Are eye-drops safe to use frequently?

“This is why most of the population will suffer from varying degree of dry eyes at some point in their lifetime,” Gunawan says.

“For some the feeling of dryness is very intense and quite painful, and these symptoms can be present all the time.”

Professor Isabelle Jalbert from the School of Optometry and Vision Science at UNSW says 10 to 20 per cent of people over age 40 experience symptoms of moderate to severe dry eye.

“The prevalence of these conditions appears to be increasing over time,” she says. “Likely due to the increase in screen time, as well as pollution and climate change.”

What kinds of eye drops are there?

University of Melbourne eye disease specialist Professor Laura Downie says there are several types of eye drops including the common lubricating variety (aka artificial tears), which reduce dryness.

For those with allergies, Downie says antihistamine eye drops contain medications that specifically target symptoms, including itchiness. There are also prescription antibiotic drops to treat eye infections, as well as steroid drops, which can manage inflammation, and anti-redness drops.

Jalbert says there are also sprays, gels and ointments. “Sprays are particularly good for people who have difficulty using eye drops … Liquid gels blur the vision more, but tend to offer a little more relief.”

Due to the number of options, Jalbert says it’s best to consult a GP to determine which ones suit your needs.

Are over-the-counter eye drops safe to use?

Most artificial tears are relatively safe to use, Gunawan says, especially if they’re being used fewer than four times a week.

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However, some people could begin to experience persistent redness and stinging due to some of the preservatives in some over-the-counter products. “The irony is often when [eyes] start stinging, we start applying more of these eye drops, which then tend to worsen the side effects,” he says.

Anti-redness drops can also prevent people from determining the root cause of their eye irritations, which could be more serious than simple allergies or eye strain, Gunawan adds.“They only improve the appearance. They don’t deal with the underlying causes of the redness.”

What to avoid when buying eye drops

Over-the-counter lubricating eye drops without preservatives (or gentler ones) are generally safer for regular use, Jalbert says. One preservative in particular, Benzalkonium chloride, prevents drops from becoming contaminated over time. However, it can be quite toxic on the eye, damaging its “good” cells and microbes, especially if used multiple times a day. (It’s also important to follow the use-by information on drops and not keep them indefinitely, even in the fridge.)

Other components to use in moderation are decongestants and vasoconstrictors, which reduce redness. “If people use those regularly, they can have a paradoxical effect when they stop using it: the eyes’ redness will increase … It’s better to use just a gentle drop that’s got a lubricant and a gentle preservative,” says Jalbert.

Jalbert also recommends eye drops that come in a single dose rather than larger bottles, which tend to contain more preservatives. Some bottles also contain filters that mean no preservatives are required; however, these tend to be slightly more expensive.

It’s also best to avoid mixing different products, Gunawan adds, unless advised by your healthcare practitioner.

What else can I try?

There are several options to improve itchiness and dryness beyond eye drops, beginning with healthy blinking habits.

“We sometimes suggest the 20-20 rule: every 20 minutes try to take a 20-second break and look far in the distance and blink a bit,” Jalbert says.Some may also benefit from a humidifier, as well as hypoallergenic environments (minimal carpets, no pets).

Even adapting your diet can help, Gunawan adds, as foods rich in omega-3 fatty acids, such as fish and seafood, can help lubricate the eyes.

“There’s also support for doing warm compress daily, and cleaning the eyelids if you wake up with a lot of crustiness,” he says. “Reducing screen time is always a key consideration.”

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Ultimately, Optometry Australia’s professional services advisor Sophie Koh says it’s imperative to understand why your eyes are irritated before investing in any product: “Is it because of an underlying allergy? Because your eyelid margins are inflamed or clogged? Is it because you have an underlying health condition that needs to be managed? Does your dry eye require a more dense gel, or oil-based formula?

“Healthcare professionals can provide a care plan tailored to your specific needs.”

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