Eye Drops and Gels for Dry Eye Treatment

Suitable dryness severity: Moderate

Target tear layer: Aqueous

Preservative and its effect: Preservative-free (single-dose UD vials).

Ingredients:

• Sodium Hyaluronate 0.2%: long-lasting hydration (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Phosphate-free; safe to use while wearing contact lenses

Suitable dryness severity: Moderate – severe

Target tear layer: All three layers together

Preservative and its effect: Preservative-free

Ingredients:

• Sodium Hyaluronate 0.24%: hydration with high water retention (target layer: aqueous)

• Carbomer: increases viscosity and prolongs retention of the drop on the surface (target layer: aqueous)

• Medium Chain Triglycerides (MCT): lipid component that supports the lipid layer and reduces evaporation (target layer: lipid)

• Glycerol: supplementary humectant (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: A carbomer + lipid component (MCT) formula that combines aqueous hydration with lipid layer support in a single drop; suitable for dry eye accompanied by excessive tearing (watery eyes)

Suitable dryness severity: Mild – moderate (with allergy)

Target tear layer: Aqueous + lipid support

Preservative and its effect: Preservative-free.

Ingredients:

• Sodium Hyaluronate 0.24%: high hydration (target layer: aqueous)

• Ectoin 2%: forms a protective shield around cells, anti-inflammatory, relieves allergy symptoms (redness, itching, burning) (target layer: aqueous + lipid support)

Additional benefits (beyond lubrication) / notes: Designed for dry eye with allergic/inflammatory symptoms (itching, redness); ectoine stabilizes the lipid layer and has an anti-inflammatory effect independent of lubrication

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + cell protection of the underlying epithelium

Preservative and its effect: Preservative-free.

Ingredients:

• Trehalose 2%: cell protection against oxidative stress and cellular desiccation (target layer: aqueous + epithelial protection)

• Sodium Hyaluronate 0.25%: high hydration and viscosity (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Trehalose provides cell protection against oxidative stress and desiccation independently of lubrication itself

Suitable dryness severity: Moderate

Target tear layer: Aqueous

Preservative and its effect: Preservative-free (single-dose UD vials).

Ingredients:

• Sodium Hyaluronate 0.2%: long-lasting hydration (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Safe to use while wearing contact lenses

Suitable dryness severity: Moderate – severe (especially evaporative dry eye)

Target tear layer: Lipid + aqueous together (two-phase emulsion)

Preservative and its effect: Free of traditional preservatives; contains a very low concentration of cetalkonium chloride as a cationic agent to stabilize the emulsion (with a mild accompanying antimicrobial effect), and it rarely causes mild irritation.

Ingredients:

• Mineral Oils: directly rebuilds the lipid layer and reduces evaporation (target layer: lipid)

• Glycerol: hydrophilic humectant (target layer: aqueous)

• Tyloxapol / Poloxamer 188: emulsifiers that combine the oil and water phases in tiny droplets (target layer: lipid + aqueous)

Additional benefits (beyond lubrication) / notes: The positive charge of the oil droplets makes them electrostatically attracted to the damaged (negatively charged) ocular surface, so they adhere to it and last longer

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous

Preservative and its effect: Free of traditional preservatives; contains SDC (silver dihydrogen citrate), which has built-in antimicrobial properties within the formula itself.

Ingredients:

• Sodium Hyaluronate: natural hydration with high water retention (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: A suitable concentration as first-line treatment for mild to moderate dry eye

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + light mucin support

Preservative and its effect: Preservative-free

Ingredients:

• Cross-linked Sodium Hyaluronate: natural hydration with high water retention (target layer: aqueous)

• Hydroxypropyl Methylcellulose (HPMC): stabilizes the tear film and prolongs its retention (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Combining sodium hyaluronate with HPMC provides fast and long-lasting hydration (cross-linked hyaluronate) together with longer tear film stability (HPMC) in a single formula

Suitable dryness severity: Moderate

Target tear layer: Aqueous

Preservative and its effect: Sodium chlorite (stabilized oxychloro complex 80%) – a "gentle" preservative that breaks down in light into natural components already present in tears; minimal irritation

Ingredients:

• Sodium Hyaluronate 0.2%: natural hydration and viscosity (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Natural hydration and viscosity

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous

Preservative and its effect: Preservative-free.

