Top 3 Over-the-Counter Eye Drops to Avoid for Dry Eye Relief


Hello everyone, I’m Dr. Audrey Thai. Welcome back to my channel! I’m a board-certified and fellowship-trained refractive and cataract surgeon, ophthalmologist, and cornea specialist. I’m here to provide you with the latest information on eye health and medicine. In today’s video, I’ll discuss three over-the-counter eye drops that I do not recommend for treating dry eye disease. If you’re interested in the eye drops I do recommend, check out my video "Top Five Over-the-Counter Eye Drops." You’ll find links to recommended products in the description below.

If you stick around until the end of this video, I’ll introduce you to a lesser-known eye drop that you may want to watch out for.

Number One: Systane Maximum Hydration Lubricant Eye Drops by Alcon

The main reason I do not recommend this eye drop is its preservative, benzalkonium chloride (BAK). There are three types of preservatives commonly used in eye drops: detergent-type, oxidative-type, and ionic-buffering systems. Detergent-type preservatives are the most toxic to the eye surface, and BAK is the most harmful among them. BAK is also found in many medication eye drops, such as antibiotics, where its toxicity can be advantageous for short-term use.

BAK can interfere with the connections between the cells on the eye’s surface and reduce the number of epithelial cells. This can be harmful when used frequently or long-term. If you prefer the Systane family of eye drops, consider using Systane Ultra Lubricant Eye Drops, which contain polyquad as a preservative. Although polyquad is also a detergent-type preservative, it is less toxic because it is repelled by the cells on the eye surface.

Even better, choose the preservative-free options in the Systane family of eye drops. If you want to learn more about the science behind artificial tears and my recommendations, check out my video on artificial tear ingredients. For quick eye care tips, follow me on Instagram at Dr. Audrey Thai.

Number Two: Clear Eyes Natural Tears Eye Drops by Prestige Consumer Healthcare

I do not recommend Clear Eyes Natural Tears for two reasons. First, this eye drop also uses BAK as its preservative, and there’s no preservative-free version. Second, it contains polyvinyl alcohol (PVA), a demulcent that lowers the eye drop's viscosity. PVA is found in older artificial tear eye drops. More effective compounds, such as propylene glycol and polyethylene glycol, are available in newer formulations. Links to some of these newer options are in the description below.

If you find this video helpful, please like and subscribe to my channel. It helps me continue bringing you more content about eye health and eye surgery.

Number Three: Visine Dry Relief, Visine Red Eye Hydrating Comfort, and Visine Red Eye Total Comfort by Johnson & Johnson

Visine Red Eye Hydrating Comfort and Visine Red Eye Total Comfort contain tetrahydrozoline, which temporarily constricts blood vessels to reduce eye redness. Frequent use can cause rebound dilation of the blood vessels when the eye drop is discontinued, leading to red eyes. Although Visine Dry Relief does not contain tetrahydrozoline, all three use BAK as a preservative. I advise against long-term use of BAK-containing eye drops due to its toxicity.

If you prefer the Visine brand, consider Visine Dry Relief Tired Eye Lubricant Eye Drops or Visine Dry Relief All Day Comfort, which use polyquad, a less toxic preservative than BAK.

Bonus Recommendation: Rohto Cooling Eye Drops

Lastly, I’d like to mention Rohto Cooling Eye Drops. Although not as well known as others, its eye-catching packaging caught my attention on the pharmacy shelf. It contains both tetrahydrozoline and BAK, making it potentially toxic to your eyes.

Let me know in the comments which eye drop surprised you the most. If you’ve been using any of these, would you consider switching after watching this video? Links to recommended over-the-counter eye drops are in the description below.

I hope you found this video helpful. If you learned something new, please like and subscribe. It helps me continue offering free videos about eye health and eye surgery. You can also follow me on Instagram, Facebook, and LinkedIn at Dr. Audrey Thai to learn more about my practice. I look forward to connecting with you there.

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