Artificial tears are the mainstay of therapy for many ocular surface conditions, including allergic conjunctivitis, postoperative discomfort, dry eye disease, or any type of nonspecific ocular irritation.
Despite many comparisons of the various tear substitutes currently on the market, there are few clearly established distinctions between drops—all supplement native tear production and all provide transient relief from ocular discomfort, regardless of the underlying etiology.
The conditions for which patients use an artificial tear are nonetheless diverse, so a one-size-fits-all approach will not meet the needs of every patient.
The limitations of this approach can be exemplified by selection of an artificial tear for a patient with dry eye; this is probably the clearest case of “one size does not fit all.” While different patients will benefit more or less from the same drop, in most cases we can ascribe this only to idiosyncratic factors.1
There has been progress on this front. Recent studies confirm that drop formulations can be tailored to conditions such as aqueous deficient dry eye or to disease profiles where there is a lipid or mucin deficiency.2
Dry eye disease, however, is still a condition where an empirical approach to drop selection is the standard practice.
Patients who use drops for other issues, such as allergy, are likely to go through a similar process to find a drop that works best.