Ingredients:

• Sodium Hyaluronate 0.15%: hydration and prolonged retention on the ocular surface (target layer: aqueous)

• L-Proline / Glycine / L-Lysine HCl / L-Leucine: amino acids that improve surface hydration and support protection of a stressed epithelium (target layer: supports the epithelium beneath the mucin)

Additional benefits (beyond lubrication) / notes: The four-amino-acid blend improves adhesion of the solution to the ocular surface and supports epithelial protection independently of the hyaluronate itself

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous + lipid support

Preservative and its effect: Completely free of preservatives and phosphates (mechanical COMOD system).

Ingredients:

• Sodium Hyaluronate 0.05%: light hydration and viscosity (target layer: aqueous)

• Ectoin 2%: protects cells, stabilizes the lipid layer, anti-inflammatory, and relieves itching and burning (target layer: lipid + cell protection)

Additional benefits (beyond lubrication) / notes: Designed for dry eye with allergic/inflammatory symptoms (itching, redness); ectoine stabilizes the lipid layer and has an anti-inflammatory effect independent of lubrication

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + lipid support

Preservative and its effect: Completely free of preservatives and phosphates (mechanical COMOD system).

Ingredients:

• Sodium Hyaluronate 0.2%: intensive, high-viscosity hydration (target layer: aqueous)

• Ectoin 2%: protects cells, stabilizes the lipid layer, strongly anti-inflammatory for chronic cases (target layer: lipid + cell protection)

Additional benefits (beyond lubrication) / notes: A higher-concentration version of Hylo Dual for severe chronic dry eye with inflammation.
Designed for dry eye with allergic/inflammatory symptoms (itching, redness); ectoine stabilizes the lipid layer and has an anti-inflammatory effect independent of lubrication

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous

Preservative and its effect: Preservative-free and phosphate-free.

Ingredients:

• Sodium Hyaluronate 0.1%: natural hydration and balanced viscosity (target layer: aqueous)

• Sorbitol: osmotic balance and supporting humectant (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Phosphate-free formula

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + lipid (thanks to vitamin E) + support of the epithelium beneath the mucin

Preservative and its effect: Completely preservative-free (UD formula).

Ingredients:

• Sodium hyaluronate (two different molecular weights): fast and prolonged hydration at the same time (target layer: aqueous)

• Vitamin E TPGS: antioxidant that stabilizes the lipid phase of the solution (target layer: lipid + cell protection)

• Polyvinylpyrrolidone (PVP): additional viscosity (target layer: aqueous)

• L-Glycine: osmoprotection of epithelial cells (target layer: aqueous)

• Centella Asiatica Extract: promotes tissue healing and supports epithelial regeneration (target layer: supports the mucin and the epithelium beneath it)

Additional benefits (beyond lubrication) / notes: A combination of an antioxidant (vitamin E) and a tissue-healing promoter (Centella asiatica) that work together independently of lubrication

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + epithelial cell protection

Preservative and its effect: Preservative-free

Ingredients:

• Sodium Hyaluronate 0.1%: additional hydration and longer retention on the ocular surface (target layer: aqueous)

• Carboxymethylcellulose Sodium 0.5%: viscosity and hydration (target layer: aqueous)

• Glycerol 0.9%: long-lasting humectant (target layer: aqueous)

• Erythritol / L-Carnitine: osmoprotection of epithelial cells (target layer: aqueous + epithelial protection)

Additional benefits (beyond lubrication) / notes: Adding sodium hyaluronate to the original Optive formula gives it better adhesion and longer retention on the ocular surface than regular Optive

