Key takeaways

  • Many types of eye drops are available for treating dry eyes. Over-the-counter (OTC) options are often effective, but a doctor may recommend prescription options if they aren’t.
  • Preservative-free eye drops may reduce the side effects associated with drops containing preservatives, but they may also be more expensive and have a higher risk of bacterial contamination if used incorrectly.
  • The best type of eye drops for a specific person can depend on the underlying cause of their dry eyes.

Dry eye syndrome, also known as dry eyes, occurs when the body can’t adequately lubricate the surface of the eyes.

The two main types are:

  • Evaporative dry eyes: This means there is a deficiency in the oily layer of your tear film, often due to dysfunction of your meibomian gland. Basically, it means your tears evaporate too quickly.
  • Aqueous-deficient dry eyes: These occur when your tear glands don’t produce enough tears.

Generally, over-the-counter (OTC) eye drops are the first-line treatment for dry eyes. If these aren’t effective, prescription-strength drops can help reduce inflammation, stimulate tear production, or prevent tears from evaporating.

The following are types of eye drops available without a prescription.

Allergy eye drops (antihistamine drops)

Dry eyes and allergies from environmental exposures can share similar symptoms. Environmental pollutants can include:

  • pollen
  • dust mites
  • pet dander
  • smoke

Antihistamine eyedrops can potentially improve allergy eye symptoms, particularly itching, which may further irritate your eyes. Some of the OTC antihistamine drops approved in the United States include:

  • ketotifen (Zaditor and Alaway)
  • pheniramine (Naphcon-A, Visine Allergy, and others)
  • olopatadine (Pataday)

Keep in mind that it’s also possible for antihistamines to worsen dry eye symptoms. Speak with a medical professional about which drops may be right for you.

Lubricating eye drops (artificial tears)

Artificial tears are available without a prescription to help moisturize your eyes. The two main types are preservative-containing and preservative-free.

Preservative-free artificial tears may help reduce side effects associated with preservatives, such as stinging or eye irritation. However, they may also have a higher risk of bacterial contamination if, for example, they come in a single-use container and are used more than once.

Products without preservatives may be more expensive as well.

Many common formulas can be effective. Active ingredients you may find in OTC products include:

  • cellulose derivatives:
    • carboxymethylcellulose (CMC)
    • hypromellose
    • hydroxyethylcellulose
    • methylcellulose
  • dextran 70
  • gelatin
  • polyols:
    • glycerin
    • polyethylene glycol (300, 400)
    • polysorbate 80
  • polymers
    • polyvinyl alcohol
    • polyvinyl pyrrolidone

Anti-redness drops

Anti-redness eyedrops are designed to reduce irritation and red eyes.

The American Academy of Ophthalmology (AAO) recommends avoiding red eye relief drops since they often contain ingredients that constrict your blood vessels and might make redness worse over time. They particularly recommend staying away from products containing naphazoline and tetrahydrozoline.

If OTC medications aren’t enough to relieve your symptoms, a doctor may write you a prescription for something stronger.

Cyclosporine (Cequa, Restasis, Vevye)

Cyclosporine is an immunosuppressant drug that helps your body produce more tears. It’s sometimes prescribed for chronic dry eyes.

Lifitegrast (Xiidra)

Xiidra works by reducing inflammation to help support your eye’s ability to produce tears.

Perfluorohexyloctane (Miebo)

Miebo treats dry eyes by targeting tear evaporation.

Anti-inflammatory eye drops

Anti-inflammatory eye drops might contain steroids. A doctor may recommend these drops if you have an underlying medical condition, like an eye infection.

Steroid drops include:

  • prednisolone (Pred Forte)
  • dexamethasone (Dextenza and others)
  • fluorometholone (Flarex)
  • loteprednol (Eysuvis, Lotemax, and others)

Antibiotic eyedrops

If you have a bacterial eye infection or have an upcoming eye procedure, your doctor may prescribe antibiotic drops. These eye drops are only available with a prescription and include:

  • erythromycin (generic)
  • azithromycin (AzaSite)
  • ciprofloxacin (Ciloxan)

You may also be able to relieve dry eyes with other remedies, such as:

  • eye masks and moisture goggles
  • humidifier for increasing moisture in your home
  • wrap-around glasses to reduce weather effects
  • scleral lenses, a type of contact lenses that fit over the white of your eye
  • medical devices and procedures, such as:
    • intense pulsed light
    • thermal pulsation therapy
    • eye inserts
    • punctal occlusion
    • eyelid surgery
    • radiofrequency
    • amniotic membrane grafting
    • autologous serum eye drops, which are made from your blood and more closely resemble real tears than other eye drops

The best eye drops for people with evaporative dry eyes are drops that list oil in the ingredients or mention “evaporative dry eyes.” For people with dry eyes caused by a lack of eye moisture, most types of eye drops can be effective. Preservative-free formulations are considered to have the fewest side effects if they are used according to the product label.

The best preservative-free eye drops for you might depend on factors like your personal preference and your price range. Most common formulas can be effective.

Systane and Refresh both offer preservative-free and preservative-containing formulations, though their active ingredients differ slightly. A 2020 study compared Systane Balance and Refresh Optive Advanced and found that both were well-tolerated and effective for people with lipid-deficient (evaporative) dry eye. If you’re not sure which one is right for you, it may help to talk with an optometrist or ophthalmologist.

The price of prescription eye drops for dry eye syndrome can vary depending on factors like where you live and whether you have insurance that will cover the drops. It may cost hundreds of dollars for a 30-day supply without insurance.

Eye drops are generally the first-line treatment for dry eyes. Many formulas are available without a prescription. If these aren’t effective, your doctor may recommend prescription options instead.

The AAO recommends seeing an ophthalmologist and having a comprehensive examination if you’re relying on OTC eye drops more than two or three times per day.