Tears Naturale: Uses, Dosage & Side Effects

What Is Tears Naturale and What Is It Used For?

Tears Naturale is an ophthalmic solution classified as an artificial tear preparation. It contains two active polymeric ingredients—dextran 70 (1 mg/ml) and hypromellose (3 mg/ml)—that work together to mimic the protective and lubricating properties of natural human tears. The formulation is designed to address the symptoms of dry eye syndrome (keratoconjunctivitis sicca), one of the most common ocular conditions worldwide, affecting an estimated 5–50% of the global population depending on the diagnostic criteria used and the population studied.

Dry eye disease occurs when the eyes do not produce enough tears, when tears evaporate too quickly, or when the composition of the tear film is imbalanced. The normal tear film consists of three layers: an outer lipid layer that prevents evaporation, a middle aqueous layer that provides moisture and nutrients, and an inner mucin layer that helps tears adhere to the corneal surface. Disruption of any of these layers can result in symptoms such as dryness, grittiness, burning, stinging, redness, blurred vision, and eye fatigue.

Hypromellose (also known as hydroxypropyl methylcellulose or HPMC) is a cellulose-derived polymer that acts primarily as a viscosity-enhancing agent. When instilled into the eye, it increases the thickness of the tear film, which prolongs contact time with the corneal and conjunctival surfaces and retards drainage through the nasolacrimal duct. This extended residence time allows for sustained hydration and protection of the epithelial cells on the ocular surface. Dextran 70 is a high-molecular-weight polysaccharide that supplements the mucin layer of the tear film, improving its stability and helping tears spread evenly across the eye.

Together, these two ingredients provide a synergistic effect that closely resembles the natural tear film. The solution spreads across the corneal surface upon instillation, delivering immediate relief from dryness and irritation. The effect typically lasts 1–4 hours, depending on the severity of the condition and environmental factors such as humidity, wind exposure, and prolonged screen use.

Tears Naturale is indicated for the following conditions:

• Dry eye syndrome (keratoconjunctivitis sicca) — Including aqueous-deficient and evaporative forms of dry eye, regardless of the underlying cause.
• Mild ocular irritation — From environmental factors such as wind, smoke, air conditioning, heating, prolonged screen use, contact lens wear, or air travel.
• Post-surgical supplementation — As adjunctive lubrication following refractive surgery (LASIK, PRK) or cataract surgery, where temporary dry eye is common.
• Medication-induced dryness — Many systemic medications (antihistamines, decongestants, antidepressants, beta-blockers) can reduce tear production as a side effect.

What Should You Know Before Using Tears Naturale?

While Tears Naturale is a well-tolerated over-the-counter medication, there are important considerations to be aware of before beginning use. Understanding the contraindications, precautions, and potential interactions will help ensure safe and effective treatment of your dry eye symptoms.

Contraindications

The primary contraindication for Tears Naturale is known hypersensitivity (allergy) to any of its components. This includes the active ingredients dextran 70 and hypromellose, as well as the excipients such as polyquaternium-1 (the preservative), sodium chloride, borax, potassium chloride, and purified water. Allergic reactions to artificial tears are uncommon but can manifest as increased redness, itching, swelling of the eyelids, or worsening of symptoms after application.

If you have previously experienced an allergic reaction to any eye drop product containing dextran, hypromellose, or similar cellulose-derived polymers, you should inform your healthcare provider before using Tears Naturale. Alternative preservative-free or differently formulated artificial tears may be more suitable.

Warnings and Precautions

Before using Tears Naturale, speak with your doctor or pharmacist if you have any ongoing eye conditions beyond simple dryness or irritation. The following situations require medical attention rather than self-treatment with artificial tears:

• Headache accompanied by eye pain — This may indicate elevated intraocular pressure, acute angle-closure glaucoma, or other conditions requiring urgent evaluation.
• Sudden changes in vision — Blurred vision, double vision, or loss of visual field could signify a serious underlying condition.
• Persistent redness or irritation — If symptoms do not improve within 72 hours of regular use, or if they worsen, discontinue Tears Naturale and consult an eye care professional.
• Signs of eye infection — Discharge (especially yellow or green), crusting, pain, or significant swelling may indicate bacterial or viral conjunctivitis, which requires specific treatment.

