Choosing Artificial Tears for Dry Eyes | EnVision Dry Eye Center

Artificial tears should be selected according to your tear film needs, comfort, and daily activities. Products differ in their ingredients, thickness, preservatives, and packaging.

There is no single best artificial tear for every patient. A product that works well for someone else may not be the right fit for your ocular surface.

Why Are There Different Formulations?

The tear film contains interacting components that help maintain a smooth, protected eye surface. Dry eye may involve inadequate tear volume, excessive evaporation, or both.

Lubricating ingredients help retain moisture or allow a drop to remain on the eye longer. Some formulations also contain lipids intended to support the oily component of the tear film.

Your examination findings can help guide selection rather than relying only on a package marked “maximum relief” or “advanced.”

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Should I Use Liquid Drops, Gel, or Ointment?

Liquid drops are often convenient during the day because they generally cause less prolonged blurring.

Gels provide thicker lubrication and may last longer, but they can temporarily affect vision clarity.

Ointments remain on the eye longer and are often reserved for bedtime when recommended. They can blur vision substantially. Wait until your vision is clear before driving or performing tasks that require clear sight.

A thicker product is not automatically better. The choice should balance lubrication with your visual needs.

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When Are Preservative Free Drops Appropriate?

If you use artificial tears every day, preservative free drops are often a preferred choice, particularly when you need them several times a day, have preservative sensitivity, or already have an irritated or damaged ocular surface.

Preservatives help prevent microbial growth in some multidose bottles. However, repeated exposure to certain preservatives can irritate the ocular surface. Benzalkonium chloride, commonly abbreviated BAK, has been shown to damage cells on the cornea and conjunctiva, promote inflammation, and disrupt the tear film. These effects can contribute to the discomfort that artificial tears are intended to relieve. The risk depends on the preservative, its concentration, and how frequently and how long the drops are used.

Not all preservatives have the same effects. Some newer preservative systems are better tolerated than BAK, but preservative free formulations avoid this source of exposure. Ask your eye doctor which formulation is appropriate for your symptoms and treatment schedule.

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Preservative free artificial tears are available in single use containers and specially designed multidose bottles. Check the label rather than assuming that every bottled product contains preservatives. Packaging alone does not establish which product will work best. Follow the product’s handling, storage, and discard instructions, and avoid touching the container tip to your eye, eyelashes, or fingers.

Can I Use Artificial Tears With Contact Lenses?

Check the label. Not every lubricant is approved for use while contact lenses are in place, including some preservative free products.

When lubricating drops are needed during contact lens wear, a preservative free product specifically labeled as compatible with your lenses is generally preferred, especially with frequent use. This avoids repeated exposure to preservatives that may irritate the ocular surface. A review of artificial tears and contact lens rewetting drops recommends choosing preservative free formulations when possible and avoiding products containing benzalkonium chloride, or BAK, during lens wear.

However, the entire formulation matters—not just whether it contains preservatives. Some dry eye products require lens removal and a specified waiting period before reinsertion. Follow the product’s instructions and your eye doctor’s recommendations rather than assuming that every preservative free drop can be used over your lenses.

Rewetting drops labeled for contact lens use help lubricate the lens and improve comfort during wear. Other artificial tear formulations are designed primarily to manage dry eye when lenses are out. Your doctor can help you choose an appropriate product for each situation.

Persistent contact lens discomfort deserves evaluation rather than repeated lubrication alone. Lens fit, lens material, the care solution, wearing time, and underlying dry eye or eyelid disease may all contribute. Lubricating drops can be one part of care, but they do not address every cause of discomfort.

Related Question: Can Contact Lenses Cause Dry Eye?

Should I Choose a Redness Relieving Drop?

Redness relieving products are not interchangeable with artificial tears. Many work by temporarily narrowing blood vessels on the eye’s surface, making the eyes appear whiter without addressing the underlying cause of irritation.

Traditional decongestant ingredients, including tetrahydrozoline and naphazoline, can cause rebound redness with repeated or prolonged use. This means redness returns or becomes worse after the drops wear off or are stopped. Some products can also become less effective over time, encouraging more frequent use and a cycle of temporary whitening followed by renewed redness.

Many multidose redness relieving formulations also contain preservatives, including benzalkonium chloride, or BAK. Repeated BAK exposure can damage ocular surface cells, promote inflammation, and disrupt the tear film, potentially adding to dryness and irritation. Check both the active and inactive ingredients because formulations differ.

Not all redness relievers have the same rebound risk. Low dose brimonidine 0.025% works differently from traditional decongestants. Clinical trials lasting about one month found maintained redness reduction with minimal rebound redness after discontinuation. However, reducing visible redness still does not establish or treat its underlying cause.

If dryness is causing irritation, an appropriate preservative free artificial tear may be more suitable than repeatedly using a whitening drop. Persistent or recurring redness should be evaluated. Redness accompanied by pain, light sensitivity, or changes in vision warrants prompt assessment.

How Should I Evaluate a New Product?

Keep track of its name, frequency of use, comfort on application, and how long any benefit lasts. Bring this information to your appointment.

Avoid changing several treatments simultaneously unless directed, because it becomes harder to tell what helped or caused irritation.

At EnVision Dry Eye Center, Dr. Jason Besecker uses tear film and ocular surface findings to guide lubrication choices and identify when additional treatment is needed.

EnVision Dry Eye Center
3752 E Amity Avenue, Suite 103
Nampa, Idaho 83687
(208) 490-8823

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Medically reviewed by Jason Besecker, OD, MS
Last updated: October 2026

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