Are there any eye drops that don’t have tetrahydrozoline for hydrating eyes?

The confusion is understandable because products like Visine and Rohto Dry, which we covered above, market themselves with words like "hydrating" or "comfort" while still including a vasoconstrictor as an active ingredient. Pure lubricating drops, called artificial tears, work on a completely different principle: instead of constricting blood vessels to mask redness, they add or mimic the moisture layer your eye is missing.

What to look for on the label

The American Academy of Ophthalmology (AAO) advises staying away from tetrahydrozoline and naphazoline entirely, and to be careful of drops marketed to relieve red eyes, as they often contain vasoconstrictors that can worsen symptoms over time.

The active ingredients in pure lubricating drops look completely different. Key lubricating ingredients include hyaluronic acid (also called sodium hyaluronate), which provides long-lasting hydration and helps retain moisture, and carboxymethylcellulose (CMC), which creates a protective, gel-like coating on the eye's surface. Glycerin is another lubricating ingredient with the added benefit of promoting epithelial cell growth and blunting the effects of extra-salty tears.

Specific products that fit the bill

Refresh Optive Preservative-Free combines carboxymethylcellulose sodium 0.5% with glycerin 0.9%, and its preservative-free composition is packaged in single-use sterile vials.

TheraTears Lubricant mimics natural tears with an electrolyte-balanced formula, making it a good fit for people whose eyes are strained by screens.

Systane Ultra offers long-lasting relief with a dual-polymer blend and is available in both preserved and preservative-free options.

Thealoz Duo combines trehalose and hyaluronic acid for repair and moisture.

Over 86% of people with dry eyes have less of the protective oily layer in their tears, so products with lipids, such as those containing perfluorohexyloctane or mineral oil, can give longer relief by addressing that specifically.

Preserved vs. preservative-free

If you use lubricants only occasionally (a few drops per week), a preserved drop is likely safe. But if you are lubricating more than four times a day over a long period, reach for a preservative-free drop. People with moderate-to-severe dry eye or sensitive eyes should prioritize preservative-free formulations to avoid the inflammation that preservatives like benzalkonium chloride can cause.

No single brand works best for every form of dry eyes, so you may need to try a few before finding the one that works best for you. And if you are reaching for drops more than two or three times a day, the AAO says it is worth seeing an ophthalmologist, because lubricants can briefly relieve symptoms of almost every type of eye surface issue, but you still need to be treated for the underlying condition.