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous

Preservative and its effect: PURITE (stabilized oxychloro complex) – breaks down into water, oxygen, and natural chloride ions on exposure to light and tears; very low toxicity

Ingredients:

• Carboxymethylcellulose Sodium 1%: high viscosity and long-lasting hydration (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Its thick gel texture makes it suitable for nighttime use as prolonged mechanical protection during sleep

Suitable dryness severity: Moderate

Target tear layer: Aqueous + epithelial cell protection

Preservative and its effect: Preservative-free

Ingredients:

• Carboxymethylcellulose Sodium 0.5%: viscosity and stable hydration of the tear film (target layer: aqueous)

• Glycerin 0.9-1%: long-lasting humectant that does not blur vision (target layer: aqueous)

• Erythritol: osmoprotection of cells against oxidative desiccation (target layer: aqueous + epithelial protection)

• L-Carnitine (Levocarnitine): restores osmotic balance and normalizes cell function (target layer: aqueous + epithelial protection)

Additional benefits (beyond lubrication) / notes: Erythritol and levocarnitine (osmoprotectants) work independently of lubrication to restore the osmotic balance of epithelial cells and normalize their function

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous + light mucin support

Preservative and its effect: Polyhexamethylene biguanide (PHMB) – a relatively gentle preservative also used in contact lens solutions; relatively well tolerated.

Ingredients:

• Hypromellose: stabilizes the tear film and prolongs its retention on the surface (target layer: aqueous)

• Sodium Hyaluronate: high natural hydration (target layer: aqueous)

• Sodium Chondroitin Sulfate: viscosity and elasticity similar to the components of natural connective tissue (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Unlike most well-known Rohto drops (red/blue), this version contains no vasoconstrictor or high-concentration menthol, so it is safe for frequent daily use without the risk of rebound redness

Suitable dryness severity: Moderate – severe

Target tear layer: All three layers together (Liquid Shield technology)

Preservative and its effect: Polyaminopropyl biguanide (PAPB) – a gentle preservative also used in contact lens solutions; relatively well tolerated.

Ingredients:

• Povidone (PVP) 0.68%: viscosity and hydration that mimic natural mucus; adheres to dry areas (target layer: aqueous + mucin support)

• Propylene Glycol 0.3%: supplementary humectant for the aqueous layer (target layer: aqueous)

• Sesame Oil / PEG-10 Castor Oil / Polyoxyl Stearate: rebuild the lipid layer and reduce evaporation (target layer: lipid)

• Poloxamer: emulsifier that combines the oil and water phases (target layer: lipid + aqueous)

• Menthol (low concentration): a light, refreshing cooling sensation (target layer: none – sensory effect only, no lubrication)

Additional benefits (beyond lubrication) / notes: Liquid Shield technology covers all layers of the tear film at once.

Suitable dryness severity: Moderate – severe

Target tear layer: All three layers together (nano-droplet technology)

Preservative and its effect: PF version: preservative-free.

Ingredients:

• Propylene Glycol 0.6%: main humectant for the aqueous layer (target layer: aqueous)

• Mineral Oil / Dimyristoyl Phosphatidylglycerol: rebuilds the lipid layer and reduces evaporation (target layer: lipid)

• Hydroxypropyl Guar (HP-Guar): forms a local gel in dry areas (target layer: aqueous + mucin adhesion)

• Polyoxyl 40 Stearate / Sorbitan Tristearate: emulsifiers that combine the oil and water phases into nano-droplets (target layer: lipid + aqueous)

Additional benefits (beyond lubrication) / notes: A nano-droplet emulsion that combines a lipid phase (mineral oil and phospholipid) and an aqueous phase in tiny droplets that spread over the entire ocular surface, covering all three types of dry eye (aqueous-deficient, evaporative, and mixed)

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous (dual HydroBoost technology)

Preservative and its effect: PF version: preservative-free.

