Dry Eyes are a common symptom of Sjogren’s Disease. I have moderate to severe dry eyes and I get pretty tired of the scratchy, itchy, achy feeling that happens every day. Working at a computer and staring at a screen for hours on end can add to the dryness and discomfort. I do my best to use drops regularly and take screen breaks, but time can get away from me. And then all of a sudden my eyes are killing me! At that point, I need to stop and take serious care with warm compresses and extra lubricating drops or gel. If I let the day get away from me without treatment, then my eyelids during the night tend to stick to my eyeball a bit. If I get to this point, the morning routine is lengthy and unpleasant. So diligence with eye care is very important!
After so many years of managing dry eyes, I am on top of the daily, and nightly routine. And I have a few secret weapons! As you read through this article, keep in mind that every BODY is different and we have different needs from products. That’s why it’s good to try new products from time-to-time. However, that can get expensive. This is where I’m trying to help — by listing some of the most popular products, tools, and techniques. This area is about OTC products and go-to solutions for dry eyes. I will address prescription (Rx) drops and other eye symptoms in blog posts.
To learn more about caring for your eyes, and informing your eye doctors about the best protocol for a Sjogren’s patient, go to the Foundation site at sjogrens.org. Specifically, the Foundation has completed Clinical Practice Guides and there is one for Ocular care here!
Now let’s get into some product options…
Daytime Eye Drops for Dry Eyes
Alcon- Systane Brand
Alcon has two product lines to address Dry Eye: Systane and Genteal. The Systane drops all have either 0.3% or 0.6% of propylene glycol with the Ultra and Hydraboost formulas adding Polyethylene Glycol 400 at 0.4%. as the active ingredients in eye drops. Genteal drops have the common ingredient of Hypromellose 2910 at 0.3% and Dextran at 70 at 0.1%. So although there are multiple boxes/brands of eye drops in each family, there are few ingredients. If you strongly prefer a product that has similar active ingredients, you may be responding (or reacting) to an ingredient labeled non-active. Be sure to consider which feels best to you and then understand the active ingredients…this way you can hunt for similar products at lower prices.
Systane Ultra Single Vials These are the best eye drops for me. I have tried others but I keep coming back to Systane Ultra. Because I have sensitive eyes and use drops often, I use the preservative-free single-use vials. I do actually use one vial several times and just place the top back on the vial after each use until it is gone. However, I do complete a vial in a day, so the product does not have time to grow bacteria or get contaminated in some way. Eye drops are so expensive, that I tend not to venture from these — I know others are as loyal to their own brand that works for them
In 2019, Novartis divested the Alcon brand and Alcon is now a standalone corporation. They have been changing their product branding and marketing activities a lot over the past 18 months. I am still researching how they have changed their packaging and if that has changed their product or not. For example, there is Systane Ultra single vial and Systane Ultra PF. This appears to be the same product with the PF (preservative-free) being the newer branded item (meaning the new package design).
I also buy Systane Ultra in the bottle to keep in my purse or take on travels. I’d rather have plenty of eyedrops, even with preservatives, than no eye drops or poor performing eye drops for me.
Systane Balance is a product that was designed to work on all three layers of the tear film (oil or lipid layer, aqueous layer, and a mucin layer). This product is best for people having trouble with all three layers.
Systane Complete is a newer product from Alcon. It has “nano droplets” and forms a protective coating across the entire eye surface. The main active ingredient is Propylene Glycol. Alcon states that it provides fast hydration and tear evaporation protection. It is only available in 10 mL bottles and it does have preservatives. I’ve tried this product and it is OK, but I still prefer Systane Ultra. So, I know I like the polyethylene added to the formula. I did not feel that the formula provided any extended relief and so I still needed as many drops. So if you need to use a lot of drops during the day, as I do, you will want to consider these are not preservative-free, This product does have Venus Williams promoting it on their website, and the imagery and relationship to Venus are direct enough that perhaps Venus actually uses these drops.
Another new product is Systane Hydration PF with Hydraboost technology. These are preservative-free and good for sensitive eyes. This product is almost identical to Systane Ultra PF with one minor addition to the inactive ingredient list which is sodium borate. And it’s the second to last ingredient. This must be the “Hydraboost technology”. LOL! I’ve tried these and I like them, but I don’t know if there is a difference between these and Systane Ultra, so I will be watching for price wars between the two products. Mostly, I think it gives Alcon another box to place on a shelf for market share (a common brand marketing practice). If you try these and think there is a difference between these and Systane Ultra, then please write to me so I can share it with other patients!
Systane also has a gel drop, in a bottle with preservatives, that has the same active ingredients as Systane Ultra. It appears the additional inactive ingredients is what adds to the viscosity. I have not tried this product but it may be a great solution for me when my eyes are drier since my favorite eye drops are the Systane Ultra. It is Systane Gel Drops on Amazon and maybe a product worth trying if you like the Systane line of products.
