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Article borrowed from sister website!

In March 2015 a website named Eye Drops Database was launched as a rescource for Eye Care and Health Care Professionals, it was envisaged to be centred around Dry Eye drops, however it has grown to be much more than that. Not withstanding its expansion, it seemed appropriate for me to write a specific article on Dry Eye drops. It was my personal consideration of Dry Eye drops and so was not necessarily the same as other Eye Care/Health Care Professionals (ECPs/HCPs), I thought it useful to re-publish it here!

Use of Dry Eye drops

The visual and physical symptoms associated with dry or excessively watery eyes (very often these are linked) seems to be increasing, due to multiple factors such as; increased use of concentrated near tasks with computers, mobile phones, tablets etc. In addition other factors, with or without the use of these tasks, such as warm, dry atmospheres, air currents (windy conditions, fan driven air) and/or Contact Lens wear add to the eye's challenge to maintain its normal hydration. As if all these external factors weren't enough to conspire against us, increasing Dry Eye problem are seen as we age (a study showed a third of people over 40 were predisposed to Dry Eye), general health conditions also contribute, as do many medications we take. Historically the only way of managing/treating Dry Eye was through eye drops, in fact they used to be called 'artificial tears', a term not used nowadays. As clinicians we knew, as patients told us, this was only partially helpful. Nowadays many modern specific eye drops are better than ever, however a weakness of all drops is the 'residence time' of the drop on the eye's surface, they get washed away quickly! Latest knowledge of the tear film has led to the development of specific formulations with properties that re-balance and and add to tear quality, stay on the eye surface longer than older products and either indirectly or directly protect the delicate cells that line the eye's surface. Your ECP can advise you on specific products. 

How do I know if I have a Dry Eye/Watery Eye or even an Allergic Eye reaction? Quite simply - talk to a registered Eye Care/Health Care Professional, I would always suggest you initially contact the Eye Care Practitioner you last attended. Typical symptoms you may be experiencing could be dryness (although often other symptoms are more noticeable), mild grittiness, burning, stinging, fluctuating vision (better  after blinking/use of drops). Do not try to self-diagnose. In the same way there isn't a drug/medication that doesn't have a side-effect (noticeable or otherwise), there isn't a Contact Lens that doesn't interfere with the eye's tear film (noticeable or otherwise), so using specific drops with Contact Lens wear is quite normal and to a certain extent recommended. Do seek specific advice from your Contact Lens Practitioner. 

Do Dry Eye drops have limitations?

Yes, we are still working on a single drop that can be applied before Today (BBCR4) and will still be effective when Newsnight (BBC2) comes on! As described, with one or two exceptions, drops don't hang around on the ocular surface very long, they don't generally treat the condition, but rather the symptoms. Newer forms of treatment, now accepted around the world, for specific Dry Eye conditions don't rely exclusively on Dry Eye drops alone - these have very high success rates. As it's always better to at least understand the condition (Dry Eye has a number of forms), than to simply mask the condition so I would always advocate Eye Care/Health Care Professional be made aware of the problem. An important limitation of older forms of drops is that they may contain preservatives, which in themselves can cause toxic reactions on the eye surface. Newer forms have self-eliminating or no preservatives. Many drops are not Contact Lens compatible so can cause eye injury if used with lenses, check with your Contact Lens Practitioner and read all product information thoroughly, this applies to the use of all drops for everyone. Don't do what I do with flat-pack furniture, decide to read the instructions half-way through assembly!

Where should I buy them from? 

It should be remembered that not all drops, and ocular surface products are equal, some are more equal than others! Obviously the practice that recommended specific products will stock them and prefer you buy from them. However, in the same way it is not always possible by your new toothbrush from your dentist, it is not always possible buy drops from your optical practice. Many drops are available from many different sources, however the range can be bewildering, it is tempting to assume all drops are the same, and pick them up with your groceries, they are not! It is probably better order on-line than switch away from the specific advised product. 

How should I use them?

good technique

Follow the advice given to you by your ECP/HCP, perhaps bearing in mind the following points. If you are commencing Contact Lens wear it is advisable to have a bottle of Contact Lens compatible drops available from day one. Sometimes Contact Lens Practitioners advise applying a drop to the lens before placing it on the eye. Contact Lens wearer or not, your ECP/HCP can show you how to safely and effectively best instill drops, not a skill that comes naturally! Starting point - always wash your and dry hands, more eye infections, and very sadly but very rarely, permanent vision loss comes from invisible hand contamination than anywhere else. Check the bottle expiry date from first opening. Don't touch the dropper to your eye or face. Look up while pulling the lower lid down to create a 'pocket' and place the drop in it. The eye can't normally hold more than one drop so multiple drops risk over-dosing the eye, wasting money or drops draining via the eye's drainage canal into your body, normally harmless, but with certain drops possible side-effects can occur. Your ECP/HCP can show you how to instil drops and how to ensure very little drains away via the eye's canal.

