Choosing the correct eye drops that won’t lead to permanent redness

Eye drops are a popular remedy for red, sore, scratchy and dry eyes. However, did you know that the wrong eye drops and excessive use of these drops can cause permanent red eye damage? Inge Loubser, one of Mellins i-Style’s optometrists has handy tips when it comes to choosing and using eye drops.

“In many cases, the symptoms are treated, instead of the cause of irritated eyes,” says Inge. To reduce redness, eye drops that are available over-the-counter are usually used. This can lead to “rebound redness”, as a result of regular use of these drops. Many of these drops contain a vascular constrictor (vasoconstrictor) that narrows the blood vessels, reducing redness. When the cause of redness is not treated correctly, the use of the over-the-counter eye drops causes the blood vessels to expand as soon as the effects of the eye drops have stopped working. If eye drops are used excessively, the user may become ‘dependent’ on these drops to control the redness of their eyes and this leads to permanent redness due to damage to the blood vessels. “It is at this stage that many patients come to us for help but at this point, there is not much we can do to constrict the blood vessels again.  We can only recommend the correct drops for the specific problem moving forward. The best option however is always to first identify the cause of the irritation before deciding on eye drops or whether the patient must be referred to an ophthalmologist”, explains Inge.

Many over-the-counter eye drops on the market contain strong preservatives and your eyes are not supposed to be exposed to these preservatives for an extended period. Preservatives are required in some eye drops for a longer shelf life and for protection from contamination of bacteria. Furthermore, the preservatives may cause further irritation and redness in the eyes.

Something as simple as eye drops is often used incorrectly and without proper instructions. The tip of the container can easily be contaminated if it comes in contact with your fingers or eyelids. The container should also be sealed immediately after use to prevent contamination. Due to the risk of contamination and infection, eye drops should not be used by more than one person. Eye drops are also available in a single-dose ampoule and some people use the drops and then save the rest to use the next day. These drops do not contain preservatives, as it is a single dose and any remaining drops must be discarded. If these drops are used at a later stage, after it has already been opened, it can increase the risk of infection. An example of a preservative that causes inflammation and cell damage is Benzalkonium chloride (BAK). Similarly, avoid drops that contain a vasoconstrictor such as, Phenylylephrine, L-Phenylylephedrine, L-Phenylylephrine, M-Methylaminoethanolphenol, M-Oxedrine, Metaoxedrinum, Metaoxedrine, Metaoxedrine, Metasynephrine and Phenylephrinum.

Contact lens wearers must only use eye drops that are prescribed for contact lenses. If drops like an antihistamine are used that are not supposed to be used with contact lenses, the contact lenses should be removed before the drops are inserted. Wait for 30 minutes until the drops are absorbed before reinserting the contact lenses. In the event of an infection, bacteria will cling to the contact lenses and the contact lens may no longer be used – it must be discarded. Therefore, contact lenses should not be worn while an infection is present”, advises Inge.

Which eye drops are suitable for dry eyes?

According to Inge, the Optive range is very good as it is absorbed by the eye’s surface cells and the cells are rehydrated. “Other moisture drops on the market only replenish the tear layer and are not absorbed. They just drain or evaporate out of the eye again.”

“Dryness and allergies usually go hand in hand. As soon as any antihistamines (in drop or tablet form) are used, your eyes will be dry, therefore moisture drops or artificial tears should always be used with antihistamines. In case of antihistamine eye drops, the antihistamine eye drops should be used first and you should then wait for 20 minutes before inserting the moisture drops so that the one does not rinse away the other.


Burning and dry eyes – especially when wearing contact lenses- could be a result of looking at digital screens for too long when people blink a third less. This can lead to distorted vision as a result of lens dehydration in the case of contact lens wearers. Eye drops can help alleviate these symptoms and your optometrist will recommend the best product.

At what stage should people contact their optometrist if self-medication doesn’t work any longer?

“You should in fact consult your optometrist from the outset to ensure that the correct eye drops are being used, especially if you wear contact lenses,” says Inge.



Can eye drops be used after the expiry date, especially if the container is still full?


Eye drops should not be used after the expiry date (regardless of the amount left) as the preservatives in eye drops have a specific ‘working period’ as soon as the bottle is opened. If the bottle is used for longer than the recommended period, the preservatives will stop working to keep the contents sterile and your risk of infection is increased drastically.