To avoid contamination, never touch the dropper tip to your eye, eyelid, fingers, or any other surface. Replace the cap tightly after each use. Contaminated eye drops can cause serious eye infections that may result in vision loss.

Pregnancy and Breastfeeding

Tears Naturale can be used safely during pregnancy and while breastfeeding. The active ingredients dextran 70 and hypromellose act locally on the ocular surface and are not expected to be absorbed systemically in clinically significant amounts. There are no known effects on fertility. No specific precautions are necessary for pregnant or lactating women using this product at the recommended doses.

This safety profile is consistent with the guidance provided by the American Academy of Ophthalmology (AAO) and the European Medicines Agency (EMA), both of which classify topical ocular lubricants as low-risk medications during pregnancy. If you have any concerns, consult your obstetrician or ophthalmologist for personalized advice.

Driving and Operating Machinery

Like all eye drops, Tears Naturale may cause temporary blurred vision immediately after instillation. This effect typically resolves within a few seconds to minutes as the solution spreads across the corneal surface and stabilizes. However, you should not drive, operate heavy machinery, or perform tasks requiring sharp visual acuity until your vision has fully cleared.

You are responsible for assessing whether you are fit to drive or perform safety-critical activities. If you notice persistent visual disturbance after using the drops, wait until your vision normalizes before engaging in such activities. Environmental factors such as bright sunlight or glare may temporarily exacerbate the visual blurring effect.

How Does Tears Naturale Interact with Other Drugs?

Tears Naturale has a favorable drug interaction profile, which is one of the advantages of artificial tear preparations. The active ingredients dextran 70 and hypromellose are inert polymers that act locally on the ocular surface without significant systemic absorption. As a result, no clinically significant drug interactions have been identified or formally studied.

However, there are important practical considerations when using Tears Naturale alongside other ophthalmic medications:

Administration with Other Eye Medications

If you are using multiple eye drops or eye ointments, proper spacing between applications is essential to ensure each medication is adequately absorbed. Applying eye drops too close together can lead to dilution, washout, or reduced effectiveness of the therapeutic agents.

Systemic Drug Considerations

Although Tears Naturale itself does not interact with systemic medications, it is important to be aware that many commonly used oral medications can contribute to or worsen dry eye symptoms. These include antihistamines, decongestants, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), beta-blockers, diuretics, and isotretinoin. If you are taking any of these medications and experiencing dry eye symptoms, consult your prescribing doctor to discuss whether dose adjustment or alternative treatment is appropriate.

Always inform your doctor or pharmacist about all medications you are using, including over-the-counter products and nutritional supplements. While Tears Naturale is unlikely to interfere with any of these, a complete medication review can help identify contributing factors to your dry eye symptoms.

What Is the Correct Dosage of Tears Naturale?

Always use Tears Naturale exactly as described in the patient information leaflet or as directed by your doctor or pharmacist. If you are uncertain about the correct dosage or frequency, seek advice from your healthcare provider. The following dosage recommendations are based on the approved product information.

Adults, Elderly, and Adolescents Over 12 Years

Children Under 12 Years

How to Apply Tears Naturale Correctly

Proper application technique is essential to maximize the effectiveness of Tears Naturale and minimize the risk of contamination. Follow these steps carefully:

1. Wash your hands thoroughly with soap and water before handling the eye drop bottle.
2. Remove the cap from the bottle. If the safety ring is loose, remove it before first use.
3. Tilt your head back and look up at the ceiling. You may find it helpful to sit in front of a mirror.
4. Gently pull down the lower eyelid with a clean finger to create a small pocket between the eyelid and the eye.
5. Hold the bottle upside down between your thumb and middle finger, positioning the dropper tip close to (but not touching) your eye.
6. Press gently on the bottom of the bottle to release one drop into the pocket formed by the lower eyelid. The DROPTAINER bottle is designed so that only light pressure is needed.
7. Close your eye gently for 1–2 minutes. Optionally, press lightly on the inner corner of the eye (near the nose) to reduce drainage into the nasolacrimal duct and maximize ocular contact time.
8. Repeat for the other eye if both eyes are affected.
9. Replace the cap immediately and tighten securely.

Missed Dose

If you forget to apply Tears Naturale at the scheduled time, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not apply a double dose to compensate for a forgotten application.

