Red eyes, blurry vision and stuff like that

If you get tired, gritty, dry eyes, and go into a pharmacy, the range of drops that will confront you can be daunting.  Every day I spend time with people who have tear film disorders, the underlying cause of dry eye, and very few have had a rational approach to which tear drops/ artificial tears/ lubricant eye drops they have chosen for themselves.

Here are some things then about drops for dry eye:

• Artificial tears come in a range of ‘thicknesses’ or viscosities.  At the ‘thinner’ end, the drop will act more like an eye wash than anything else – making the eyes feel better for a little while, and not interfering with vision – but their effect is quite short lasting. The other ‘thinner’ end of the spectrum is an eye ointment – effectively preventing the eye drying out for a long time, but it’s so thick and gluggy that vision isn’t much good.  The best drop for you will be somewhere along that spectrum.
• Artificial tears can come in multi-dose bottles or boxes of single dose units.  In general, the multi-dose bottles need to be discarded after a month, so if you only need drops ocassionally, you may get better value out of the single dose option.  Single dose drops are preservative free, so have to be used up when opened.
• Some drops contain an eye whitening agent, that shrinks the blood vessels on the surface of the eye.  They can be useful if used infrequently, but aren’t good for longer term use.  This is because the eyes ‘get used’ to receiving the drop, and end up going red if you don’t put the drops in.  Some people end up in a bad cycle of continuing use of these drops when the best thing for their red eyes would actually be to stop using the drop. See more about these drops for red eye here.
• Some drops contain an anti-histamine, which reduces the eye’s allergic response.  If allergy isn’t the cause of your dry eye, anti-histamines won’t help your eyes.
• Timing/ frequency of drops for dry eye is important in treatment.  Just getting the right drop isn’t the end of the story.

And some things about dry eye:

• On examining eyes it’s often possible to determine the likely cause of the dryness.  Is it because not enough tears are being produced, or are they unstable, or are they drying up too quickly, or are the dry eye symptoms coming as a secondary effect of something else happening in the eyes?
• Artificial tears are one way that dry eye symptoms can be treated, but there are a range of different treatments, ranging from anti-inflammatories, to environmental change, nutritional supplements, eyelid hygiene, punctal plugs which reduce tear drainage etc.  So don’t imagine that you’re stuck with dry eye just because you’ve tried some drops and they didn’t fix it right away.

The main thing before starting to treat yourself for dry eye is to get your eyes examined, and so to maximise the likelyhood of getting put onto the best option for you from the start.