Why Over-the-Counter Drops Don’t Treat the Root Cause of Dry Eye

Over-the-counter lubricating drops may offer temporary relief, but the dry eye problem is often more complicated than simply not releasing enough tears. A commonly accepted medical explanation portrays dry eye as a complex condition in which tear film instability, elevated tear concentration, inflammation, surface damage, and even nerve-related alterations can all play a role.

That is why many individuals get a short boost after taking drops, but their troubles return within hours.

What Most Over-the-Counter Drops Actually Do

  • They add moisture but do not rebalance the tear film

Many products act like lubricants that temporarily improve the watery layer of tears. Some also aim to support tear stability. This can reduce burning, grittiness, and blurred vision for a while, especially during screen work or dry indoor air.

But lubrication alone usually cannot fix tear film imbalance if the underlying issue is inflammation or poor oil flow from the eyelids.

  • They do not open blocked oil glands

A very common driver of dry eye is meibomian gland dysfunction, where the eyelid glands that supply the oil layer are blocked or produce poor-quality oil. When the oil layer is weak, tears evaporate too quickly, even if you are making enough watery tears. 

Drops can sit on top of an unstable tear film, but they cannot clear gland blockage on their own.

The Root Causes That Drops Usually Cannot Be Treated

  • Eyelid and gland dysfunction

If the eyelids are inflamed or the oil glands are clogged, the tear film breaks up faster, and the surface stays irritated. This can become a cycle where irritation worsens inflammation, which further destabilises tears. 

  • Inflammation on the eye surface

Inflammation is not just a side effect. It is part of what keeps dry eye going. In those cases, symptom relief from drops can mask the problem while inflammation quietly persists. 

  • Aqueous-deficient dry eye

Some people truly produce fewer tears, including those with autoimmune-related dryness. In moderate cases, clinicians may use prescription anti-inflammatory treatments aimed at improving tear production when inflammation suppresses it. For example, Canadian product monographs for cyclosporine ophthalmic emulsion describe its indication for moderate to moderately severe aqueous-deficient dry eye disease. 

Why Symptoms Can Still Persist Even If Drops Help Briefly

Dry eye is common in Canada. One Canadian analysis in BMJ Ophthalmology cites an estimated prevalence of around 21%, which helps explain why so many people reach for drops first.

Also, modern routines matter. Long hours on screens often reduce blink rate and increase tear evaporation, which can make eyelid gland-driven dry eye flare more often, even in younger adults. 

What a Clinic Looks for That a Pharmacy Shelf Cannot

  • Targeted testing, not guesswork

A dedicated assessment often includes checking tear stability, staining patterns, and the health of the eyelid margins and glands. The goal is to identify whether the main driver is evaporative dry eye, aqueous deficiency, or a mix.

  • Treatment that matches the cause

Depending on findings, care plans commonly include eyelid warming and hygiene to improve oil flow, plus prescription options when inflammation is significant. TFOS guidance summarises that dry eye management often requires treating lid abnormalities and inflammation, not just adding lubricants. 

If you are searching for a dry eye clinic near me, a helpful way to choose is to look for clinics that explicitly evaluate meibomian glands and tear film stability, not only recommend drops.

When It Is Time to Get Checked

If symptoms keep returning, or your eyes stay irritated even after using artificial tears, provincial health guidance recommends contacting a clinician for next steps. 

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