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With dry eye, two basic forms are distinguished, and this matters for the choice of drops. In the first, the tear glands produce too little fluid, so the eye lacks water. In the second, more common form, the composition of the tear film is disturbed, usually with missing oil from the lid glands, so the tears evaporate too quickly. Simply put: if mainly water is missing, watery drops with hyaluronic acid help especially well. If the film evaporates too quickly, lipid-containing products are the better choice. Often there is a mix of both. This distinction also explains why not every drop works equally well for everyone: a product that helped a friend may do little for a different form of dry eye.
Artificial tears, also called tear substitutes, are the most important quick help. They do not fix the cause, but they moisten the eye surface and stabilise the tear film. Which one fits depends on which layer of the tear film is missing. That is why it pays to look at the ingredient rather than the brand.
| Ingredient or type | Effect | For whom and when |
|---|---|---|
| Hyaluronic acid | Binds water and stays on the eye surface for a long time | When mainly watery tear fluid is missing; a good all-rounder for mild symptoms |
| Lipid-containing drops and liposome sprays | Replace missing oil and slow down evaporation | With a disturbed oil layer and lid gland problems, the most common case |
| Gels and ointments | Thick, stay on particularly long | For stronger symptoms and for the night; can blur vision briefly |
| Dexpanthenol and regenerating additives | Support the regeneration of the eye surface | For irritated, stressed surfaces, often as a combination |
One point is especially important: with frequent or longer use, use preservative-free products. Preservatives such as benzalkonium chloride can irritate the eye surface and further damage the tear film. Preserved drops should not be used more than four to five times a day, while preservative-free ones can be used as often as you need them, some people every hour, others only two to three times a day. Preservative-free products often come in single doses or special multi-dose bottles with a filter and are the safe choice especially with sensitive eyes and when wearing contact lenses.
The form also matters: thin drops are suitable for mild symptoms and frequent use, gels and ointments for stronger symptoms and the night, and lipid-containing sprays are sprayed onto the closed eye and make sense with evaporation problems. Which form and which ingredient fit best can be clarified in an eye practice with simple tests, such as measuring the tear volume and the break-up time of the tear film.
In an eye practice the form of dry eye can be determined precisely. The Schirmer test measures how much tear fluid the eye produces. The break-up time shows how quickly the tear film breaks up, that is how stable it is. A look at the lid margins and the meibomian glands clarifies whether the oil layer is disturbed. From these findings it follows which tear substitute and which further measures make sense and whether an underlying condition should be assessed. The advantage: instead of trying various products at random, the care can be matched specifically to the actual cause.
The most common cause in particular, screen work, can be eased well with simple habits. Just a few adjustments at the workplace and in the daily routine take a lot of stress off the eyes.
Many tips circulate around dry eyes that vary in how useful they are. Omega-3 fatty acids from fish or algae oil can slightly improve the symptoms for some people, but do not replace drops. Caution is advised with eye baths using chamomile or other herbs, as they can further irritate the eyes and are usually not recommended. Never rinse the eyes with tap water, as it tends to disturb the tear film rather than help. Contact lenses often worsen dry eyes; here wearing breaks, a different lens type or simply glasses help. And as tempting as it is: drops that only take away the redness do not treat the dryness. Some of these decongestant drops can even cause a habituation effect with frequent use and irritate the eyes more in the long run.
Some situations deserve special attention. Contact lenses sit directly on the tear film and can worsen dry eyes, especially with long wear. Here wearing breaks, a different lens type or switching to glasses help, plus moisturising drops that are suitable for lenses. After eye surgery such as a laser treatment, dry eyes are temporarily common and usually improve on their own, but should be accompanied. Hormonal changes also play a role: during the menopause and with certain hormonal contraceptives, dry eyes occur more often. Anyone who suspects a connection here is best to discuss it with their medical practice. Often a small change, such as a different lens or an adjusted product, is enough to ease the symptoms noticeably.
Dry eyes usually improve with good care and the right drops. In some cases a medical assessment is important to rule out more serious causes.
Have it medically assessed
See an eye practice if the symptoms do not improve despite artificial tears after a few days, if pain, marked redness, light sensitivity or vision problems occur. Think of Sjögren's syndrome and a rheumatology assessment if, alongside the dry eyes, a dry mouth, joint problems and persistent fatigue are present. Untreated, severe dry eyes can damage the cornea and impair vision.
If a rheumatic or other underlying condition is behind it, treating that is decisive. Read more in our article on rheumatism. Because tired, burning eyes burden everyday life, dry eyes often go together with concentration problems and general fatigue, especially with a lot of screen work.
Whether eye drops, thyroid or rheumatism medications: brite helps you manage your remedies, get reminded to use them and check possible side effects such as dry eyes.
A lot can be prevented by relieving the eyes in everyday life. With screen work, plan fixed breaks, blink consciously and set up the workplace eye-friendly, with the screen slightly below eye level. Provide a good room climate with some humidity and avoid direct draughts and smoke. Anyone who wears contact lenses gives the eyes regular glasses days. Enough sleep and sufficient drinking provide additional support. Acting early often prevents occasional burning from turning into a lasting problem. Even small routines, such as a bottle of drops at the workplace and conscious blinking breaks, make a noticeable difference over the day.
The bottom line: dry eyes are usually harmless and treatable when you know the cause and choose the right tear substitute. Conscious blinking, breaks and preservative-free drops are the most important levers. If the symptoms stay stubborn or further signs appear, it is worth looking at causes such as medications or Sjögren's syndrome, together with medical help. Anyone who knows the ingredient of their drops and keeps their own triggers in view can counteract specifically, instead of letting product promises guide them.
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This article is for general information and does not replace medical advice, diagnosis or treatment. Information on ingredients and tear substitutes is kept general. With persistent, painful or vision-impairing symptoms, or with signs of an underlying condition, please contact an eye or general practice.
