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.

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TheraTears

TheraTears EXTRA Dry Eye Hydration Preservative-Free Eye Drops 10ml (Hyaluronate 0.3%)

Name: TheraTears EXTRA Dry Eye Hydration Preservative-Free Eye Drops 10ml (Hyaluronate 0.3%)
Brand: TheraTears
SKU: 9317039003263
Price: 38.10 NZD
Availability: InStock

TheraTears EXTRA Dry Eye Hydration Preservative-Free Eye Drops 10ml (Hyaluronate 0.3%)

$38.10 NZD

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TheraTears EXTRA Dry Eye Hydration is the stronger of the two new TheraTears drops: sodium hyaluronate 3 mg/mL (0.3%), preservative-free, in a 10 mL multi-dose bottle, $38.10. It replaces the TheraTears night-time gel we used to stock — a heavier, longer-lasting drop for eyes that are dry most of the day, without the blur of a gel.

What it is

Active: sodium hyaluronate (hyaluronic acid) 3 mg/mL — three times the concentration of TheraTears Dry Eye Hydration.
Preservative-free multi-dose bottle, 10 mL. Use within 180 days of first opening.
Contact lens compatible: the label allows 1–2 drops directly onto the lens, before or after insertion.
Indicated on the label for dry, dehydrated, irritated, reddened and tired eyes; suitable for sensitive eyes.
Made in Italy for Care Pharmaceuticals (Sydney); distributed in New Zealand by Healthcare Logistics. Sterile medical device.

Who it's for

Persistent, all-day dryness — the person who used to need a gel at night but hated the blur.
Eyes that are gritty by late afternoon on a 0.1% drop.
Contact lens wearers with longer wearing days, including scleral and ortho-k wearers who need a drop that can go in over the lens.
Anyone who has been told to stop using preserved drops, or who uses drops many times a day.
For occasional, mild dryness the lighter TheraTears Dry Eye Hydration is usually enough.

How to use

Wash and dry your hands.
Instil 1–2 drops in each eye, 1–5 times daily, or as directed by your optometrist.
Contact lens wearers: 1–2 drops directly onto the lens, before or after insertion.
Don't touch the dropper tip to the eye or any surface. Store between 5°C and 35°C. Discard 180 days after opening.

Not for children under 1 year. Children's drops must be given by an adult. If you are pregnant, breastfeeding or have a medical condition, check with your optometrist or doctor first. If irritation persists, stop and get your eyes looked at.

The honest caveat

A 0.3% hyaluronate is thicker and stays on the eye surface longer than a 0.1% drop — tear-film imaging studies show the extra volume persisting for around ten minutes rather than three. Head-to-head trials have not shown a clear difference in symptoms between the two strengths, though, so think of this as a longer-lasting feel per dose rather than a stronger medicine. It still only replaces the watery layer of the tear film. In clinic studies most people with dry eye show signs of meibomian gland dysfunction — the eyelid oil glands under-deliver and tears evaporate too fast — and that needs treating at the lids, not with ever-stronger drops. If you need this bottle several times a day, every day, the next step is a full eye examination (with us, or a copy of one done elsewhere in the last six months) followed by a Dry Eye Evaluation, where we measure the tear film and find the cause. It's a paid appointment; the fee is confirmed when you book.

Questions we get asked

Is this a gel? Does it replace TheraTears Gel?
It replaces the gel in our range, but it is a drop, not a gel. It is thicker than the 0.1% version and lasts longer, with far less blur than a true gel. If you genuinely need something to hold your eyes through the night, a gel or ointment is still the right tool — ask us. What changed and why is in TheraTears in NZ has changed.

0.3% versus 0.1% — which should I buy?
Start with 0.1% for occasional dryness and 0.3% for dryness that is there most of the day or by the end of it. If neither keeps you comfortable, that is a sign to be assessed, not to buy a third bottle. We lay the whole range out by strength and chemistry in the Rose Optometry dry eye drop formulary, and what the percentages actually change in sodium hyaluronate eye drops explained.

Can I use it with contact lenses in?
Yes — the label allows 1–2 drops directly onto the lens, before or after insertion. It suits scleral and ortho-k wearers who want a thicker drop that is still lens-safe. See eye drops for contact lens wearers.

How does it compare with Hylo-Forte?
Hylo-Forte is a 0.2% preservative-free hyaluronate in the COMOD pump bottle; TheraTears EXTRA is 0.3%, the same strength as Lacrifresh Ocu-Dry 0.30%. They are close relatives — the differences are the strength, the bottle system and the other ingredients — and people often simply prefer the feel of one over another. If one isn't holding you, try the other before concluding that drops don't work.

Why preservative-free?
Preservatives keep a bottle sterile; they do nothing for your eye. Benzalkonium chloride, the commonest one, can damage the surface cells of the eye with frequent or long-term use, and a soft lens can soak it up and release it slowly. That is why preservative-free is the standard advice for moderate to severe dry eye, for anyone using drops many times a day, and generally for contact lens wearers. More in preservative-free eye drops: why they matter and the preservative-free range.

Why buy from Rose Optometry

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