Here is an excellent video related to administration of eye drops:


Here is another very useful video related to administration of eye drops to babies and children:

Space drops out by at least 10 minutes, if you are using a gel or ointment instill that last. Alternatives to drops are sprays, again check with your ECP/HCP that they are appropriate for you and how best to use them. If this article has whetted your interest to know more it is always best to consult your current ECP initially.

 Alernatively if you would like to contact us for non-urgent eye care discussions related to dry eyes or contact lenses you can  by email:

  • Mr Andrew D Price (Nantwich, Glossop & Widnes or general enquiries) This email address is being protected from spambots. You need JavaScript enabled to view it.  
  • Elizabeth Ralph (East Midlands and South Yorkshire) This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Ms Vanessa Uden (Surrey, Hants, Berks) This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Mr Ganeshbabu Mahalingam (West Yorkshire) This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Mr Mohamed Ayyaz Kasmani BSc(Hons) MCOptom This email address is being protected from spambots. You need JavaScript enabled to view it. 
  • Mr Colin Jones FBDO(Hons) CL This email address is being protected from spambots. You need JavaScript enabled to view it.

Personal portfolios can be found here: 



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Dry/Watery Eye FAQs

Eye makeup and skin care used in and around the eyes is a potential source of irritation, inflammation, infection, allergy and possibly adverse permanant changes to eye health. As just one example out of many aspects of eye cosmetics Amy Gallant Sullivan, Creator of 'Èyes Are The Story' highlights eyelash extensions; "eyelash extensions aren’t always pretty, lash extensions can cause irritation, conjunctivitis, keratitis, and even severe allergic reactions. False eyelashes can promote the risk of bacterial & fungal infection. Eyelash extensions can even cause eyelash loss! Watch the video for more information on lash extension.


You will find the Eyes Are The Story web site here.

Kathyrn Chidwick BSc(Hons) Ophthalmic Dispensing, in a recent article in Re:View the ABDO College journal, discussed the possible contamination and infections from ocular cosmetics. Her critical research analysis found studies that revealed high contamination of ocular cosmetic products being used by patients with potential sight-threatning bacteria and fungi. It is strongly advisable for ocular cosmetics not to be shared or used past their expiry date. 

The same research analysis found studies showing eye liner can destabilise the tear film and block the vital meibomian glands in the eye lid. Many skin-care products contain retinoids, these may cause or excerbate meibomian gland dysfunction. 

Alllergic reactions to the multitude of chemicals found in ocular cosmetics have been known for many years, even leading to a dermatitis condition on the eye lids, from the ocular cosmetics themselves, or hair products. 

The complete article can be found in the December 2021 issue of Re:View  .


Always apply makeup outside the lash line and apply mascara from the tips rather than the roots of the lashes, preferably to the top lashes only.

Never apply eye makeup over the oil glands that line the very edge of your upper and lower lids, just inside the eyelash line. These are the glands that secrete oils to keep the eye lubricated. If you need to use an eye drop, apply it 15-30 minutes before putting on your makeup.


It is a must to remove makeup before bed. Sleeping with eye makeup on can lead to clogging of the oil producing glands and eye infections. Try a gel based product that is oil and paraben free. Avoid getting the makeup remover into the eyes as this may irritate them further.
Avoid mineral oil, sodium lauryl sulfate, and diazolidinyl urea. While they work well to remove makeup, they are known to cause irritation to the eyes.
A gentle lid scrub with baby shampoo on a clean cotton pad or soft cloth or a store bought lid scrub can help remove excess makeup and unclog the eye’s oil glands.

Makeup Hygiene

Keeping makeup applicators clean is critical to keep infection at bay. Make sure to sharpen your makeup pencils before application to remove the top coat of bacteria. Also, wash makeup brushes as well as using a brush cover to keep them clean. Avoid using store samples, but if you must make sure to use a fresh applicator.
Do not use the same applicator on different parts of the face. For example, do not use the same pencil on your lips and your eyes.
Avoid sharing makeup with anyone else and using makeup past its expiration date. As a rule of thumb, dispose of your eye makeup every three to six months. You can keep a marker in your makeup kit to note the date the makeup was opened.
Do not use any type of eye makeup if you have an eye infection and see your optometrist right away. If you do develop an infection, throw away all your eye makeup and buy a new set to start with after your optometrist OKs you wearing it again.
Always wash your hands before applying makeup and avoid using saliva to assist in putting your makeup on as this could lead to an eye infection.

