Choosing and using Eye Drops

How to choose an eye drop

  • For mild dry eyes, hypromellose eye drops have traditionally been used to act as artificial tears. These often need to be applied frequently to achieve maximum benefit.
  • Carbomers cling to the eye surface and can help reduce frequency of application to four times a day.
  • Polyvinyl alcohol increases the strength of the tear film and is useful when there is not enough mucin on the eye surface.
  • Other ingredients such as polyethylene glycol are added lubricants that improve the moisturising ability of the eye drops.
  • For moderate dry eyes, sodium hyaluronate is the ingredient of choice. It is a naturally occurring lubricant, found in our eyes and joints.
  • The amount of sodium hyaluronate varies and is expressed as a percentage. The lowest concentration is 0.1% and the highest is 0.4% in Clinitas Soothe. Higher concentrations can give a thicker drop.
  • The combination product Thealoz Duo contains both trehalose and sodium hyaluronate 0.15% providing a unique alternative.
  • Some oily eye drops are particularly good if this layer of the tears needs improving. Emustil and Eye Logic are examples.
  • Some thicker formulations such as gels and ointments containing paraffin, carboxymethylcellulose or carbomer can be useful for overnight use as they stay longer in the eyes.

You can use eye drops as often as necessary through the days, for example every hour, although every few hours is usually sufficient with newer products. If you need to apply them more frequently than four times a day and over the long term, choose a preservative free version. This is because our eyes can react to preservatives and aggravate dry eye symptoms.

As a general rule, if eyes are dry in the morning after the eyes have been closed overnight, blepharitis is the problem. If eyes become dry throughout the day, then evaporation of tears from the eye's surface is the cause.

Finally, if an eye drop doesn't seem to be helping, choose another with a different lubricant. It can take trial and error to find the drop that is right for you.

How to insert eye drops

To insert eye drops, gently pull down the lower eyelid and squeeze the drop into the pocket formed. To stop the drop flowing away, close the lid for ten seconds and gently apply pressure to the inner corner of the eye for at least a minute. This stops it draining into the nose. You only need to insert one drop, any more than this and it will be diluted or overflow. Wait about thirty minutes before inserting another type of drop.

Eye ointments are applied in the same way, by squeezing a small amount into the pocket formed when the eyelid is gently lowered. It should melt rapidly and blinking helps to spread it.