3 Eye Drop Categories Every HCP Must Explain to Their CDE Patient

Key Takeaways

• Advise patients to avoid "redness-reducing" drops, as they mask inflammation and cause rebound redness without treating the underlying dryness.
• For frequent use, recommend preservative-free artificial tears to avoid corneal toxicity and irritation caused by additives like benzalkonium chloride (BAK).
• Suggest high-viscosity gels and ointments for severe cases or overnight protection, counseling patients to expect temporary blurry vision upon application.

Your patient with chronic dry eye (CDE) is standing in the pharmacy. They face a wall of confusing eye drop options. They are seconds away from grabbing the wrong box, wasting money, and potentially making their symptoms worse.

Using clear, simple explanations of the different types of eye drops and categories can help ensure your patients understand your recommendation and purchase the correct over-the-counter (OTC) product to manage their condition.

Vasoconstrictors

The first step is to warn patients about the drops they should not buy. These are the redness-reducing drops, such as those containing tetryzoline or naphazoline. Their primary function is cosmetic.¹

When explaining to patients, tell them these drops work by shrinking the blood vessels on the white part of the eye. This makes the eye look less red, but it does not solve the underlying problem.¹

Why they are bad for CDE

Use simple terms. Explain that these drops do not add lubrication or moisture, which is what their dry eyes need.¹

Warn them that when the drop wears off, the blood vessels can swell open again, often becoming redder than before. This is called rebound redness. It can lead to a cycle of overuse and dependence.^1,2

Emphasize that redness is a warning sign. Hiding it masks the true inflammation, which can prevent them from knowing if their condition is worsening.^1,2

Lubricants

This is the therapeutic category you are recommending. Their entire purpose is to treat the symptoms of dry eye.¹

Explain that these drops, also called artificial tears, work by adding moisture and helping to stabilize the eye's natural tear film.¹

Within this category, the most critical counseling point is the difference between preserved and preservative-free drops:^1,3

Drops with preservatives – Explain that most drops in multi-dose bottles contain chemical preservatives. These chemicals, like benzalkonium chloride (BAK), are there to stop bacteria from growing in the bottle.
Preservative-free (PF) drops – Explain that these drops do not have those chemicals.

This distinction is clinically significant. For patients with moderate to severe CDE, or for anyone using drops frequently (more than 4 to 6 times per day), those preservatives can be toxic to the corneal surface. They can cause more irritation and worsen the CDE symptoms you are trying to treat.^1,3,4

Advise your patient that preservative-free (PF) is the clinical standard for sensitive eyes or frequent use. You can clarify that PF drops typically come in single-use vials or in newer, specially designed multi-dose bottles with a filtered tip. Using specific products, such as the Refresh® line, which are all OTC, can be a helpful example. It offers a clear spectrum of options, from low-viscosity PF drops to PF gels, allowing for a stepped-care approach.⁵

Gels and ointments

This category is a subtype of lubricants. These high-viscosity products are designed for severe cases or for long-lasting protection.¹

Tell your patient these are thicker, so they stay on the eye longer. They create a protective barrier that is very good at preventing moisture loss, especially overnight.¹

This is the most important part of counseling for gels and ointments. You must manage their expectations about the side effects. Tell them clearly: "Because this is a thick gel, it will make your vision blurry for a few minutes right after you put it in. This is normal. That is why it is best to use it right before you go to sleep." This prevents them from thinking the product is harmful and stopping its use.¹

Simplifying the aisle improves treatment adherence

By equipping your patients with these 3 simple categories, you empower them to walk into the pharmacy with confidence. Using clear, simple language demystifies the eye drop aisle. It reduces confusion, reduces the chance of a poor purchase, and ultimately improves their adherence to your therapeutic plan.