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Preservative Free Eye Drops For Dry Eye Disease

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I love to share advice and tips gleaned from my own experiences.

If you explain the symptoms of dry eye to your optometrists or pharmacists they will be able to suggest a list of products that will help you deal with this issue. You can purchase over the counter eye drops which are referred to as artificial tears that are designed to help alleviate the symptoms of dry eye disease.

There are two types of eye drops, one that contain preservatives and one that is preservative free. The preservative free eye drops are a better choice for anyone who has dry eye disease because there is less chance of you getting irritated eyes while using it. It is also considered safer for those who wear contact lenses as you don't need to remove your contact lenses before putting the eye drops in your eyes.

Factors That Contribute to Dry Eye

When you have dry eyes it is due to the production of fewer tears in your eye. Your eyes need to stay moist and if they don't then this leads to dry eye. The following factors can cause dry eye.

  • Age
  • Medication
  • Eye surgery
  • Your environment
  • Computers
  • Long term use of contact lenses

If your dry eyes aren’t caused by age, medication or eye surgery, then most likely your environment, long hours spent on a computer or your contact lenses is the cause of your dry eye disease.

Symptoms

The symptoms of dry eyes can build over a few hours and if you ignore it can become very irritating. Your eyes might begin to feel dry, gritty and red. In the morning they might be sore and sticky.

If your eyes start to tear up when you step outside or once you have finished a job or take a break, then your job or your work environment is the cause of your dry eye disease.

Most people never have a problem with eye drops that contain a preservative. Artelac eye drops are not preservative free eye drops but Hylo Tear is.

Most people never have a problem with eye drops that contain a preservative. Artelac eye drops are not preservative free eye drops but Hylo Tear is.

What Work Environment Factors Can Causes Dry Eye Disease

  • Having to work in an environment that requires you to focus extensively on a job.
  • Staring at a computer all day without taking a few breaks every 2 to 3 hours.
  • Having to work long days in a poorly ventilated room that has no windows.
  • Working in a room that has the air conditioning or the central heating on all the time depending on the season it is.
  • Not taking enough breaks throughout the day and letting your eye get some rest.
  • Having to sit and work in a room with fluorescent lighting for a number of hours each day.

Why Do Contact Lenses Cause Dry Eye

When you wear contact lenses they cover the retina of the eye and this means that oxygen cannot get into the eye.

If you don't blink enough throughout the day while wearing the contact lenses then they are not getting any moisture and therefore they cannot stay hydrated.

This means that the contact lenses will dry up and the contacts will be very dry and start to stick to your eyes. This in turn can lead to irritation in your eyes and stops people from wearing them long term.

To avoid this happening, you need to blink more throughout the day, avoid being in an environment that will dry them out, start using eye drops or wear them less frequently

Why Is a Preservative Added to Eye Drops?

The preservative is added to the eye drops to stop the growth of bacteria. That is why many brands of eye drops have to be dumped after one to three months even if there is still solution left in them.

Once the preservative is added it works for a certain time limit to ensure no contamination occurs. However overtime the strength of the preservative weakens and when this happens there is a higher risk of the eye drops getting contaminated. If you continue to use the eye drops past their suggested used by date, then you could end up with eye infections.

While many people never have an issue with eye drops that contain a preservative for those who are prone to getting dry eye disease, they can actually cause further eye irritation.

You are better of choosing a preservative free eye drop if you are ever diagnosed with dry eyes because over use of the regular eye drops can actually lead to a more severe case of dry eye disease.

Why Is Phosphate Added to Eye Drops

Phosphate is a solution that is added to the eye drops to ensure that the eye solution is safe for the eyes. Most eye drops contain this ingredient and it is added to balance out the solution and to ensure that the eyes don't get irritated by all the ingredients in the solution.

Why Phosphates Are Removed

Corneal calcification is a condition that leads to a build-up of insoluble crystals of calcium in the cornea. Surgery is then required to remove this build-up. There have been some studies carried out to see if phosphates in eye drops can be a factor in causing this.

Over the years the results of these studies have changed and the overall result seems to suggest that if you have any kind of serious eye issues then you are better off not using eye drops with this ingredient in it.

In 2007, an article in the Investigative Ophthalmology & Visual Science found a link between preservative free eye drops and calcareous degeneration in patients.

