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December 24, 2025
3 min read
Key takeaways:
- Artificial tears are not true substitutes for biological tears, so the terminology can be misleading in treatment decisions.
- The term “lubricating drop” could be less confusing for patients and providers.
Calling eye drops “artificial tears” can mislead people into thinking the drops are more sophisticated than they truly are and misguide clinical decisions in dry eye, according to a letter to the editor in The Ocular Surface.
Instead, the term “lubricating drop” should be adopted, as it is “more accurate, more descriptive and more all-encompassing,” Kaleb S. Abbott, OD, MS, FAAO, FOWNS, and Andrew D. Pucker, OD, PhD, FAAO, FSLS, FBCLA, wrote. They believe such a shift would benefit patients and providers alike.
“The use of the term ‘artificial tear’ inaccurately elevates a simple topical agent to the status of a biological replacement, which is false because artificial tear does not replicate the immunological, nutritional or regenerative functions of the tear film,” they wrote. “This language may cause patients to delay seeking prescription therapies or procedural interventions, and it may contribute to providers being less likely to recommend alternative, more effective treatment options.”
We talked with Abbott and Pucker to learn more about their proposal.
Healio: How would patients and providers benefit from a shift away from these terms?
Abbott: The term “artificial tears” misleads patients by implying these drops recreate the biological complexity of natural tears, when in reality they primarily function as lubricants designed to provide symptom relief. Clarifying the terminology helps patients understand the strengths of these products without assuming they are full tear substitutes. When expectations are realistic, patients are better able to recognize when additional therapies may be necessary, which ultimately supports better long-term management of dry eye symptoms.
This clarity benefits providers as well. When patients understand what over-the-counter drops can and cannot do, it becomes easier for clinicians to guide them toward appropriate next steps rather than spending time correcting misconceptions. Clear terminology also prevents unintentional confusion during clinical decision-making, ensuring providers view these drops within the broader therapeutic framework rather than as full replacements for natural tears. Ultimately, more accurate language strengthens communication and improves care for everyone involved.
Healio: How did you come up with the recommended term “lubricating drop”?
Abbott: The term “lubricating drop” was chosen because it accurately describes the primary action of these products in a way that is clear and patient friendly. Although many formulations now include components that offer additional benefits — such as rehydrating the ocular surface, protecting epithelial cells from osmotic stress, stabilizing the tear-film layers, reducing evaporation, improving tear-film stability and supporting healing — their central purpose remains to provide lubrication and comfort to the ocular surface. Using terminology that reflects this main function helps avoid both overpromising and underrepresenting what these products can accomplish.
Importantly, the term “lubricating drop” does not diminish the value of these solutions. Instead, it highlights their strengths by emphasizing the relief and protection they consistently provide. The goal is not to criticize current products but to adopt terminology that is transparent, accurate and easy for both patients and providers to understand.
Healio: Your letter suggests that a shift in terminology would improve FDA guidance around these products. Can you explain that?
Pucker: The original intent with rewetting drops was to make a product that was safe to use with contact lenses. The original iteration of artificial tears contained harsh preservatives, such as thimerosal or benzalkonium chloride, which are not used in modern artificial tears. In fact, many new artificial tears are preservative free. Therefore, artificial tears in theory are safe to use with contact lenses, and my research along with work from many others suggests that artificial tears can be safely used with contact lenses. Reclassifying artificial tears and rewetting drops into a single category — lubricating drops — would allow contact lenses wearers to use the most update-to-date drop on label. It would also make treatment selection less confusing (eg, picture the vast array of options at your big box store — which one should you buy?).
Healio: What steps should be taken to implement this change?
Pucker: We first need to gain consensus among the ophthalmic community. This would include optometry and ophthalmology. We then need to push regulators (eg, FDA) to take up this issue. We could then subsequently have an FDA workshop where we could debate the topic and determine new industry guidance.
For more information:
Kaleb S. Abbott, OD, MS, FAAO, FOWNS, can be reached at kalebabbottod@gmail.com. Andrew D. Pucker, OD, PhD, FAAO, FSLS, FBCLA, can be reached at andrewpucker@hotmail.com.
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