Ingredients:

• Sodium Hyaluronate 0.15%: natural hydration with high water retention (target layer: aqueous)

• Polyethylene Glycol 400 (0.4%) / Propylene Glycol (0.3%): dual primary lubricants (target layer: aqueous)

• Hydroxypropyl Guar (HP-Guar): helps lubricants stay on the ocular surface (HydroBoost) (target layer: aqueous + mucin adhesion)

Additional benefits (beyond lubrication) / notes: HydroBoost technology combines sodium hyaluronate and HP-Guar to keep active lubricants on the ocular surface longer than conventional formulas

Available in two versions: a multi-dose bottle and a single-dose UD version

Suitable dryness severity: Moderate

Target tear layer: Aqueous

Preservative and its effect: Bottle version: POLYQUAD (polyquaternium-1) 0.001% – a modern, gentle preservative with low toxicity that rarely causes irritation.
UD version: preservative-free (single dose).

Ingredients:

• Polyethylene Glycol 400 (0.4%): main humectant that prolongs tear retention on the surface (target layer: aqueous)

• Propylene Glycol (0.3%): hydration and lubrication (target layer: aqueous)

• Hydroxypropyl Guar (HP-Guar): turns into a viscous gel on contact with a dry surface (target layer: aqueous + mucin adhesion)

• Sorbitol / Potassium Chloride / Sodium Chloride: supporting humectant and electrolyte balance (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: HP-Guar technology reacts with the pH of the ocular surface to form a local protective gel network specifically in the driest areas, without affecting the rest of the surface

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous + light support of the mucin layer

Preservative and its effect: Preservative-free (single dose).

Ingredients:

• Dextran 70 (0.1%): thickens the tear film and prevents its rapid break-up between blinks (target layer: aqueous)

• Hypromellose (HPMC) 0.3%: adheres to dry areas of the epithelium, forming an artificial mucin layer (target layer: aqueous + mucin support)

• Sorbitol: osmotic balance and supporting humectant (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: The Duasorb system combines the viscosity of dextran with adhesion to dry areas of the epithelium at the same time

Suitable dryness severity: Moderate – severe

Target tear layer: Aqueous + epithelial cell protection

Preservative and its effect: Preservative-free (ABAK system with a 0.2-micron filter that mechanically prevents contamination).

Ingredients:

• Trehalose 3%: cell protection and activation of cell survival mechanisms in severe dryness (target layer: aqueous + epithelial protection)

• Sodium Hyaluronate 0.15%: hydration and viscosity that prolong retention of the solution on the surface (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Trehalose stimulates cellular autophagy, which helps epithelial cells survive under severe dryness – a biological effect independent of lubrication

Suitable dryness severity: Mild – moderate

Target tear layer: Mainly aqueous

Preservative and its effect: Preservative-free.

Ingredients:

• Sodium Hyaluronate 0.15%: hydration, viscosity, and adhesion to the ocular surface (target layer: aqueous)

• Ginkgo Biloba Extract 0.05%: antioxidant that protects corneal cells and supports tear film stability (target layer: supports aqueous stability and cell protection)

Additional benefits (beyond lubrication) / notes: Ginkgo biloba is an antioxidant that protects corneal cells from free radicals and supports rebuilding of a damaged tear film after refractive surgery or LASIK

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous

Preservative and its effect: Preservative-free.

Ingredients:

• Sodium Hyaluronate 0.18%: balanced natural hydration (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: Precisely mimics the osmotic and electrolyte composition of natural tears (multiple matching salts)

Suitable dryness severity: Mild – moderate

Target tear layer: Aqueous

Preservative and its effect: Completely preservative-free.

Ingredients:

• Sodium Hyaluronate 0.21%: quick hydration for mild to moderate dry eye symptoms (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: A suitable concentration as first-line treatment for mild to moderate dry eye; safe for frequent use

Suitable dryness severity: Severe

Target tear layer: Aqueous

Preservative and its effect: Preservative-free; safe to use for up to 6 months after opening.

