The best eye drops for dry eyes depend on why your eyes are dry. For most people, a preservative-free artificial tear is a safe first choice.
If your tears evaporate too fast, a lipid-based drop often works better. If drops are not enough, prescription treatments can address inflammation, tear production, or eyelid mites.
There is no single best drop for everyone, so this guide is organized by category rather than by brand.
Important safety note: Never stop or change a prescribed eye drop or medication without talking to your doctor first. This includes glaucoma drops, which can look like simple eye drops but protect your vision.
Step One: Find Out Why Your Eyes Are Dry
The Tear Film and Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II), an international expert report, describes dry eye as a disease of the tear film and eye surface with several causes. It classifies dry eye along a range from aqueous deficient (the eye does not make enough watery tears) to evaporative (tears dry up too fast). Many people have elements of both.
Evaporative dry eye is commonly linked to meibomian gland dysfunction (MGD), where the oil glands in the eyelids do not release enough healthy oil. Eyelid problems, such as lids that do not close fully or turn outward, can also dry the eye.
That is why the first step is a comprehensive eye exam. The TFOS DEWS II management report found that telling aqueous deficient and evaporative dry eye apart is critical in choosing the right treatment. Learn more at our Dry Eye Center.
Over-the-Counter Dry Eye Drops: Lubricating Eye Drops
Lubricating eye drops, often called artificial tears, are available over the counter. They add moisture and smooth the eye surface. They differ in two main ways: preservatives and thickness.
Preservative-free vs preserved artificial tears
Preserved drops come in a multi-use bottle with a chemical that keeps germs from growing. Preservative-free drops usually come in single-use vials, or in special bottles designed to stay clean without preservatives.
Preservatives can irritate the eye surface with frequent use. A 2025 review in Acta Ophthalmologica found evidence of toxic effects from the preservative benzalkonium chloride (BAK) and noted that long-term BAK exposure may contribute to disease progression.
A practical rule many eye doctors use: if you need drops more than about 4 times a day, choose preservative-free. If you also use other drops, such as glaucoma drops, ask your doctor about total preservative exposure.
Thin drops, gels, and ointments
- Thin (low-viscosity) drops blur vision the least and work well for mild, daytime dryness.
- Gel drops are thicker. They last longer but may blur vision briefly.
- Ointments are the thickest. They are best used at bedtime, because they blur vision.
Many people use thin drops by day and a gel or ointment at night.
Lipid-based drops for evaporative dry eye
Lipid-based artificial tears contain oils that help support the tear film's outer oil layer. They are often a good choice for evaporative dry eye and meibomian gland dysfunction. These drops may look slightly milky, which is normal.
Prescription Eye Drops for Dry Eyes
When over-the-counter drops are not enough, prescription options target different causes. Learn more on our prescription dry eye drops page.
Perfluorohexyloctane (Miebo)
Miebo is a water-free, preservative-free prescription drop designed to reduce tear evaporation. The FDA label directs one drop 4 times daily. In the phase 3 GOBI trial of 597 treated patients with dry eye and MGD, it improved corneal staining and eye dryness scores more than a saline drop at week 8.
Remove contact lenses before use and wait at least 30 minutes to put them back.
Anti-inflammatory drops: cyclosporine and lifitegrast
Inflammation keeps dry eye going. Cyclosporine drops calm the immune response on the eye surface. In two phase 3 studies of 877 patients, cyclosporine 0.05% improved corneal staining and Schirmer test results (a measure of tear production) compared with the vehicle drop.
Lifitegrast (Xiidra) blocks a different inflammation pathway. In the OPUS-3 trial of 711 participants, it improved eye dryness scores compared with placebo, with improvement seen as early as day 14. These drops often take weeks to reach full effect, so patience matters.
Loteprednol 0.25% (Eysuvis) for flares
Eysuvis is a mild steroid drop approved for short-term treatment, up to two weeks, of dry eye signs and symptoms. Steroids can raise eye pressure with longer use. The FDA label says it should be renewed only after an eye exam that includes checking eye pressure.