Makeup Type

The tiny particles in glitter and powder based shadows and foundation can get into and aggravate the eyes. Instead sparingly use cream shadows, highlighters and foundations.
Use a thickening mascara instead of lash-lengthening or waterproof ones as they are less likely to flake and get into the eyes.
Stick with hypoallergenic brands to avoid excess irritation. Avoid makeup with arsenic, beryllium, cadmium, carmine, lead, nickel, selenium, and thallium.

Find Alternatives

A plastic eyelash curler is a great alternative to mascara. (The metal in regular eyelash curlers can cause irritation and dryness around the eye).
You might also get away with less eyelid makeup if you concentrate on your eyebrows instead.

If you suffer from severe and chronic dry eye and are intolerant of eye makeup try highlighting other aspects of you face, such as your lips and cheeks, which allows you to highlight your natural beauty without ever touching your eyes.

Eyelash extensions

These have grown in popularity due to beauty trends favoring the appearance of more robust eyelashes and eyebrows. Eyelash extensions are synthetic fibers (e.g. polyester) that are applied on the natural lashes using glue that may contain chemicals such as formaldehyde, lead, and benzoic acid.  Allergic reactions to eyelash glue can be serious as well as associated complications including keratoconjunctivits, contact dermatis and blepharitis, conjunctival and corneal erosion, subconjunctival hemorrhage. To prevent complications arising from eyelash extensions, both the patients and the beauty industry should learn the potential complications of the procedure and the ingredients of the glue and lash removers should be strictly regulated and monitored.


Yes, it is possible. Many general health conditions have a role in dry eye and/or blepharitis. At your Dry Eye Assessment we will want to know about your general health and health conditions/treatments you have had in the past. We believe it is simply not possible to address your dry eye condition and best help you without knowing this information. Just as one example, rheumatoid arthritis or other types of inflammatory disease are a risk factor in dry eye disease, so if that is the case we would want to manage it specifically, another good reason why self-treatment with self-selected eye drops is not advised.

Yes, it is possible. Many general and eye medications and the conditions they are taken for can exacerbate the general condition called dry eye. At your Dry Eye Assessment we will want to know your medications, food supplements and ask about your diet, do you eat oily fish for instance. We believe it is simply not possible to address your dry eye condition and best help you without knowing this information. Importantly we very rarely advocate a medication change but rather work with your medication prescriber to manage your dry eye condition, certainly you should not change medication in any way without consulting your doctor or pharmacist.

On an allied point there are available specific dry eye food supplements with evidence of effectiveness available, but these are contra-indicated if you are taking certain medications or other food supplements, we will advise you at your Dry Eye Assessments. 

As in the ‘hot flannels’ question, this advice, although well meaning, is not based on any evidence of its effectiveness. In fact there is evidence that it can adversely affect vital glands on the eye surface that contribute to good quality tears. It also has a detergent effect, which actually beaks up the tear film. Its use has never been proposed by the manufacturers of such a product, and recently a well-known global producer of ‘baby shampoo’ officially wrote to an UK ophthalmologist strongly supporting his advice against its use. 


If this was the question in 1975, perhaps so, if only because we didn’t understand the complexity of the eye lids or the tears then and we had nothing better. This approach was neither safe (risk of it being too hot and/or very unhygienic) or effective (the required heat is not maintained for nowhere near long enough). In 2020, with our much better understanding of the ocular surface, lids and tears we know much better. Heat application alone is not usually sufficient to help one of the types of dry eye (the type of dry eye needs to identified correctly) most Eye Care Professionals, who understand dry eye/blepharitis would not advocate their use.

Yes, most glaucoma drops have preservatives within them to protect against contamination. Very often the continued application of these very necessary drops, with their preservatives, to the eye can cause eye surface inflammation and irritation.
Many of the same age group of patients using glaucoma drops are predisposed to dry eye, these two factors (preservatives and dry eye) often mean the eye is not comfortable.
The answer is NOT to stop using the glaucoma drops, they are vital, it may well be, after a specific Dry Eye Assessment, the dry eye and effects of the glaucoma drops can be managed better, leading to the eyes being more comfortable and, evidence has shown, the glaucoma drops being more effective.

Although a few specific dry eye drops have very sophisticated formulations, even they don’t have ability to stay on the eye’s surface for many hours. Most dry eye drops, with more basic components, will have only have an effect for one or two hours.
The answer, in many cases, following a specific Dry Eye Assessment and diagnosis (there are different types of dry eye) is to treat the eye’s surface in addition to the use of very particular drops. Once the particular cause is identified in the exam, targeted therapy can be advised, sometimes aided by in-practice treatment. The very good news is that this approach gives me, and more importantly, my patients a 95% success rate!