Ingredients:

• Sodium Hyaluronate 0.4%: intensive hydration for severe dry eye, long-lasting comfort (target layer: aqueous)

Additional benefits (beyond lubrication) / notes: High concentration for longer-lasting relief – ideal for nighttime use and severe dry eye.

Suitable dryness severity: Moderate – severe (evaporative dry eye)

Target tear layer: Aqueous + lipid together (nanoemulsion)

Preservative and its effect: Preservative-free and phosphate-free.

Ingredients:

• Sodium Hyaluronate 0.15%: hydrates the aqueous layer (target layer: aqueous)

• Castor Oil 0.25%: rebuilds the lipid layer and reduces evaporation (target layer: lipid)

• Tocopherol (Vitamin E TPGS): antioxidant that stabilizes the emulsion and protects cells (target layer: lipid + cell protection)

• Glycerin / Polysorbate 80 / Macrogolglycerol Hydroxystearate: complementary emulsifiers and humectants that form the nanoemulsion (target layer: lipid + aqueous)

Additional benefits (beyond lubrication) / notes: Castor oil and vitamin E droplets spread evenly over the entire ocular surface to specifically rebuild the lipid layer – best suited for evaporative dry eye caused by a deficient lipid layer

Suitable dryness severity: Moderate – severe (especially after surgery)

Target tear layer: Aqueous + support of the epithelium beneath the mucin

Preservative and its effect: Preservative-free; safe to use for up to 6 months after opening.

Ingredients:

• Sodium Hyaluronate 0.15%: hydration and viscosity (target layer: aqueous)

• Dexpanthenol (Pro-vitamin B5) 0.2%: promotes healing and regeneration of an inflamed or damaged ocular surface (target layer: supports the epithelium beneath the mucin)

Additional benefits (beyond lubrication) / notes: Dexpanthenol (provitamin B5) promotes epithelial regeneration independently of lubrication; useful after surgery or severe irritation

Overall target layer: All three layers together

Preservative and its effect: It actually contains two preservation-related substances: (1) cetrimide – a traditional cationic antiseptic and the main antimicrobial preservative, which may cause irritation with frequent or long-term use; (2) sodium edetate (EDTA) – a chelating agent that acts as a "preservative potentiator" by binding the metal ions bacteria need to grow, thereby strengthening the effect of cetrimide. The manufacturer recommends nighttime use only to limit repeated exposure to both.

Ingredients:

• Carbomer (0.2%): high-viscosity gel that stays on the ocular surface all night (target layer: aqueous + mucin adhesion)

• Medium Chain Triglycerides (MCT): supports the lipid layer and reduces overnight evaporation (target layer: lipid)

• Sorbitol: osmotic balance (target layer: aqueous)

Additional benefits (beyond lubrication): The combination of carbomer with medium-chain triglycerides (MCT) makes it one of the few gels that directly support the lipid layer in addition to lubrication – designed specifically for nighttime, not daytime, use

Overall target layer: Aqueous

Preservative and its effect: Preservative-free (single-dose UD).

Ingredients:

• Sodium Hyaluronate 0.3%: intensive hydration with high viscosity and longer retention than regular drops (target layer: aqueous)

Additional benefits (beyond lubrication): Intensive hydration for severe dry eye

Overall target layer: Aqueous

Preservative and its effect: Preservative-free.

Ingredients:

• Sodium Hyaluronate 0.30% (FHA 1.0): hydration and prolonged retention on the ocular surface, with higher viscosity than the drops (target layer: aqueous)

• L-Proline / Glycine / L-Lysine HCl / L-Leucine: amino acids that improve surface hydration and support protection of a stressed epithelium (target layer: supports the epithelium beneath the mucin)

Additional benefits (beyond lubrication): The same amino acid blend as the drops (L-proline, glycine, L-lysine HCl, L-leucine), but in a gel texture with a higher hyaluronate concentration (0.3% instead of 0.15%) for longer retention on the surface

Overall target layer: Aqueous

Preservative and its effect: Preservative-free (mechanical COMOD system).

