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.

The new TheraTears range in New Zealand: TheraTears Dry Eye Hydration and TheraTears EXTRA preservative-free bottles

TheraTears in NZ Has Changed: What Replaced the Day and Night Drops

Q: Can I still get the old TheraTears vials or gel anywhere in NZ?

Not from the Rose Optometry online store. The old range is being phased out in New Zealand, so remaining pharmacy stock will run out. OCuSOFT Retaine CMC is the closest carmellose (CMC) equivalent to the old TheraTears vials.

Q: Is the new TheraTears preservative-free?

Yes. Both TheraTears Dry Eye Hydration (0.1% cross-linked sodium hyaluronate) and TheraTears EXTRA (0.3% sodium hyaluronate) are preservative-free multi-dose bottles, labelled for use up to 180 days after first opening.

Q: Can I use the new TheraTears with contact lenses in?

Yes. The label allows 1 to 2 drops directly onto the lens, before or after insertion, for soft, rigid, ortho-k and scleral lenses.

Q: Does TheraTears EXTRA replace TheraTears Gel at night?

TheraTears EXTRA replaces the gel in the range and is a thicker, longer-lasting 0.3% hyaluronate drop, but it is a drop rather than a gel. If you need overnight protection, a true gel or ointment is still the right tool.

Q: Where can I buy the new TheraTears in New Zealand?

TheraTears Dry Eye Hydration ($34.50) and TheraTears EXTRA ($38.10) are in stock at Rose Optometry, Hamilton, and ship NZ-wide from store.roseoptom.co.nz, with free NZ shipping on orders over $100.

TheraTears in New Zealand has changed. The familiar "day" single-use vials and the "night" gel (both carmellose) are being phased out and replaced by two preservative-free sodium hyaluronate bottles: TheraTears Dry Eye Hydration (0.1%, cross-linked) and TheraTears EXTRA (0.3%). Both are contact-lens compatible, both last 180 days after opening, and both are on the shelf at Rose Optometry, Hamilton.

If you have been buying TheraTears for years, you will have noticed the pharmacy shelf looks different. This is what has happened, what the new drops are, and how our optometrist team is moving patients across.

What happened to TheraTears Drops and TheraTears Gel?

The TheraTears you knew was a carmellose (carboxymethylcellulose, CMC) tear: a hypotonic, electrolyte-balanced formula sold as single-use "day" vials and a thicker preservative-free "night" gel. Those two products are being phased out in New Zealand. Our online store now carries the replacements, and the old TheraTears product pages redirect to them.

The brand has not gone; the chemistry has. The new TheraTears range is built on sodium hyaluronate (hyaluronic acid), the same family of molecule used in Hylo-Forte, Hylo-Fresh and Lacrifresh, in a preservative-free multi-dose bottle instead of vials.

What are the new TheraTears products?

	Old range (phased out)	New range (in stock)
Everyday drop	TheraTears Drops — carmellose 0.25%, single-use vials	TheraTears Dry Eye Hydration — cross-linked sodium hyaluronate 1 mg/mL (0.1%), 10 mL bottle, $34.50
Heavier drop	TheraTears Gel — carmellose 1%, single-use vials, night-time	TheraTears EXTRA — sodium hyaluronate 3 mg/mL (0.3%), 10 mL bottle, $38.10
Preservative	None (vials)	None (multi-dose bottle, 180 days after opening)
Contact lenses	Vials could be used with lenses	Label allows 1–2 drops directly onto the lens, before or after insertion
Blur	Gel blurred noticeably	EXTRA is thicker than Hydration but is a drop, not a gel

Both new bottles are made in Italy for Care Pharmaceuticals and distributed in New Zealand by Healthcare Logistics. They are sterile medical devices labelled for dry, dehydrated, irritated, reddened and tired eyes.

Which new TheraTears should I buy?

You used TheraTears Drops (the vials) during the day → start with TheraTears Dry Eye Hydration. It is the everyday drop: 0.1% hyaluronate, light, no blur.
You used TheraTears Gel at night, or your eyes are dry most of the day → TheraTears EXTRA. At 0.3% it is three times the hyaluronate concentration and stays on the eye longer per drop. It is not a gel, so if you need something to hold the eye through the night, a true gel or ointment such as Viscotears Gel PF or Vita-POS is still the right tool.
You wear contact lenses → either. The label allows drops over the lens. Scleral and ortho-k wearers often prefer EXTRA for the longer hold.
You want to stay on a carmellose (CMC) drop → OCuSOFT Retaine CMC is the like-for-like replacement: preservative-free carmellose in single-use vials.

Is hyaluronate better than the old carmellose formula?

Different rather than simply better. Hyaluronate holds water and thins on the blink, so it lubricates without blurring. Across trials comparing hyaluronate drops with non-hyaluronate drops (including carmellose), most studies favour hyaluronate for corneal staining and symptoms, but the differences are modest and not consistent across every measure. The old TheraTears was formulated as a hypotonic, electrolyte-balanced tear intended to counter tear hyperosmolarity, which the new range is not; what the new one does that the old one did not is give you 180 days from one bottle with no preservative, and a 0.3% option without a gel's blur.

