Preservative free artificial tears, are there any negatives.

[Yorkshireguy25]

I'm just wondering if there are any negative things that can happen from using preservative free artificial tears.

I have tried:
Systane Ultra - Hydroxypropyl Guar
Hyabak - Sodium Hyaluronate 0.15%
Lumecare - Carmellose 0.5%

As I understand you need to use artificial tears regardless say every 2-4 hours throughout the day to prevent dryness and if your eyes become dry it is too late. My problem comes when I seem to get varying outcomes from the different drops. One day systane feels great then the next not so I change and then Hyabak is great then it doesn't work. Then I use nothing and my eyes feel perfect. What is happening? Can these drops have any negative effect, i.e make my eyes feel worse and they may actually be OK but I've started some vicious cycle?

I also wear soft contacts or try to for the gym on some days and the feeling I get fluctuates again sometimes OK sometimes very dry.

[PotatoCakes]

The only drop you mention that I'm familiar with is Systane. I went through a period that I liked it but as rule, it's too thick for me and when I use it, my eyes feel gummy. I have found that, on occasion, when I need something more than Refresh Plus (more liquid-y than thick), layering the Refresh Plus with something more viscous, like Systane or Refresh Celluvisc can help and give me a less gummy feel but more protection than the Refresh Plus.

It's possible that on different days, your eyes have different needs. My own personal experience with dry eye tells me that some days my dry eye is tolerable, other days, agony, and some days I almost feel like maybe, just maybe, my eyes might be improving (those days are far and few between, sadly). Generally, I use serum drops but I supplement with artificial, preservative-free drops when I'm on the go and when I need something with more staying power. I've gone through stages where I liked Brand A, then I discover Brand B and fall in love and then someone suggests Brand C and I'll love that for a few weeks. It's possible that your needs change; it's also possible there's a mental aspect to it. Personally, I don't think you're harming yourself as long as you are able to go back to some of these brands and have them work again (I'm not a dr though so take what I say with a grain of salt -- my only expertise comes from decades of dealing with dry eye and a total lack of fear of doctors so I'm not afraid to ask all sorts of questions).

The one thing that I have heard is that artificial tears can disrupt the production and / or make up of real tears. Whether this poses a problem for you, I don't know. In my case, I have to use something because if I don't, my eyes won't produce anything so I'm still better off using artificial because there's nothing to disrupt but, it sounds like your dry eye may not be constant so you might want to talk to your doctor about whether artificial tears could be causing you more problems than they are fixing.

One thing you don't want to do is use a drop with a vasoconstrictor (Visine is a good example)-- they can definitely make your eyes worse.

How critical is it to you to wear contact lenses? They could be a major contributor to your dry eye and it may be worth it, to talk to your doctor about their potential impact on your eyes, or, take a long enough break that you can really gauge whether or not your contact lenses could be making a negative impact.

Sorry I don't have a clear answer for you but hopefully there's something in my post that is helpful.

[buntbean]

I've been using pres-free thera tears for 9+years now (I use refresh celluvisc at bedtime and I'm also on restasis). I just had a schirmer tear test done last week and I barely registered a 1 (10-12 is normal). I also suffer from MGD and my glands are completely clogged so my eyes are VERY dry. I was told I need to use the tears at least every 15 min. I've never needed to be reminded because my eyes let me know just how dry they are. When I go to the doctors they always say the same thing, "your eyes look good, continue what you're doing". I know some people say it can be overkill but I am also believed to have Sjogrens syndrome and the advice there is every 15 min as well. It all depends on the severity of your dry eye. I tried refresh pres-free and they don't work as well for me. I don't know why that is. We're all individual and what works for one person won't necessarily work for another. Unfortunately, it's trial and error for all of us.

[buntbean]

[/QUOTE] "The one thing that I have heard is that artificial tears can disrupt the production and / or make up of real tears. Whether this poses a problem for you, I don't know. [/QUOTE]
When I had my schirmer test done years ago I believe it was a 2 so it's hard to say. For me, it made no difference. Without artificial tears I would suffer severely.

[PotatoCakes]

@buntbean - I'm in the same boat; I need to use them regardless of what they do. I do frequently wonder, if I'd had access to the information on this site when I first began my disease, if I'd be as bad off as I am now. I try not to go down that road though, as I can't turn back time.