Eye drops, though designed for relief, can sometimes cause unexpected discomfort, making eyes feel worse. Various factors contribute to this irritation, and understanding them can help in making informed eye care choices.
Common Ingredients and Their Irritating Effects
Eye drops often contain ingredients that, while serving a purpose, can also lead to irritation. Preservatives are common in multi-dose eye drops, added to prevent bacterial growth once opened. Benzalkonium chloride (BAC) is a frequently used preservative known to potentially irritate or be toxic to the ocular surface, especially with prolonged or frequent use, or in sensitive eyes. Polyquad and Sodium Perborate are other preservatives; Sodium Perborate is an oxidative agent that can disrupt cell function, though some formulations are gentler.
Another group of ingredients are vasoconstrictors, such as tetrahydrozoline and naphazoline, designed to reduce eye redness by constricting blood vessels. While offering temporary cosmetic relief, overuse can lead to a “rebound effect,” making eyes redder and more irritated as the drops wear off. This creates a cycle of dependency and worsening symptoms.
The pH and osmolarity of eye drops also play a role in comfort. For an eye drop to feel comfortable, its pH and salt concentration (osmolarity) should closely match that of the natural tear film. Deviations from this balance can cause stinging or burning sensations. Some individuals might also experience allergic reactions to inactive ingredients or the active drug, resulting in symptoms like itching, redness, or swelling.
When Drops Exacerbate Existing Conditions
Sometimes, eye drops do not cause new irritation but rather worsen pre-existing eye conditions. Individuals with dry eye disease may find that certain eye drops, particularly those containing preservatives, intensify their symptoms. Preservatives can disrupt the tear film’s stability and damage the ocular surface, creating a cycle of increased dryness and irritation.
If the ocular surface, including the cornea or conjunctiva, is already compromised by inflammation, abrasions, or infection, even seemingly benign eye drops can cause stinging or discomfort. The damaged surface is more sensitive to foreign substances. Similarly, for those with allergic conjunctivitis, certain ingredients in eye drops might further irritate the sensitive, inflamed eye, or the drops may simply not be effective enough to counter the ongoing allergic reaction.
Contact lens wearers must also be cautious, as many eye drops are incompatible with lenses. Incompatible drops can cause irritation or damage to the lens material. It’s recommended to remove lenses before applying most medicated eye drops and wait a specified period before reinserting.
Misuse or Inappropriate Drop Selection
User behavior and choice of eye drops can significantly impact how the eyes react. Overuse of redness-relief drops is common, leading to rebound redness. The temporary vasoconstriction can result in chronic redness and increased irritation once effects subside, prompting more frequent application and perpetuating the problem.
Using an eye drop not suited for the specific eye issue can also worsen symptoms. For instance, applying a redness-relief drop for dry eye or a mild lubricating drop for a bacterial infection will not address the underlying problem and may delay appropriate treatment. This can lead to prolonged discomfort or a progression of the condition.
Contamination of eye drops is another serious concern. Improper handling, using expired products, or sharing eye drop bottles can introduce bacteria or other pathogens, potentially leading to eye infections and increased discomfort. The tip of the dropper should never touch the eye or any surface to maintain sterility. Improper instillation techniques, such as missing the eye or touching the bottle to the eye, can reduce effectiveness and increase contamination risk.
When to Seek Professional Advice
It is important to recognize when self-treatment with eye drops is insufficient and professional medical advice is necessary. If discomfort, redness, pain, or blurred vision persists or worsens despite discontinuing problematic eye drops or trying different types, consult an eye care professional. These symptoms could indicate a more serious underlying issue requiring diagnosis and targeted treatment.
New symptoms, such as severe pain, sudden changes in vision, increased sensitivity to light, unusual discharge, or a persistent feeling of something in the eye, warrant immediate medical attention. These signs might signal an infection, inflammation, or other serious condition that eye drops alone cannot resolve. If you suspect an allergic reaction, especially if symptoms like significant swelling, intense itching, or a rash develop, seek medical help promptly.
Ultimately, only an eye care professional can diagnose the root cause of persistent eye discomfort and recommend the most appropriate treatment. Consulting a professional ensures underlying conditions are identified and addressed, preventing long-term complications.