If you want the chemistry in depth — what 0.1% versus 0.3% changes, what "cross-linked" means and where the evidence stops — read sodium hyaluronate eye drops explained.

How do I switch from the old TheraTears to the new?

Finish any vials you have; they do not need to be thrown out early.
Start with 1–2 drops in each eye, 1–5 times a day, or as your optometrist directed for the old drops.
Write the opening date on the bottle. Discard 180 days after opening.
Give it two weeks. If Hydration is not holding you by late afternoon, move to EXTRA.
If you are on EXTRA several times a day and still uncomfortable, stop buying bottles and get the cause found.

When a new drop is not the answer

Any lubricant replaces the watery layer of the tear film. In clinic-based studies, around 86% of people with dry eye show signs of meibomian gland dysfunction, where the eyelid oil glands under-deliver and tears evaporate too fast. No drop corrects that on its own. If you have been cycling through brands, the problem is the diagnosis, not the bottle.

At Rose Optometry the path is a full eye examination first (with us, or a copy of one done elsewhere in the last six months), then a Dry Eye Evaluation, where our optometrist team measures the tear film and treats the cause. It is a paid appointment; the fee is confirmed when you book.

New to Rose Optometry, or no recent examination? Book a full examination and we will line up the Dry Eye Evaluation as your next appointment. Examined within the last six months? Book a Dry Eye Evaluation, and bring a copy of the record if it was done elsewhere.

Questions we are being asked

Can I still get the old TheraTears vials or gel anywhere in NZ?
Not from our online store. The old range is being phased out in New Zealand, so remaining pharmacy stock will run out. OCuSOFT Retaine CMC is the closest carmellose equivalent.

Is the new TheraTears preservative-free?
Yes. Both Dry Eye Hydration and EXTRA are preservative-free multi-dose bottles, labelled for use up to 180 days after first opening.

Can I use the new TheraTears with contact lenses in?
Yes. The label allows 1–2 drops directly onto the lens, before or after insertion, for soft, rigid, ortho-k and scleral lenses. See eye drops for contact lens wearers.

Does TheraTears EXTRA replace TheraTears Gel at night?
It replaces it in the range, and it is the drop we would reach for first. It is not a gel. If you need overnight protection, ask us about a true gel or ointment.

What does "cross-linked" on the Hydration box mean?
The hyaluronate chains are tied to one another so the drop is designed to persist on the eye longer at the same concentration. The supporting data are laboratory and animal studies; a human trial of cross-linked against ordinary hyaluronate alone has not yet been published.

Where can I buy the new TheraTears in New Zealand?
Both are in stock at Rose Optometry, Hamilton, and ship NZ-wide from our TheraTears collection. Free NZ shipping on orders over $100, and free optometrist advice with every order.

Rose Optometry is an independent, optometrist-owned practice in Hamilton, New Zealand, established 1969. Everything linked above is in stock and dispatched by us.

Written by the Rose Optometry optometrist team. Reviewed by Jagrut Lallu — BOptom (Hons), MSc Specialty Lenses (Hons), FIAOMC. Therapeutic Optometrist & Contact Lens Specialist, Partner, Rose Optometry. Last reviewed November 2026.

This is general information, not individual clinical advice. Always read the current label and follow the advice your own optometrist has given you.

References

Ang BCH, Sng JJ, Wang PXH, et al. Sodium hyaluronate in the treatment of dry eye syndrome: a systematic review and meta-analysis. Sci Rep. 2017;7(1):9013. doi:10.1038/s41598-017-08534-5
Yang YJ, Lee WY, Kim YJ, et al. A meta-analysis of the efficacy of hyaluronic acid eye drops for the treatment of dry eye syndrome. Int J Environ Res Public Health. 2021;18(5):2383. doi:10.3390/ijerph18052383
Kim SJ, Yoo WS, Kwon LH, et al. A prospective, crossover, randomized, double-blind clinical study comparing the effectiveness and ocular comfort of 0.1% hyaluronic acid and 0.3% hyaluronic acid in patients with dry eye disease. Clin Ophthalmol. 2025;19:407-416. doi:10.2147/OPTH.S489669
Grego AL, Fankhauser AD, Behan EK, et al. Comparative fluorophotometric evaluation of the ocular surface retention time of cross-linked and linear hyaluronic acid ocular eye drops on healthy dogs. Vet Res Commun. 2024;48(6):4191-4199. doi:10.1007/s11259-024-10559-x
Lemp MA, Crews LA, Bron AJ, et al. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012;31(5):472-478. doi:10.1097/ICO.0b013e318225415a
Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: Management and Therapy. Am J Ophthalmol. 2025;279:289-386. doi:10.1016/j.ajo.2025.05.039

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