Ingredients:

• Sodium Hyaluronate 0.2%: intensive, high-viscosity hydration for severe and chronic cases (target layer: aqueous)

• Sorbitol: osmotic balance (target layer: aqueous)

Additional benefits (beyond lubrication): Despite its viscous, gel-like texture, it is technically a high-viscosity solution rather than a carbomer gel; it combines a double hyaluronate concentration (0.2%) with a reusable bottle

Overall target layer: Lipid

Preservative and its effect: Preservative-free

Ingredients:

• White Soft Paraffin (Petrolatum): occlusive lipid barrier that fully prevents overnight evaporation (target layer: lipid)

• Liquid Paraffin (Mineral Oil): softens the ointment and helps it spread evenly (target layer: lipid)

Additional benefits (beyond lubrication): Forms a complete barrier that prevents evaporation all night; especially useful for incomplete eyelid closure (lagophthalmos) or severe nighttime dryness. Technically it is a paraffin ointment rather than a carbomer gel, but it is marketed in the thick nighttime lubrication category alongside gels

Overall target layer: Aqueous + lipid together (semi-ointment texture)

Preservative and its effect: Hydroxymethyl glycinate – a relatively gentle preservative used at very low concentrations; better tolerated than BAK.

Ingredients:

• Sodium Hyaluronate 0.4%: intensive, high-concentration hydration (target layer: aqueous)

• Vaseline Oil (Petrolatum): lipid barrier that reduces evaporation and prolongs overnight retention (target layer: lipid)

Additional benefits (beyond lubrication): A rare hybrid formula that combines sodium hyaluronate (aqueous hydration) with Vaseline oil (lipid barrier) in a single isotonic ointment-like texture – a mid-priced option between a light gel and a traditional heavy ointment

Overall target layer: Supports the mucin and the epithelial surface

Preservative and its effect: It actually contains two preservation-related substances: (1) cetrimide – the main cationic antimicrobial antiseptic; (2) disodium edetate (EDTA) – an agent that enhances the effectiveness of cetrimide by chelating the metal ions bacteria need to grow. Long-term or very frequent use is not recommended because this combination may irritate the cornea.

Ingredients:

• Dexpanthenol (Pro-vitamin B5) 5%: strongly promotes regeneration and healing of the corneal epithelium; useful after surgery. (target layer: supports the mucin and epithelial surface)

• Carbomer: prolongs contact of dexpanthenol with the ocular surface and acts as a water reservoir (target layer: aqueous + mucin adhesion)

Additional benefits (beyond lubrication): Almost the same formula as Corneregel (dexpanthenol 5% + carbomer), but marketed under a different name in some markets; used to speed up healing of the ocular surface after surgery

Overall target layer: Aqueous + epithelial cell protection

Preservative and its effect: Preservative-free (single-dose UD, phosphate-free).

Ingredients:

• Trehalose 3%: cell protection and activation of cell survival mechanisms in severe dryness (target layer: aqueous + epithelial protection)

• Sodium Hyaluronate 0.15%: hydration and viscosity (target layer: aqueous)

• Carbomer 0.25%: keeps trehalose and hyaluronate on the ocular surface for up to 6 hours (target layer: aqueous + mucin adhesion)

Additional benefits (beyond lubrication): Adding carbomer to the original Thealoz Duo formula (available as drops) keeps trehalose and hyaluronic acid on the surface for up to 6 hours, making it the better choice for nighttime use or severe dry eye compared with the drops

Overall target layer: Aqueous

Preservative and its effect: Preservative-free (single-dose UD).

Ingredients:

• Sodium Hyaluronate 0.3%: high hydration with a gel texture and higher viscosity than regular drops (target layer: aqueous)

Additional benefits (beyond lubrication): Intensive hydration for severe dry eye