A study carried out in 2013 by the European Medicine Agency to determine if phosphate in eye drops can lead to a build-up of corneal calcification found that it was very rare for this to occur in patients who use eye drops.

Another study carried out in 2019 of 53 different types of eye drops concluded that any patients that has corneal damage should only be prescribed eye drops that have a suitable PH balance and a buffer that does not lead to corneal calcification.

How to Avoid Getting Dry Eye

To avoid getting dry eye, you really need to remember to blink more throughout the day which isn’t always easy to achieve.

Many of us get too caught up in what we are doing that we don’t even realize that we aren’t blinking as much as we should.

So the only solution for many people is to start using artificial tears which are specifically designed to add moisture to your eye to help clear up dry eye.

How Often Should You Use Eye Drops?

Most often you should apply one eye drop three to five times a day. It can vary from person to person and you might not need to even apply them that much. Always read the directions on the bottle of eye drops to see the frequency of usage.

Both of the bottles of eye drops above have the same usage directions, one drop three to five times a day. It really depends on how much your eyes are irritating you throughout the day.

If you wear contact lenses it is more convenient to use a preservative free eye drop as you do not have to remove your contacts.

If you use eye drops with a preservative, then you need to remove your contact lenses before applying them and you need to wait at least 15 minutes before you put them back in.

Soft contact lenses actually absorb the preservative in eye drops and this can damage the cornea.

Why Blinking More Is Important to Create Tears

If you don’t blink then you don’t produce tears and if you don’t produce tears, then this can lead to dry eye disease.

According to an article in the Proceeding of National Academy of Science of the United States of America, we blink 15 to 20 times per minute. But sometimes people might not even blink that much if they are extremely focused on something.

Diagram of how tears are produced in the eye.

Diagram of how tears are produced in the eye.

How Are Tears Produced in the Eye?

They are three layers that cover the surface of the eye. A mucous layer, a watery layer and an oil layer and all of these layers help to keep the eye moist.

Oily Layer: This layer is found around the rim of the eyelashes and produced in the meibomian glands. This layer helps to keep the eye lubricated.

Mucous Layer: This layer is found in the conjunctiva and every time you blink it spread a layer over the ocular surface of the eye.

Watery Layer: This layer is located in the lacrimal gland which is above your eye lid.

Why Should Contact Lens Wearers Use a Preservative Free Eye Drops?

Firstly if you are a contact lenses wearer who uses the soft lenses that come in the monthly or six months packages, then over time using products that contain preservatives can cause Giant Papillary Conjunctivitis.

This condition causes the wearer to have sore eyes and a build-up of mucus in the eye after the contact lenses are removed.

Secondly it might also be the cause of meibomial dysfunction in the eye which is a blockage in the meibomian gland where tears are produced.

How Long Do Preservative Free Eye Drops Last

Regular artificial tear eye drops that contain a preservative once opened usually have a shelf life of one to three month before you need to dump them.

However if you use preservative free eye drops you are able to continue using them for up to six months once they have been opened.

The only thing that might stop people from using preservative free eye drop is that they contain maybe a third less liquid in the bottle compared to the regular eye drops for dry eye.

Also the preservative free eye drops usually costs about a third more than the regular eye drops.

Conclusion

If you get dry eyes then it can be very irritating and it can lead to over reliance on eye drops as a solution to the problem. Most times, if you remove yourself from the cause especially if its work related, then you can solve the problem.

Also it is vital to not lose focus and start training your eyes to blink more. It's usually when you are extremely focused on a task that you forget this. If you have to use a computer all day, try to have it at eye level or below. There is less chance of you straining your eyes and your neck.

Fluorescent lighting is also another culprit of this condition and this is harder to escape as some office building has this in every room so it is unavoidable. So you might need to wear tinted glasses that are designed to help protect your eyes from the brightness.

To help keep your eyes in good shape, you can add the vitamins A and C as well as omega-3 to your diet to help keep your eyes healthy which might lead to less eye problems in the future.

