Can drops reduce tear prodcution?

[insidious988]

What do you think?
Some People Claim that if you use drops many times a day that they will reduce normal tear production.
I can't really believe this - but what do you think?

As of now my eyes are so bad again I drop like every few minutes but without relief...

[SirDryEye]

Nah use them as much as you need to. I use eyes drops once an hour or when I get burning/foreign body sensation! and wear moisture goggles most of the day. At night, I use ointment, always wake up a few hours later (due to dryness) then reapply then go back to sleep until wake up. Drops are the only thing that are making my life manageable

[ebi1368]

I ve heard this too (not from specialist mostly people in this forum) but my doctor always tells me to use drop and do not let your eye to dry out.

[Alix]

What do you think?
Some People Claim that if you use drops many times a day that they will reduce normal tear production.
I can't really believe this - but what do you think?

As of now my eyes are so bad again I drop like every few minutes but without relief...

What did your doctor say? What type of dry eye do you have?

I have evaporative dry eye and was told by an ophthalmologist that I can use eye drops if they are preservative free as much as I feel I need to, even every 30 minutes, it does no harm. WRONG.

Once I did this for a week or so, the burning sensation intensified and my eyeballs became very sore. Once I stopped the drops the burning went down a notch but my eyes have never recovered. I believe this is because the eye drops disturbed the natural tear/oil producing mechanisms in my eyes.

So I think you need to seek medical advice and find what works for you be it putting in eye drops once an hour or once every six, everyone is different.

[Rebecca Petris]

I've never seen evidence of any kind that daily or very frequent application of tears could interfere with tear production. That's... assuming we're talking about preservative free lubricants

But... at the risk of being annoying, the thing I'm always tempted to point out when this subject comes up is, there's really two different purposes for drops:
1) Lubrication - i.e. as a matter of safety, if the eye is getting desiccated, it needs to be kept lubricated.
2) Sensation/pain management - we put in drops to make our eyes feel more comfortable.

Those two things don't always overlap. Lots of people with MGD who have no staining or anything that's a threat to the cornea are nonetheless very very uncomfortable and use drops constantly. And it may or may not work. That's when it's time to turn to other stuff... imo, especially the protective, insulative stuff like dry eye glasses, and sclerals in extreme cases

[MGD1701]

If frequent dropping still no relief, likely wrong drops or other issues (allergy, inflammation etc) or
Toxicity from too many drops which I learnt recently from Prof. Bennie Jeng, USA, a famous dry eye expert, from one of his articles.

I learnt from another doctor who does not recommend to mix too many different brands a day.
and when pain, burning occur, better stop this brand - these are in line with what Prof. Jeng's too.

If your lipid layer is low, oil-based drop is the best.

[insidious988]

Lipid layer is low but any oil based drop I tried burnt. I seem to be not tolerating the oils from the drop. It's strange but that is how it is. Tried everything from evotears to the drop Dr Korb invented etc.

Normal Drops without oil are better but on many days no relief.

[insidious988]

Can you tell me more about toxicity from too many drops?

[Milo007]

What do you think?
Some People Claim that if you use drops many times a day that they will reduce normal tear production.
I can't really believe this - but what do you think?

As of now my eyes are so bad again I drop like every few minutes but without relief...

Unfortunately yes. Too frequent instillation of lubricant eye drops can reduce the secretion of lacrimal glands.

NOT ONLY THAT frequent instillation of eye drops wash away the mucin layer as well which is the inner most tear layer that adheres to the aqueous layer of the tear film. Without the mucin layer your tear film won't adhere to the conjunctival surface.

You must know how the lacrimal glands function to understand how artifical supply of tears can affect lacrimal functioning. The lacrimal gland is stimulated by feedback from the corneal nerves which sends signals to the brain when the inner surface of our eyelids slide against the corneal surface. A decrease in the aqueous component of tear film results in slightly increased friction between the corneal surface and the inner surface of the eyelids. When the corneal nerves sense this increase in sensation as a result of increased friction it sends signal to the brain and the brain sends signal to the lacrimal glands to secrete more volume of the aqueous component of tear to compensate for a thinner tear film and decreased hydrodynamic lubrication between the inner eyelid surface and the ocular surface. When you keep on instilling artifical tears frequently this feedback loop is interrupted and the lacrimal glands down regulate over time and atrophies in certain cases over long periods of time.


Ideally you should not instill drops more frequently than once in every 30 minutes for the most severe cases of dry eyes. That too preservative free drops.

The corneal nerve-lacrimal gland feedback loop is one of the reasons why people with prolonged contact lense use develop aqueous deficiency over a few years with or without MGD. The other reason being corneal cell cytotoxicity due to decreased oxygen supply from the atmosphere.

Rigid gas permeable contact lenses also known as scleral lenses aren't completely safe as well since they disrupt the feedback loop but are better than contact lenses that cut off oxygen supply to the cornea.

[insidious988]

Tank you for the valuable Information. I think this is VERY Important to know. Why doesn't any doctor give this info? Even on this forum I never read about this.

I now believe definetely instilled drops too often and hope I don't have caused irreversible trouble...

[Milo007]

Tank you for the valuable Information. I think this is VERY Important to know. Why doesn't any doctor give this info? Even on this forum I never read about this.

I now believe definetely instilled drops too often and hope I don't have caused irreversible trouble...

Go through as many clinical studies as you can related to dry eyes to gain knowledge. Think logically and act accordingly. This is the best way to go as I have found out. Unfortunately most doctors don't feel the necessity to educate their patients. But the patient himself/herself is the best person to manage his/her condition on a daily basis and doctor's must understand this.

Anyways speaking from my personal experience there was a time when I used to instill artifical eye drops once in every 10 minutes. And guess what?

My condition got worse and worse until my opthalmologist put me on azithromycin and doxycycline which helped my glands recover a lot if not make them work completely normally. I don't use artifical tears anymore. And to be honest they are good at alleviating symptoms but never a solution even on a temporary basis.

[quattroboy]

Also drops will wash away natural tears which contain essential nutrients and growth factors.

Of course serum based drops are different because they contain the good stuff.

As soon as my improving eyrs began over tearing I got my upper plugs removed quickly.

I aim to get my bottom plugs removed at some point. If I can.

Glands are like muscles use them or lose the.

Of course you mustn't allow your cornea to dry out, this is bad

[Milo007]

Also drops will wash away natural tears which contain essential nutrients and growth factors.

Of course serum based drops are different because they contain the good stuff.

As soon as my improving eyrs began over tearing I got my upper plugs removed quickly.

I aim to get my bottom plugs removed at some point. If I can.

Glands are like muscles use them or lose the.

Of course you mustn't allow your cornea to dry out, this is bad

Also when artificial tears wash away the natural tear film frequently the eyes become prone to secondary infections since natural tear contains lysozymes and other anti bodies that prevent pathogens from infecting the ocular surface. Another good reason why one should not splash water into eyes. My uncle got an infection recently when he was splashing his eyes with water every hour. The same logic goes with excessive use of artificial tear drops.