There are many over-the-counter eye drops available to relieve itchy, red or watery eyes. But the types of eye drops available on pharmacy or supermarket shelves vary as much as the possible causes of your eye irritation.
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How do you know which eye drops will work best for you? Ophthalmologist Peter McGannon, MD, breaks down eye-drop products into three categories based on their active ingredients:
1. Allergy drops
How they work: These drops block the overreaction of the immune system to allergens. They’ll most commonly contain an antihistamine like pheniramine or a newer, long-acting antihistamine called ketotifen, which prevents immune cells from releasing histamine in the first place.
Use: These help reduce redness and itchy, watery eyes from the seasonal onslaught of allergies from grasses, pollens or molds or from allergies to the hair and dander of your household pets. Use, as needed, according to product instructions.
2. Anti-redness drops
How they work: These shrink the blood vessels on the surface of the eye — a process called vasoconstriction. Typical active ingredients found in these products are tetrahydrozoline or naphazoline. Anti-redness drops may occasionally also contain allergy relievers and mild lubricants.
Use: As the name indicates, these help reduce the redness of irritated eyes. They’re OK for occasional use. However, they may make your redness worse if you use them for many days in a row.
3. Artificial tears
How they work: These are simply lubricants that help keep the surface of the eye hydrated.
Use: Use them, as needed, to treat dry eye or to ease contact lens irritation or mild allergies. However, don’t confuse artificial tears with anti-redness drops, which you should use only sparingly, Dr. McGannon says.
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More about dry eye
Dry eye is a common problem, especially as we get older. While contact lens wearers often experience dryness and irritation, women may experience dry eye after menopause because of hormonal changes.
“Symptoms of dry eye are typically scratchy, gritty or sore eyes,” says Dr. McGannon. “But contrary to what most people think, tearing is one of the most common signs of dry eyes.”
Tears are a reaction to dry eye but these reactive tears are too watery and don’t lubricate the eye well, he says.
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Sorting out terms on eye drop labels
Dr. McGannon says, generic store brands generally work as well as name-brand products for eye drops, he says.
However, be wary of drops labeled “natural,” “homeopathic” or “herbal.” While they could work well for you, there is no reliable data to support their use or effectiveness, he says.
When should you see a doctor?
If you have seasonal or pet allergies that have been well-documented by your doctor, using over-the-counter eye drops, as needed, is a good idea.
“But if you have unexpected eye irritation after a recent upper respiratory infection or exposure to someone with a red eye, then there is a high probability of a viral or bacterial infection,” says Dr. McGannon.
Eye conditions that are not improving with OTC products, are quickly worsening, or accompanied by severe pain or vision changes or loss should be evaluated by a doctor right away, he says.
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