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Eye drops are recommended for treating symptoms of dry eye, allergic reactions, and eye redness. But most eye drops contain a preservative ingredient called benzalkonium chloride (BAK).
This ingredient, when used consistently, can actually be counterproductive to treating your symptoms.
According to Dr. Barbara Horn, president of the American Optometric Association, “The Food and Drug Administration (FDA) requires that all multidose ophthalmic solutions be preserved against contamination from a standard group of pathogens. With chronic use, however, these preservatives may cause adverse effects, including reduction of the desired effect, allergic response, and toxic reaction.”
In recent years, manufacturers have begun introducing preservative-free eye drops. If you use eye drops often, it might be worth switching up your normal eye product to see if a preservative-free option works better.
We asked two eye doctors about preservative-free eye drops and the products they recommend for soothing tired, dry eyes, and for lubricating contact lenses. Here’s what they had to say.
Price range guide:
- $ (less than $20)
- $$ (between $20 – $30)
“Each patient’s dry eye treatment regimen is personalized for them and the causes of dry eye can differ from patient to patient. Simple dry eyes may be more than just ‘simple.’ Although short-term treatment with artificial tears and other supportive therapy might help for a time, a comprehensive examination from their doctor of optometry, specifically evaluating for dry eyes, can potentially help address the causes.”
— Dr. Barbara Horn, president, American Optometric Association
Systane Ultra High-Performance
These drops come in preservative-free, single-use vials. The single-dose containers ensure that the eye drops don’t get contaminated with pathogens between uses.
According to consumer reviews, the drops have a soothing, gel-like feeling after you apply them, calming the surface of your eye while lubricating your eye’s surface. You can use them twice per day to soothe irritated, dry eyes.
Buy them: Find Systane preservative-free eye drops at pharmacies, grocery stores, or online.
Refresh Relieva PF
This product is relatively new to the market. It’s different from other preservative-free eye drops for an important reason. These drops come in a multidose bottle instead of single-use vials, which cuts down on packaging waste.
Doctors recommend this formula, including Dr. Jonathan Wolfe, an optometrist in Ardsley, NY.
Wolfe says, “Refresh Relieva is something that I am excited to use in my practice, because it is a preservative-free formulation packaged in a multidose bottle. This means that patients will have the benefits of a preservative-free artificial tear, while keeping the convenience of a single bottle that can be used for days or weeks at a time.”
Buy them: Find Refresh Relieva preservative-free eye drops at pharmacies, grocery stores, or online.
Eye drops for contact lubrication focus on “wetting” your eyes, not necessarily including other ingredients that will soothe irritation.
“It’s very important that contact lens wearers use the drops/solutions recommended for them as those drops would be appropriate for [their] condition and specifically compatible with contact lenses.”
— Barbara Horn, president, American Optometric Association
Bausch and Lomb Soothe Lubricant Eye Drops
These single-use vials of eye drops claim to use a longer-lasting formula than some competitors. This brand is also known as one of the more affordable eye drop options.
The manufacturers also claim that these eye drops are better for sensitive eyes or for people recovering from LASIK surgery. Because they’re preservative-free, these eye drops might be especially gentle on your eyes and are safe to use twice per day.
Buy them: You can find Bausch and Lomb Soothe Lubricant preservative-free eye drops at some pharmacies or online.
Refresh Optive Lubricant Eye Drops
These eye drops come in single-dose containers and are safe for use with contact lenses. The formula claims to wet your eyes and keep them moist by forming a seal that keeps the moisture in your eye without blurring vision.
The long-lasting hydration soothes your eyes while keeping them lubricated, even while wearing contacts.
Buy them: You can find Refresh Optive Lubricant preservative-free eye drops at most pharmacies or online.
Recent studies have found that BAK can make antibiotics less effective and actually be toxic to the structure of your eye. According to Wolfe, “Benzalkonium chloride acts as a pro-inflammatory agent on the surface of the eye.”
A 2018 review strongly suggests that BAK is counterproductive to the treatment of symptoms of dry eye. That’s because it essentially works as a detergent, breaking up the layer of oil that rests on top of your eye’s tear film. Over time, eye drops with preservatives in them can actually lead to dry eye syndrome.
Wolfe adds, “BAK is something that a number of patients are simply allergic to, and exposure to it can lead to redness, irritation, and ocular inflammation.”
Wolfe cautions consumers who may want to treat ongoing eye conditions with drops.
“If your eyes are producing thick mucus discharge, have become very sensitive to light, or are excessively red and itchy, it’s likely you’re dealing with something that over-the-counter drops were not designed to treat,” he told Healthline.
“Contact lens wearers should be especially wary of any pain or sensitivity to light, as this can be a sign of corneal ulceration, which requires immediate medical treatment.”
A preservative-free product called Restasis Multidose is also available for chronic dry-eye, but so far only by prescription. If you’re experiencing dry eye symptoms that don’t go away, you may want to ask your doctor about prescription eye drop options.
See an eye doctor if you suspect you have any kind of eye infection. They can prescribe antibiotic drops to treat your symptoms so you don’t infect others. Keep in mind that some common eye infections, such as pink eye, clear up on their own.
Preservative-free eye drops are becoming widely available. Early research indicates that they may be more effective at lubricating and protecting your eyes. What’s more, doctors recommend them.
Next time you’re looking for switch up your eye care routine, consider trying a preservative-free option.