References

European Medicines Agency, (2012), Questions and answers on the use of phosphates in eye drops, Ema.europa.eu, https://www.ema.europa.eu/en/documents/medicine-qa/questions-answers-use-phosphates-eye-drops_en.pdf

Corneal Calcification Associated With Preservative Free Eye Drops and Persistent Epithelial Defects (2007), Investigative Ophthalmology & Visual Science, https://iovs.arvojournals.org/article.aspx?articleid=2386988

Final Report Summary - OFFICAIR (On the reduction of health effects from combined exposure to indoor air pollutants in modern offices), (2014), CORDIS | European Commission. https://cordis.europa.eu/project/id/265267/reporting

Assessment of Phosphate and Osmolarity Levels in Chronically Administered Eye Drops, (2019), US National Library of Medicine National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6624467/

Comparative Toxicity of Preservatives on Immortalized Corneal and Conjunctival Epithelial Cells, (2009), Journal of Ocular Pharmacology and Therapeutics, NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958436/#:~:text=Most%20eye%20drops%20contain,biodegradation%20and%20maintaining%20drug%20potency.

Dry Eye Syndrome (2017), NHS, https://www.guysandstthomas.nhs.uk/resources/patient-information/eye/dry-eye-syndrome.pdf

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2020 Sp Greaney

Comments

Sp Greaney (author) from Ireland on October 31, 2020:

@Umesh Chandra Bhatt, thank you. Glad you found it interesting.

Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on October 31, 2020:

Useful and informative article.

Sp Greaney (author) from Ireland on October 08, 2020:

@Kalpana lyer, I know, right. It's such a simple thing that we all don't do as much as we should.

Kalpana Iyer from India on October 07, 2020:

I am a contact lens wearer. This info was very useful for me as I suffer from dry eyes if I wear my contact lens for too long. I should remember to blink more often.

Fay Favored from USA on October 02, 2020:

I didn't realize that. Thanks for letting me know Sp. Appreciate it.

Sp Greaney (author) from Ireland on October 01, 2020:

@Fay Favored, I don't we can comment on articles once they are transferred over to the network site.

Fay Favored from USA on September 20, 2020:

I visited several of your other articles, but the .com ones won't let me comment. Where do you comment on those articles?

Sp Greaney (author) from Ireland on September 19, 2020:

@Fay Favored, that's so annoying. I was the same and it was only when I complained to my optician about my symptoms that it came out.

I totally agree with you about the increase of information that should be available. It takes a while to get control over it.

Fay Favored from USA on September 19, 2020:

Really good information. Until a recent eye injury I didn't realize that when the eyes tear it really means they are dry. Finding the right eye solution isn't easy, so the more information on eye care is so helpful. I wish I saw this article back in May.

Sp Greaney (author) from Ireland on August 18, 2020:

@Adrienne Farricelli, that's so annoying. That has to be touch especially as it's quite dry out there. I think many of us just persevere and put up with the irritation. You never think it could be something else that is contributing to it.

I used to get sore eyes a lot and the preservative one irritated them. I found the preservative free one so much more gentler.

Adrienne Farricelli on August 17, 2020:

Thanks for writing such an in-depth and detailed article on eye drops for dry eyes. Since living in Arizona, I got terrible episodes of dry eye. Thanks to your article, I now think I know why eye drops were making my eyes burn and making matters much worse.

Sp Greaney (author) from Ireland on August 14, 2020:

@ Abby Slutsky, Thank you.Yes I have it to. It was my optometrist who helped me realise it. That's great you are able to control it that way. Glad it was helpful.

@ Liz Westwood, thank you. I think it's one of those conditions that affect only a percentage of people.

Liz Westwood from UK on August 13, 2020:

As a contact lens wearer I have read your helpful article with a lot of interest.

Abby Slutsky from America on August 12, 2020:

Hi,

I have dry eye and have been on perscription drops for years. You did an excellent job of describing the symptoms and telling people some of the treatment options. I did not know much about preservative and preservative free eye drops so that was nice to learn. I take a prescription medication. Thanks for sharing.

Sp Greaney (author) from Ireland on August 12, 2020:

@Pamela Oglesby, Thank you. Yes, I think we all experience it at one time or another. Unfortunately for those who get it on a continuous basis it can be very annoying.

Pamela Oglesby from Sunny Florida on August 12, 2020:

This is an excelllent, well-written article. Dry p.eyes are a common problem and you explain so many reasons why this happens. Thnks for this information, Sp.