Overdose

An overdose of Tears Naturale applied to the eye is unlikely to cause serious harm. If you accidentally instill too many drops, the excess solution can be gently flushed from the eye with lukewarm tap water. If the solution is accidentally swallowed—for example, if a child ingests the contents—contact a healthcare provider or poison control center for assessment, although significant systemic toxicity is not expected given the inert nature of the polymeric ingredients.

What Are the Side Effects of Tears Naturale?

Like all medicines, Tears Naturale can cause side effects, although not everyone experiences them. The vast majority of side effects associated with artificial tear preparations are mild, transient, and localized to the eye. Serious adverse reactions are extremely rare. The following side effects have been reported in clinical trials and post-marketing surveillance.

The temporary blurred vision reported as a very common side effect is a normal consequence of instilling any viscous solution into the eye. The blurring typically resolves within seconds to a few minutes as the solution distributes across the corneal surface and the tear film stabilizes. This effect is not a cause for concern unless it persists for an extended period.

The paradoxical dry eye sensation listed as a common side effect may occur during the initial period of treatment, particularly in patients with moderate-to-severe tear film deficiency. As the ocular surface begins to heal with regular use, this effect typically diminishes. If dryness worsens or persists beyond the first week of treatment, consult your eye care professional to evaluate whether the formulation is appropriate for your condition.

Reporting Side Effects

Reporting suspected side effects after a medicine has been authorized is important for the ongoing monitoring of its benefit-risk balance. Healthcare professionals and patients are encouraged to report any suspected adverse reactions to their national pharmacovigilance authority. In the United States, reports can be made to the FDA MedWatch program. In the European Union, reports should be directed to the national medicines agency of your country. In the United Kingdom, the Yellow Card Scheme operated by the MHRA accepts reports from both healthcare professionals and patients.

How Should You Store Tears Naturale?

Proper storage of Tears Naturale is essential to maintain the sterility, stability, and efficacy of the product throughout its shelf life. Improper storage can lead to chemical degradation of the active ingredients, loss of preservative efficacy, and microbial contamination, all of which can compromise the safety and effectiveness of the eye drops.

Follow these storage guidelines:

• Temperature: Store at or below 25°C (77°F). Do not freeze. Avoid exposing the bottle to direct sunlight or excessive heat (e.g., leaving it in a car during summer).
• After opening: Discard the bottle 4 weeks after first opening, even if there is solution remaining. Write the date of opening on the bottle or carton for reference.
• Before opening: Use before the expiry date printed on the packaging (marked as “EXP” or equivalent). The expiry date refers to the last day of the indicated month.
• Keep out of reach: Store out of the sight and reach of children to prevent accidental ingestion.
• Cap security: Always replace the cap tightly after use to prevent contamination and evaporation.

Do not dispose of medicines via wastewater drains or household waste. Return unused or expired medicines to your local pharmacy for safe disposal. This helps protect the environment and prevents accidental exposure.

What Does Tears Naturale Contain?

Understanding the full composition of Tears Naturale can help you identify potential allergens and understand the role of each ingredient in the formulation. The product is a clear, colorless solution supplied in a 10 ml plastic bottle (DROPTAINER) with a screw cap.

About the Preservative

Tears Naturale uses polyquaternium-1 (commonly known as Polyquad) as its preservative rather than the more traditional benzalkonium chloride (BAK). This is a significant advantage for patients who use artificial tears regularly. Benzalkonium chloride is known to cause dose-dependent toxicity to corneal and conjunctival epithelial cells with prolonged use, potentially worsening dry eye symptoms and causing punctate epithelial erosions. Polyquaternium-1, by contrast, has been shown in clinical studies to be significantly less cytotoxic to the ocular surface while still providing adequate antimicrobial protection.

For patients requiring very frequent application (more than 4–6 times daily) or those with moderate-to-severe ocular surface disease, preservative-free formulations (available in single-dose units) may still be preferable. Discuss your options with your ophthalmologist or optometrist.

Packaging Information

Tears Naturale is supplied as a clear, colorless solution in a 10 ml plastic DROPTAINER bottle with a screw cap. The bottle is designed for controlled, single-drop dispensing with minimal squeeze pressure required. Each package contains one 10 ml bottle. The product is manufactured by Alcon, a global leader in eye care, with manufacturing facilities in Belgium and Spain.