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Restasis vs Xiidra: Which is Best for Dry Eye?

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Anybody who has experienced the itchy, irritable sensation of dry eyes has probably tried using drops to relieve the pain. But did you know your eye doctor can prescribe specialty eye drops specific to treating those symptoms?

Xiidra and Restasis are prescription eye drops designed for people with dry eye. Let’s explore what dry eyes are all about and how these two products provide solutions for stinging, red, inflamed eyeballs.

What is Chronic Dry Eye?

Chronic dry eye is a condition in which someone struggles to produce enough natural quality tears to lubricate the eyes and eyelids. There are several causes of this condition, ranging from environmental factors (like smoke, air pollens, or animal dander) to hormonal changes, or simply getting older. 

Certain medications, like antihistamines or anti-depressants, can induce dry eye symptoms. The most common signs of dry eye are redness, inflammation, stinging, burning, and light sensitivity. Blurred vision and watery eyes are also associated with the condition.

Another common cause of dry eye is meibomian gland dysfunction (MGD). This specialized gland is responsible for producing oils that contribute to regular tear production. A break in the normal function of this gland will lead to dry eye symptoms.

A Drop of Relief

All dry eye solutions are concerned with adding, conserving, or improving tear production. While there are several treatments available to quell the effects of dry eye, medicated drops remain one of the most reliable methods. Eye drops are non-invasive, stress-free, and can be administered at home, work, or any controlled environment.

Restasis vs Xiidra 

Two of the leaders in medicated eye drops are Xiidra and Restasis. These two products address the root of dry eyes but have some differences between them. There are also some important differences between prescription eye drops and generic drops that can be purchased over-the-counter.

Over-the-Counter, Under-Performing

Over-the-counter eye lubricants, also known as artificial tears, are designed to give short-term ocular relief or aesthetic appeal. They moisten the eye and temporarily mask symptoms, but do not change the ability of your body to produce tears.

Many of the over-the-counter eye drops contain preservatives. These are the type of eye drops that you see on the shelf in most pharmacies. These can be purchased without consulting an eye doctor. 

Prescription eye drops target medical changes that will lead to improved tear production. Although users sometimes feel immediate side effects of irritation and redness, the ultimate goal is increasing natural tear creation. Over-the-counter eye drops are simply a band-aid, and prescription eye drops solve the underlying issues behind dry eye syndrome.

Restasis (Cyclosporine)

Restasis is an eye drop designed to increase tear production for people who suffer from ocular inflammation. It is a liquid emulsion that includes the chemical cyclosporine. This substance belongs to a class of drugs that suppress the immune system, ultimately leading to an increase in natural tears. 

Long-term use is typically prescribed for Restasis, as it can take up to 6 months to see a significant difference in tear production. For this reason, you may use preservative-free lubricating drops in conjunction with Restasis in the early stages. Take Restasis twice daily, with a 15-minute wait before inserting contact lenses or other eye drops.

Xiidra (Lifitegrast)

Xiidra impacts dry eyes by diminishing inflammation on the surface of the eye. Lifitegrast is the active drug in this solution, which reduces swelling in the eye tissue. By addressing this swelling, it allows the eye to produce tears more plentifully and without irritation. 

As with Restasis, you will be asked to take Xiidra twice daily, about 12 hours apart. It is important not to overdose with either of these medications, so follow instructions from your optometrist.

Zoomed perspective of a single blue spherical water drop about to fall into a body of water that is already rippling

What is My Best Eye Drop Solution?

The most important thing to remember is that consulting with your optometrist is always the first step. By diagnosing your ocular health, they can recommend the best prescription eye drops for your situation. 

The very nature of both Restasis and Xiidra being prescription drops means that you must get your optometrist’s approval beforehand anyways.

So that being said, which is better, Restasis or Xiidra?

And the Winner Is…

The truth is, both Xiidra and Restasis have their niche in the world of eye care treatment. Although they follow different chemical paths, each treats the underlying cause of dry eyes. Your eye doctor will be able to recommend the best treatment following discussion and a dry eye exam

Being aware of the dry eye solutions available is the first step in your eyes feeling comfortable again. Ignoring dry eye symptoms can lead to eye infections and other painful situations. There really is no reason to suffer from red, itchy eyes when safe eye drop remedies are available, practical, and safe.

Both Restasis and Xiidra may be covered under your health insurance plan. Exact pricing will vary with location and insurance coverage, but a general comparison can be found here. Do yourself a favor and ask your optometrist about prescription eye drops if you experience dry eyes. It doesn’t matter if it’s a chronic problem or a condition that flames up after staring at a computer. Schedule an eye exam, because you deserve to feel relieved and resolved from dry eye syndrome.

Written by Benjamin Teller

Dr. Teller earned his doctorate in optometry from the Pennsylvania College of Optometry in 1996 and has been helping local residents see clearly ever since. After graduation, Dr. Teller completed an internship with the Hopewell Valley Eye Associates, as well as several externships with the National Naval Medical Center and Katzen Eye Group.

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