Alcon- Genteal Brand
Genteal Tears family of products offers solutions for mild, moderate, and severe dry eyes. As mentioned earlier, the eyedrops have Hypromellose 2910 at 0.3% and Dextran at 70 at 0.1%. as the active ingredients in both the mild and severe dry eye. If these products work for you and you use multiple drops a day, consider the Genteal Tears Preservative Free on Amazonvials to protect your eyes. And then the individual bottles in your desk, purse, car, etc. for handy use.
For moderate to severe dry eye, each brand has an eye gel product that is 0.3% Hypromellose. So Systane Lubricant Eye Gel and Genteal Tears Lubricant Eye gel in the tube are identical formulas (down to every last inactive ingredient). I love the eye gels for nighttime sleeping and I pretty much just go for price comparison here! The consistency of gels prevents me from seeing clearly so daytime use is out (unless I am having a very bad eye day). Then I will use these and simply not work. Resting my eyes with gel product in them, and placing a warm compress on my eyes can rejuvenate them as well.
OcuSoft
OcuSoft has a product that many people love called Retaine MGD . It comes in preservative-free single-use vials and bottle dropper. This product has a long list of active ingredients including light and heavy mineral oil. I seem to react to mineral oil, so this product was irritating to me, but I know people who will ONLY use this product because it works for them. The product is thicker and it took a minute or so to clear enough so I could see; but I could read (until the mineral oil irritated my eyes). So if mineral oil is not an issue for you and you have very dry eyes, you may want to try this product.
Allergan (recently acquired by Abbvie)
Refresh is the brand name for the Allergan line of eye drops and gels. And they have a lot of good products to offer and are the favorite of many patients! The Refresh line uses Carboxymethylcellulose Sodium as a base for most of its products. I like their products, and they have quite a few preservative free options. Here is a list of Refresh products:
- Celluvisc Sensitive Lubricant Eye Drops
- Classic Sensitive Lubricant Eye Drops
- Celluvisc Lubricant Eye Gel
- Tears Lubricant Eye Drops
- Liquigel Lubricant Eye Drops
- Optive Lubricant Eye Drops
- Refresh Optive Sensitive Lubricant Eye Drops
- Optive Advanced Single Vial and Sterile
- Refresh Plus Sensitive Lubricant Eye Drops
- NEW: Refresh has a new product called Refresh Relieva on Amazon which, again, has the main ingredient of Carboxymethylcellulose Sodium. What seems new here is the preservative-free bottle! It is not packaged in small vials but in a specially-capped bottle. If the base ingredient is your favorite dry eye solution, this is the perfect product for easy 1-bottle distribution.
TheraTears
Finally, TheraTears Dry eye Therapy is also a good product. The main ingredient is sodium carboxymethylcellulose which is similar to the Refresh products. So if one product works well for you, you may find the other product line does as well. Theratears does provide the solution ins single vial preservative-free packaging as well as bottled.
Nighttime Products for Dry Eyes
I use the Systane Eye Gel or Genteal Tears Lubricant eye gel at night. The products are the same and I usually look for the best-priced item when I’m in need. The Systane gel in the tube is a different formula than their Systane Gel Drops in the bottle, so be clear on which product you want to try first.
TheraTears also has a gel formula that I have not tried. Their Liquid Gel Night Time Dry Eye Therapy Lubricant Eye Gel looks like one I should try because it is in single vial preservative-free packaging. Just from the packaging, I believe (but don’t know) it is a bit less viscous than the gels in a tube. The main ingredient in this product is sodium carboxymethylcellulose. This is the same main ingredient in many of the Refresh products, so if those suit you well, you may want to price shop with TheraTears.
Alcon also makes an Eye Ointment for the Systane and Genteal Tears . Ointments are a heavier product with a consistency closer to vaseline. Here again, it is the same product behind the brand name. The key ingredients are .03% mineral oil and 94% purified white petrolatum. The Systane product is listed as preservative-free, however. I have a hard time with this product in my eyes it feels like I have a foreign object in my eyes and it irritates them. This is why I stick with the gel. inside my eye. However, I do use this product at the corners of my eyes. When I’m having particularly bad eye days, the corners of my eyes get very irritated and the ointment helps (especially in winter).
Retaine PM Ointment which has a similar formulation to the Systane and Genteal Tears brands.
Refresh PM Sensitive Lubricant Eye Ointment. This is also a similar formula with mineral oil and white petrolatum.
Product for Red Eyes That I Love
For the past year, my favorite product on the market is Lumify by Bausch & Lomb. This link is for two bottles at Amazon as I know you will want to bottles and save a little cash.
