethnicity, a family history of diabetes, previous diabetes in pregnancy, high blood pressure or smoking [1].

HbA1c vs time in range

HbA1c is an average, so it hides the swings. A continuous glucose monitor (CGM) reports time in range: the share of the day spent between 3.9 and 10.0 mmol/L. International consensus suggests more than 70% for most adults with diabetes [7].

Why your blood sugar matters to your eyes

Diabetic retinopathy. Long-term raised glucose damages the small blood vessels of the retina, and retinopathy is a leading cause of preventable vision loss in working-age adults [8]. In type 1 diabetes, intensive glucose control reduced the risk of developing it by 76% [9]. More time in range is also linked with less retinopathy in observational studies [10,11]. Read our guide to diabetic retinopathy and diabetes eye checks.
A glasses prescription that shifts. After very high glucose is corrected, a temporary long-sighted shift can appear within about a week and take from two weeks to about three months to settle [12]. Tell your optometrist if your glucose has been changing.
Earlier cataract. In a UK study of 56,510 people with diabetes, cataract was diagnosed about twice as often as in the general population, with the greatest extra risk at ages 45 to 54 [13].

Ways to check your glucose

HbA1c blood test through your GP — the long-term average, and the test used for diagnosis.
Finger-prick meter — a blood reading at one moment.
Continuous glucose monitor — a sensor that tracks glucose day and night. We stock the LinX 15-day CGM in our wearables range. ✔ Stock on hand — ships NZ-wide from Rose Optometry, Hamilton. A CGM is not a diagnostic test.

Common questions

What HbA1c is prediabetes in NZ?

42 to 47 mmol/mol since the 2026 change. 48 mmol/mol or above is in the diabetes range [5].

What is a normal fasting blood sugar?

Usually below about 6.0 mmol/L; in New Zealand 6.1 to 6.9 is the prediabetes range and 7.0 or above the diabetes range [1].

Can blood sugar changes blur my vision?

Yes. A temporary change in focus has been measured after high glucose is corrected, lasting weeks to months [12]. Any sudden change in vision should be checked promptly.

How do I lower my blood sugar?

That depends on why it is high. Work through it with your GP or diabetes team rather than changing medication on your own.

References

New Zealand Society for the Study of Diabetes. Type 2 Diabetes Management Guidance. t2dm.nzssd.org.nz (accessed October 2026).
American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1). doi:10.2337/dc26-S002
Shah VN, DuBose SN, Li Z, et al. Continuous glucose monitoring profiles in healthy nondiabetic participants: a multicenter prospective study. J Clin Endocrinol Metab. 2019;104(10):4356-4364. doi:10.1210/jc.2018-02763
Health New Zealand. Understanding your HbA1c results. healthnz.govt.nz (accessed October 2026).
Health New Zealand. Changes to the HbA1c threshold for diagnosing diabetes and prediabetes in New Zealand. 8 June 2026. healthnz.govt.nz
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403. doi:10.1056/NEJMoa012512
Battelino T, Danne T, Bergenstal RM, et al. Clinical targets for continuous glucose monitoring data interpretation: recommendations from the International Consensus on Time in Range. Diabetes Care. 2019;42(8):1593-1603. doi:10.2337/dci19-0028
Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet. 2010;376(9735):124-136. doi:10.1016/S0140-6736(09)62124-3
Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977-986. doi:10.1056/NEJM199309303291401
Beck RW, Bergenstal RM, Riddlesworth TD, et al. Validation of time in range as an outcome measure for diabetes clinical trials. Diabetes Care. 2019;42(3):400-405. doi:10.2337/dc18-1444
Lu J, Ma X, Zhou J, et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care. 2018;41(11):2370-2376. doi:10.2337/dc18-1131
Okamoto F, Sone H, Nonoyama T, Hommura S. Refractive changes in diabetic patients during intensive glycaemic control. Br J Ophthalmol. 2000;84(10):1097-1102. doi:10.1136/bjo.84.10.1097
Becker C, Schneider C, Aballéa S, et al. Cataract in patients with diabetes mellitus — incidence rates in the UK and risk factors. Eye (Lond). 2018. doi:10.1038/s41433-017-0003-1

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