Many factors can cause dry eyes. Over-the-counter (OTC) artificial tears can treat dry eyes. If someone does not experience relief from OTC treatments, they may need prescription eye drops.

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Artificial tears are eye drops that help to lubricate dry eyes. They add extra fluid to the eyes and can help relieve the symptoms of dryness.

People may experience dry eyes for many reasons, such as tiredness, eye strain, or dry environments. In some cases, dry eyes can be due to an underlying medical condition.

In this article, we look at different types of artificial tears and how they may help relieve dry eyes.

Dry eyes can affect anyone. Usually, tear glands produce tears that keep the eyes wet and well-lubricated. People may get dry eyes if the tears are not able to provide enough moisture to the eye, which could happen because:

  • the tear glands are not producing enough tears to keep the eyes well-lubricated
  • the tears are drying up too fast
  • the tears are not effective enough at keeping the eyes wet

In addition, some environmental and lifestyle factors may cause dry eyes. These include:

  • dry or windy climate
  • smoky environment
  • air conditioning
  • eye strain from using a computer or not blinking regularly enough when looking at a screen
  • tiredness

Certain risk factors can also increase the likelihood of dry eyes, which includes people who:

  • are aged 50 years or older
  • are female and have hormonal changes due to oral birth control use, pregnancy, or menopause
  • wear contact lenses
  • do not get enough vitamin A or omega-3 fatty acids
  • have certain medical conditions, such as diabetes, thyroid issues, or some types of autoimmune conditions, including lupus and Sjögren’s disease
  • have inflammation of the eye or eyelids
  • take certain medications, such as antihistamines, decongestants, blood pressure medications, or antidepressants, all of which may decrease tear production
  • undergo refractive eye surgery

If people have dry eyes, they may experience the following:

  • scratchy sensation, as if something is in the eye
  • stinging or burning sensation in the eye
  • red eyes
  • blurred vision
  • increased sensitivity to light

People may find relief for mild cases of dry eyes with OTC eye drops. OTC eye drops work to provide artificial extra tears, or fluid, to cover the cornea and conjunctiva, which make up the surface layer of the eye.

A 2016 review of 43 randomized controlled trials found that OTC artificial tears may be a safe and effective treatment option for dry eyes. However, researchers still need further evidence to support this. The review suggests that most OTC eye drops have similar effects.

If people find that OTC eye drops are not effective in treating dry eyes, they may need prescription eye drops.

A doctor may prescribe cyclosporine (Restasis, Cequa) or lifitegrast (Xiidra) to treat more severe cases of dry eyes. These eye drops help the eyes produce more tears or target sources of inflammation that may fuel dry eyes.

People can choose between eye drops with preservatives and preservative-free eye drops.

Some eye drops contain preservatives to stop bacteria from growing within the mixture once people open the product seal. Some people may find that eye drops with preservatives cause irritation to the eyes, particularly if these individuals have severe eye dryness.

According to the American Academy of Ophthalmology, eye doctors usually recommend that people use eye drops with preservatives no more than four times every day.

If people find that eye drops with preservatives cause irritation, or they need to use eye drops more than four times a day, they may be best with preservative-free eye drops.

Preservative-free eye drops contain fewer additives and may suit people who have moderate-to-severe cases of dry eyes.

People will usually be able to treat mild cases of dry eyes with OTC eye drops. If OTC eye drops are not effective, people may need to see their doctor for prescription eye drops.

It is usually safe for people to use preservative-free artificial tears as often as they need to. If people use artificial tears with preservatives, they should use them no more than four times a day, or as the instructions or a doctor advises.

People may experience some side effects from using artificial tears, including blurred vision. For this reason, people may find it best to use artificial tears before sleeping or when resting.

In some cases, artificial tears may cause an allergic reaction. People will need to stop using the eye drops and contact their doctor straight away if they experience any of the following symptoms:

  • swelling
  • itching
  • difficulty breathing
  • dizziness
  • nausea

If people continue to have dry eyes that do not respond to artificial tears, they may need further treatment. This may include the following:

  • blocking the tear ducts with small plugs to prevent tears from draining or undergoing surgery to block the tear ducts permanently
  • increasing omega-3 fatty acid intake through the diet or supplements
  • decreasing inflammation around the eye with warm compresses, lid massage, or eyelid cleaners

People can talk with their doctor to learn more about the additional treatment options available to them.

People may experience dry eyes for a variety of reasons, which can include:

  • dry or windy environments
  • medical conditions, such as an autoimmune condition
  • tiredness
  • eye strain, such as from using a computer or smartphone for long periods
  • lack of vitamin A or omega-3 fatty acids

OTC artificial tears, in addition to dietary and lifestyle modifications, are usually the first treatment option for dry eyes. If people are not experiencing any relief from OTC treatments, they may need prescription eye drops.

People may find that preservative-free eye drops cause less irritation, and people can use them more frequently throughout the day.

If people have persistent dry eyes that do not improve with the use of artificial tears, they may need to see a healthcare professional for an eye test to check for any underlying conditions.