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4 Types of Eye Drops and How to Use Them Safely

These can help with dryness, redness, allergies and irritation

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Millions of Americans use over-the-counter eye drops every year to treat common problems such as dryness, redness and itching. If you’re one of them, an alert from the Centers for Disease Control and Prevention — which found that two brands of eye drops were linked to drug-resistant bacteria — may have you worried that you’re at increased risk of infection.

The reassuring news is that most likely you’re not. The CDC’s recommendation was specific for two brands of artificial tears products — EzriCare and Delsam Pharma. In general, “over-the-counter eye drops are safe to use,” says Stephanie Erwin, an optometrist at the Cleveland Clinic. It may still be overwhelming for you to figure out which drop is right for you. “There could be 40 or 50 different eye drops available, so it may be difficult for someone to determine what is best,” she says.

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Here’s a look at four types of over-the-counter eye drops, and what you should use, when.

1. Artificial tears

These drops are used to lubricate eyes. They are designed to treat dry eye, a condition in which your eyes don’t produce enough tears. It becomes more common with age, due to hormonal changes, especially among postmenopausal women. You can help prevent dry eye by avoiding environmental triggers, such as low humidity, says Anat Galor, M.D., spokesperson for the American Academy of Ophthalmology and professor of ophthalmology at the University of Miami. But you may need to restore tear health by using over-the-counter artificial tears, she says.

There are two main types of artificial tears on the market: those that have preservatives, which are found in bottles, and those that are preservative-free, which are packaged in individual vials, says Laura Palazzolo, M.D., an ophthalmologist at NYU Langone Health in New York City. In general, it’s best to opt for the latter “if dry eye is more severe and you need to use drops more than four times a day,” Palazzolo says. Since high quantities of preservatives can be toxic on eyes, you want to “use preservative-free tears to limit the total amount of preservative exposure,” she says.

It’s true that preservative-free eye drops, such as the ones involved in the recall, carry a higher risk of infection, notes Christopher Starr, M.D., a clinical spokesperson for the American Academy of Ophthalmology. The preservatives have antimicrobial qualities that can prevent bacteria and fungus from growing. But that shouldn’t deter you from using preservative-free products. Check your bottle or package label to make sure it isn’t one of the recalled products, Starr advises. If it isn’t, it’s safe to use. Just make sure that the eye drops aren’t expired, and keep the bottle or vial tip clean and free of contamination.

2. Nighttime dry eye drops

These are thicker and usually come in a gel or ointment form to help keep your eyes hydrated overnight. The benefit is that “the drops obviously last longer, but trying to see through something thick and goopy is difficult because it makes your vision blurry for a little while,” says Vicente Diaz, M.D., a Yale Medicine eye doctor who is the chief of ophthalmology at Bridgeport Hospital in Connecticut. That’s why eye specialists recommend that you apply them right before you hop into bed in the evening. Though they often contain preservatives, that’s usually not an issue, since you use them only once per day, Diaz points out.


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3.  Antihistamine eye drops

These drops can help relieve eye itching and redness due to allergies. “They block histamine, a chemical released by the allergy response that causes itchiness,” Erwin says.

It’s a good idea to see your eye doctor if you notice symptoms of eye allergies, Galor says. These can include itching, burning, redness, tearing, puffy eyelids and stringy eye discharge. A specialist can examine the lining of your eyes to make sure your symptoms are caused by allergies. If they are, over-the-counter antihistamine eye drops are the best solution, rather than allergy medications that you take by mouth. “An antihistamine itself can dry eyes out,” Galor explains.

One quick tip: Store your drops in the fridge, and take them out as needed. “The cold sensation will help soothe the eye,” Palazzolo says. It’s fine to use preservative-free eye drops, as well, if you also have dry eye. Palazzolo recommends that you apply one, wait five minutes, then apply the second one. This way, “one does not dilute the other,” she says.

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4.  Anti-redness eye drops

These drops contain ingredients such as tetrahydrozoline that work to reduce redness by constricting blood vessels around the eye. Experts don’t recommend them other than for very occasional use. “If these are used daily and consistently, they will have the opposite effect: Blood vessels will dilate and become bigger so that the eyes become even more red,” Palazzolo says. It’s OK to use them in a very rare situation, such as an event where you need to have your eyes look more white in a photo, she says. Using them more often may be problematic: “If your eyes are red daily, it’s probably for a reason,” she says. “There might be something else going on. You want to treat the cause, not mask it.”

If you need to use something for a one-off event, Palazzolo recommends an eye drop that contains low-dose brimonidine tartrate, a drug normally used to treat glaucoma patients. “It has the side effect to make blood vessels smaller, so they do not appear as red,” she says. It’s less harsh than traditional anti-redness drops.

How to lower risk of eye infections

Regardless of which drops you choose, there are a few things you can do to ensure that you use them safely to reduce the risk of infection. Starr advises that you don’t let anything come in contact with the bottle tip. That includes your eyeball. To insert drops safely, he recommends, you tilt your head back, pull the lower eyelid down and away from the eye and “drop the drop” from a distance. “If you’re not sure if the drop got into the eye, it’s generally safe to try again,” he says. If you think your bottle tip has been contaminated, he says you should either throw it away or clean the tip with alcohol and let it air-dry before reusing.

If you develop eye discharge, redness or pain, see your eye doctor right away, since these could all indicate infection that may require other treatments, such as antibiotic eye drops.

What types of drops can contact lens wearers use?

If you have contact lenses, you may wonder if you can use eye drops while wearing them. The answer is yes, eye doctor Vicente Diaz says, but “the thicker a drop is, the less of a good idea it is.” Rewetting drops and most of those for dry eye (sold over the counter in drugstores) are fine, since they are very thin and won’t distort your vision, he says. But if you have a thicker drop, such as a gel or ointment, it can stick to your contact lens and make it hard for you to see, he says. Since these are usually only applied at night, before bed, it’s less of an issue. If your doctor prescribes an eye drop, talk to them about contact lens use.

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