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Understanding eye drops can feel overwhelming. At The Eye Practice, we prefer preservative-free formulations, as added preservatives can irritate the delicate surface of the eye and, over time, may worsen the very symptoms they’re intended to relieve.
Main uses of eye drops
Eye drops serve four primary purposes: treating infections, relieving dry eyes, reducing inflammation and allergies, and controlling glaucoma.
Antibiotic eye drops
Most eye irritation is not caused by bacterial infections. In Australia, chloramphenicol (Chlorsig) is commonly available over the counter, but unnessescary or repeated use can be problematic. Many people reach for antibiotic drops when their eyes are simply dry or irritated. Other topical prescription antibiotics like Ciloxan or Ocuflox prove valuable for contact lens related infections or following eye surgery.
Dry eye drops
Dry eye disease and meibomian gland dysfunction affects millions of Australians, and is worsened by our harsh climate, air conditioning, and prolonged screen use. Most lubricating drops provide temporary symptomatic relief rather than treating underlying causes of dry eye disease. Overuse of artificial tears can actually flush away your eye’s natural oil layer, which is essential for tear stability.
If using drops more than four times per day, switch to preservative-free formulations. (Hint: you can tell a drop has preservatives usually if it’s in a multi-dose bottle) Preservatives become toxic to the ocular surface with repeated use. Australia’s intense UV exposure, low humidity, bushfire smoke, and dust all stress your tear film.
Anti-inflammatory drops
Steroid drops (FML, Maxidex, Pred Forte, Lotemax) require a prescription and eye pressure monitoring, as they can trigger high eye pressures in susceptible individuals. These drops do a very good job in controlling acute inflammation like uveitis chronic allergies or corneal graft changes.
NSAIDs (Voltaren, Acular) calm inflammation differently and are commonly prescribed after eye surgery. Often both types are prescribed together for complementary effects.
Allergy drops
Australian pollen from native grasses, wattles, and flora creates distinct allergy seasons. Antihistamine drops (Patanol, Zaditen) effectively control symptoms with twice-daily dosing but can cause dehydration. Mast cell stabilisers suit longer-term use and contact lens-related allergies.
Preservatives themselves trigger allergic reactions. Request preservative-free formulations from compounding pharmacies when possible. Again, preservative-free formulations are preferred for OTC or compounding pharmacies.
Glaucoma drops
Glaucoma typically presents no noticeable symptoms until significant and irreversible damage has occurred. These topical medications lower eye pressure through various mechanisms.
Prostaglandin analogues (Xalatan, Lumigan) increase fluid drainage with minimal side effects. Beta blockers (Timoptol) decrease fluid production but may have systemic effects. You can minimise systemic absorption by gently closing your eyes after application. This will also increase contact time on the eye surface while reducing drainage into the tear duct. Adherence is crucial – many patients lose vision permanently through non-compliance.
How to use eye drops correctly
- Wash hands thoroughly
- Shake the bottle well
- Use a mirror for alignment
- Avoid touching the dropper to eyelids
- Look away from the bottle
- Gently pull down the lower lid and aim the drop into the bottom lid
- Close eyes gently for 30-60 seconds to improve drop efficacy and reduce systemic absorption.
If struggling, try lying down or using a drop dispenser from pharmacies. It’s normal to need to practice!
Final thoughts
Regular eye examinations remain crucial. Discuss your regimen with your optometrist or ophthalmologist to optimise treatment and switch to preservative-free options where possible. Australia’s environmental challenges demand a thoughtful understanding of eye care and management.