I get red eyes a lot! I’m guessing you do too. My red eyes are the thing that can really make me look sick. When I awake in the morning, they are so red and sore that even the skin around them is red from the inflammation. Just one drop or two in each eye and my red-eye is gone. The active ingredient in this drop is 0.025% brimonidine tartrate ophthalmic solution. At a higher prescription dosage, this product is used for glaucoma. I have used the Rx medication for severe redeye before (called Alphagen) but was concerned about using it off-label and too much. At this low dosage, there is little risk, no pain, and it’s over-the-counter. I have one at my desk, one at my make-up mirror, and one in my purse. I love this product!
Cleansing Products for Dry Eyes and Lids
There are a number of eyelid/eyelash cleansing formulas on the market. These products are intended to clear the debris and clean the clogged glands at the lash line. Read the ingredients of your selected product if you have wipes, because they may not have enough antibacterial or cleaning ingredient that works well. Some wipes are really just eye-make-up removers (even some from eyecare companies) so be sure to read the ingredients. A common active ingredient that works well in the products I’ve tried is Tea Tree Oil. But there are also products with other active ingredients.
To use these products effectively, I move the product at the lash line outside and inside my eye to ensure I get good coverage and clean away as much oil and debris as possible. A true light scrub is needed, not just allowing the formula to rest on top of your lid and lashes. The top products in this category are:
- TheraTears SteriLid Eyelid Cleanser which comes in a bottle that squirts out a foam cleanser. This is the product I’ve used most.
- OCuSOFT Lid Scrub Allergy Formula Wipes has tea tree oil. I’ve used these for travel.
- OCuSOFT Lid Scrub Formula. This is similar to the Sterilid formula. OCuSOFT also has an “Plus” formula and a Platinum formula for extra help. I have not used these before, and if you have and I like them, please let me know and I will share with other readers.
Tools and Techniques for Dry Eyes
Warm wet compresses. This helps soothe my eyes at night after a long day of computer work. I simply run a washcloth under hot water, wring out, fold, and drape over my eyes. If I need extra treatment, I’ll put some Systane Eye Gel in first and then place the warm cloth on my eyes. Sometimes, I remove the cloth and rub my eyes with the palm of my hands to move the gel and heat around and then replace the cloth again. For a little aromatherapy, I sometimes put lavender oil on my temples so I can whiff the calming scent as I do this. The only challenge with this treatment is keeping the cloth warm long enough to have a good result. It usually takes several trips to the sink to reheat and reapply.
A company called EyeEco has been making wonderful warming goggles for a while and they are a big supporter of the Sjogren’s Foundation and patients. I have an older pair of their Tranquileyes Eye Hydrating Therapy. this essentially solves the problem of re-heating a washcloth and is a much more direct concentration of heat on your eyeballs. I’ve been missing them ever since I moved — they are in a box somewhere! But I think a new pair is warranted since they came out with updated versions where the inserts are more easily re-heated. In fact, they now have nighttime goggles, daytime eyewear, and cleansing products. The owner of the company, Suzanne Paulson, is a really kind and committed person trying to help Sjogren’s patients! So do give her products a look here.
Humidifier. I use a humidifier most nights and in my office during the day if it’s a particularly dry day. Some day, I will test humidifiers because finding the right one is so annoying! I like the one I use now, but the filter is an issue…enough so that I am not comfortable promoting it. However, there are plenty of humidifiers from which to choose.
Conclusion for The Best Products for Sjogren’s Eyes
There is trial and error in what products work best for each patient. But once you find the product that works best for you, take a look at the ingredients. Perhaps you can find other products that have the same ingredients and will also work well for you. With this approach, we can price hunt for products and save a little money, AND watch for new products with similar or BRAND NEW ingredients.
Here is my list of daily eye care must-haves:
- My favorite Daytime drops are Systane Ultra in the preservative-free formula on Amazon.
- A bottle of my favorite drops (with preservatives) are in my purse, car, and desk for emergency use.
- Lumify for red eyes . I also have one of these in my purse and at my desk.
- Systane Nighttime gel
- Sterilid on Amazon eyelid and lash cleansing solution used weekly (or more if needed).
- Warm compresses or goggles such as Eye Eco Tranquileyes (used when needed).
- Moisture chamber glasses for driving/walking from Ziena.
I’ll keep this page up to date with the best of my ability for new and favorite products. As a reminder, I am an Amazon Associate and some of the products below do have affiliate links. This means that if you use that link to purchase a product, I will get a small commission at no additional cost to you. I am hoping that your clicks will offset the cost of running SjogrensLife. Thank you if you choose to make your Amazon purchases using my links!
To learn more about caring for your eyes, and informing your eye doctors about the best protocol for a Sjogren’s patient, go to the Foundation site at sjogrens.org. Specifically, the Foundation has completed Clinical Practice Guides and there is one for Ocular care here!