Why Aren't My Eye Drops Working?

Here’s what may be hap­pen­ing when your eye drops don’t help. 

You’ve been dili­gent­ly using your eye drops. You’ve fol­lowed the direc­tions from your eye doc­tor and those on the pack­age. But the results aren’t what you expected. 

Eye drops can be used to man­age a num­ber of dif­fer­ent eye prob­lems, like itch­ing, red­ness, or dry­ness. They can reduce symp­toms of var­i­ous con­di­tions such as aller­gies and cure eye infec­tions. While drops can be high­ly effec­tive, they don’t always work in the way you might expect. In some cas­es, you may find that your symp­toms are lin­ger­ing, or even get­ting worse. And now, you may be won­der­ing, ​“What exact­ly is happening?” 

Here are 5 rea­sons why your drops may not be doing the trick — and what you can do about it. 

1. They’re just not the right type of drops for you. 

There isn’t a one-size-fits-all solu­tion to eye drops. If your eye drops aren’t work­ing, the key may be as sim­ple as switch­ing to a new one. 

There are sev­er­al rea­sons why one type of drop may work bet­ter than the oth­ers, even if they all promise to treat the same symptoms: 

• You are not treat­ing the cause of your symp­toms. For exam­ple, you are using red eye relief drops; when what you need are arti­fi­cial tears (lubri­cant eye drops) or aller­gy relief drops. 
• Each brand of eye drops con­tains dif­fer­ent ingre­di­ents, and your eyes might not tol­er­ate cer­tain ingre­di­ents well. 
• Some drops have preser­v­a­tives, which make them last longer and help pre­vent infec­tion. But preser­v­a­tives can dam­age the sur­face of your cornea (clear out­er lay­er locat­ed at the front of your eye), irri­tat­ing your eyes. If you use drops more than four times a day or have mod­er­ate or severe red eye, you may want to try a drop that doesn’t con­tain preservatives. 
• Not all drops are con­tact lens-friend­ly. Look for prod­ucts that are specif­i­cal­ly designed for con­tact wearers. 

Ques­tions about eye drops? Sched­ule an appoint­ment with a Duly Health and Care oph­thal­mol­o­gist or optometrist. 

2. You’ve overused red­ness eye drops. 

Most over-the-counter eye drops used to treat red eyes con­tain the decon­ges­tant tetrahy­dro­zo­line. They act quick­ly and effec­tive­ly to reduce red eyes by decreas­ing swelling of the blood ves­sels in your eyes. This might seem like a mir­a­cle for peo­ple with chron­ic red­ness, but there is a catch. They are not always treat­ing the root cause of your red eyes, and eye drops with decon­ges­tants should not be used long-term. 

The decrease in swelling is only tem­po­rary. Once the drops wear off, the swelling can return and cause ​“rebound red­ness” — your eyes become red again, pos­si­bly even worse than before. This won’t nec­es­sar­i­ly hap­pen every time, but it becomes a risk when you use the drops too often. 

Some new­er red eye relief drops use bri­moni­dine rather than tetrahy­dro­zo­line. They have a small­er risk of rebound red­ness, but they should still be used with cau­tion. Bri­moni­dine drops may cov­er up red­ness that’s caused by eye dis­eases or infec­tions, like pink eye. It’s impor­tant to deter­mine the true cause of your red eyes to treat it appro­pri­ate­ly. Before using these drops on a long-term basis, it’s a good idea to get the red­ness checked out by your oph­thal­mol­o­gist or optometrist. 

Also read: Should I See an Optometrist or Oph­thal­mol­o­gist?

3. You’re using eye drops past their expi­ra­tion date. 

It can be tempt­ing to stretch the life of your eye drops past their expi­ra­tion date, espe­cial­ly if the bot­tle was nev­er even opened. Eye drops can have a high­er risk of com­pli­ca­tions if used after the expi­ra­tion date com­pared to oth­er med­ica­tions. So, it’s bet­ter to be a lit­tle waste­ful and replace your old drops with new drops. 

Over time, the chem­i­cals in eye drops can break down. There are two main issues when this occurs: 

1. The drops won’t be as effective. 
2. The chem­i­cals could turn into harm­ful sub­stances and con­t­a­m­i­nate the drops. This could lead to irri­ta­tion, red­ness, blur­ry vision, and even seri­ous eye infections. 

Even if you’re far from the expi­ra­tion date, keep tabs on when you first opened the bottle. 

4. Your eye drops could be caus­ing an infection. 

Once drops are open, there is a pos­si­bil­i­ty of bac­te­ria grow­ing on the bot­tle and con­t­a­m­i­nat­ing the drops. Eye drops that con­tain preser­v­a­tives can ward off bac­te­ria, so opt for those (unless the preser­v­a­tives irri­tate your eyes more). 

An infec­tion could also be the result of the tip of the bot­tle com­ing into con­tact with your eyes. When you’re putting drops in, be care­ful to apply the drop from a short dis­tance rather than pok­ing the bot­tle direct­ly onto the sur­face of your eye. Also, don’t let any­thing else come into con­tact with the tip of the bot­tle. If some­thing does, clean the tip with alco­hol and let it air-dry, or just throw the bot­tle out. 
 

In some cas­es, it might not be the result of the drops them­selves. Putting drops in requires pulling your eye­lid down. If your fin­gers acci­den­tal­ly touch your eyes — espe­cial­ly if you didn’t wash them right before — you run the risk of infection. 

5. You’re using over-the-counter drops, but you need some­thing more. 

Often­times, an over-the-counter rewet­ting or red­ness drop will take care of the prob­lem. But some­times, they aren’t the right treatment. 

You might just need a dif­fer­ent med­ica­tion. For exam­ple, if you have aller­gic con­junc­tivi­tis (itchy, red eyes due to aller­gies), over-the-counter drops might not be strong enough. You may need your provider to pre­scribe stronger aller­gy drops. 

Or you might be treat­ing the wrong prob­lem alto­geth­er. You might think that red­ness is due to sea­son­al aller­gies, but it could actu­al­ly be a sign of infec­tion or inflam­ma­tion, in some cas­es glau­co­ma — an eye dis­ease that, if left untreat­ed, can even­tu­al­ly cause blindness. 

Also read: 10 Ways to Main­tain Your Eye Health 

If your eye drops aren’t work­ing or you’re not sure which to use, reach out to your eye doc­tor. And if you have long-last­ing or severe symp­toms, sched­ule an appoint­ment to get your eyes checked. Whether you need over-the-counter drops, pre­scrip­tion drops, or some­thing else entire­ly, your provider can make sure that your eyes are healthy.