Acoltremon (Tryptyr)
Tryptyr is a newer drop that stimulates cold-sensing nerve receptors (called TRPM8) to increase natural tear production. In the COMET-2 and COMET-3 trials, more patients reached a 10 mm or greater increase in tear production by day 14 than with vehicle (42.6% vs 8.2% and 53.2% vs 14.4%). The FDA label lists instillation site pain in 50% of patients, which was mostly mild in the trials.
Other Prescription Options
Varenicline nasal spray (Tyrvaya)
Tyrvaya is a nasal spray that activates a nerve pathway signaling the tear glands. In the ONSET-2 trial, 47.3% of patients on the 0.03 mg dose achieved a 10 mm or greater tear improvement at week 4, compared with 27.8% on vehicle. The FDA label reports sneezing in 82% of patients.
Lotilaner (Xdemvy) for Demodex blepharitis
Tiny Demodex mites on the eyelashes can cause eyelid inflammation called blepharitis, which worsens dry eye symptoms. Xdemvy is used one drop in each eye twice daily for 6 weeks.
In the Saturn-2 trial, collarette cure (clearing of the crusty dandruff at the lash base) was 56.0% vs 12.5% with vehicle. See our page on Demodex blepharitis and Xdemvy.
Autologous serum tears
For severe dry eye, drops can be made from a patient's own blood serum, which contains natural growth factors. A 2026 network meta-analysis in Sjogren's syndrome dry eye found autologous serum improved tear film stability, though the certainty of evidence was low to moderate.
Drops to Avoid or Limit
Redness relievers with tetrahydrozoline or naphazoline shrink blood vessels to make eyes look whiter. They do not treat dry eye. The American Academy of Ophthalmology warns that redness can come back worse than before, called rebound redness, and advises not using them for more than 72 hours.
Low-dose brimonidine whitening drops carry a lower risk of rebound redness. In an integrated analysis of four clinical trials, rebound redness was rare. Still, they treat appearance, not dryness. Read more in our article on eye drops that make dry eye worse.
When Drops Are Not Enough
- Punctal plugs block the tear drain so your own tears stay on the eye longer.
- Lacrifill is a gel placed in the tear drain. In a randomized trial, it was noninferior (not worse) to standard plugs at improving tear measures, with benefits sustained through 6 months.
- LipiFlow applies warmth and gentle pressure to the eyelids to open blocked oil glands. A meta-analysis of 10 randomized trials found improved symptoms and gland function. Learn more on our MGD and LipiFlow page.
- Eyelid surgery can help when eyelid position keeps the eye from closing or blinking well.
Dry eye and cataract surgery
Dry eye matters before cataract surgery too. An unstable tear film can distort the eye measurements used to choose your lens power. In one randomized study, treating MGD with LipiFlow before surgery improved the eye surface after surgery.
If you are planning cataract surgery, our Lens Simulator (opens in a new tab) can help you compare lens options.
From Dr. Shomer
"Most patients I see for dry eye have already tried three or four drops from the drugstore. The drop usually is not the problem. The problem is that nobody has looked at why the eye is dry. When I examine the eyelid oil glands, the tear film, and the eyelid position, the right treatment often becomes clear. Start with a preservative-free tear, but if you are using it all day and still struggling, come in. There are many good options now that did not exist a few years ago."
Dry Eye Care Near Upland, Rancho Cucamonga, and Ontario
Eye MDs of Inland is located at 1298 W 7th Street in Upland, California. We care for patients from Upland, Rancho Cucamonga, Ontario, Claremont, Montclair, Pomona, Fontana, and nearby communities. Spanish is spoken in our office.
We accept Medicare and PPO plans, and do not accept community HMO plans. Dr. Marc Shomer is a board-certified ophthalmologist who evaluates dry eye as part of comprehensive eye care at our Dry Eye Center.
A Safety Reminder
Reminder: Never stop or change a prescribed eye drop or medication without talking to your doctor first.
This article is for general education and does not replace advice from your own eye doctor. Brand names are given for identification only and are not endorsements.
Works Cited
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