Eye Drop Review Part 1: Setting the Benchmark with Systane Ultra
DRY EYE DROPS
Welcome to our first official review!
On this website, we’ll be exploring a wide range of eye care products, from the latest and newest to the classics.
To establish a solid foundation for our comparisons, it's essential to start with a benchmark—a popular and widely-used product that sets the standard for over-the-counter relief. That's why we’re starting our journey with Systane Ultra Lubricant Eye Drops.
While not necessarily the "best" eye drop for every single occasion, Systane Ultra is a highly popular and trusted product that has earned its place on pharmacy shelves around the world. It provides a reliable and accessible option for many people experiencing dry eye symptoms. By understanding its formulation and purpose, we can better evaluate how other drops stack up.
Product Information:
Active Ingredients: Hydroxypropyl Guar, Polyethylene Glycol 400, Propylene Glycol,
Non-active Ingredients: Sorbitol, Aminomethylpropanol, Boric acid, Potassium Chloride, Sodium Chloride
Preservative: POLYQUAD™ (Polyquaternium-1) 0.001%, also available preservative-free.
Target patients: mainly for mild to moderate sufferers, and mainly for patients with aqueous-deficient dry eyes
Suitable for contact lens wear.
How HP-Guar works: According to Petricek et al (2008), HP-Guar is a pH-sensitive polymer that triggers a "gelling" process when it interacts with the natural pH or acidity level of the tears. However, a person with dry eye disease often has a slightly more acidic tear film. So when HP-Guar this more acidic environment, it undergoes a transformation that turns it into a cross-linked matrix/gel. Thus, the viscosity of the drop increases to match the conditions of the ocular surface. This thicker, more viscous substance adheres better to the eye, stays longer on the eye, and protects the surface layer (epithelium) of the eye, as it is often damaged in dry eye patients.
Polyethylene glycol (PEG) 400 (0.4%) and propylene glycol (PG) (0.3%) are two hydrophilic demulcents. Polyethylene Glycol 400 (PEG 400)'s primary function is to attract water and retain it on the eye, thus helping to rehydrate the eye, and Propylene Glycol (PG)'s primary function is to create a smooth, lubricating layer on the ocular surface. This layer reduces friction between the eyelid and the cornea during blinking, which is a major cause of discomfort for people with dry eye. Sorbitol and boric acid maintain a higher pH level in the solution while it is liquid in the bottle, preventing it from solidifying. They dissipate once the drop is on the eye, so that the drop becomes thicker and more gel-like.
POLYQUAD®: Systane Ultra contains a preservative called POLYQUAD® (Polidronium Chloride). Compared to other preservatives such as benzalkonium chloride (BAK), POLYQUAD® is often considered a milder option. This is because its large molecular size prevents it from penetrating the eye's surface cells, minimising the potential for long-term irritation. However, I would always recommend preservative-free options if that's available.
Our Verdict: A Solid Starting Point
Systane Ultra is a fantastic starting point for anyone looking to relieve typical dry eye discomfort. Think of Systane Ultra as the reliable sedan of the eye drop world—it's not the flashiest, but it's consistent, trustworthy, and gets the job done for millions of people every day.
As we continue to review other products on this site, we will often refer back to Systane Ultra. We’ll compare its properties and overall effectiveness to help you determine which eye drop is the right fit for your unique needs.
A Note from the Author
Thank you for taking the time to read my review. As an optometrist based in Australia, I aim to provide practical and well-researched information.
It is important to note that clinical studies around eyedrops are usually funded by the company that makes them. Therefore, I encourage you to consider the findings with a discerning eye. More importantly, what works for one person might not work for another, and what doesn't work for you might work for someone else. Such is the nature of dry eye treatments.
Now, this website is currently a work in progress, and I plan to add more visuals, including pictures and videos, and links to where you can purchase these products in the future. Please keep in mind that product names and availability may vary in your country.
References
Alcon. (n.d.). SYSTANE® ULTRA Lubricant Eye Drops. Retrieved from https://systane.myalcon.com/au/products/systane-ultra/
Srinivasan, S., & Manoj, V. (2021). A Decade of Effective Dry Eye Disease Management with Systane Ultra (Polyethylene Glycol/Propylene Glycol with Hydroxypropyl Guar) Lubricant Eye Drops. Clinical ophthalmology (Auckland, N.Z.), 15, 2421–2435. https://doi.org/10.2147/OPTH.S294427
Petricek, I., Berta, A., Higazy, M. T., Németh, J., & Prost, M. E. (2008). Hydroxypropyl-guar gellable lubricant eye drops for dry eye treatment. Expert Opinion on Pharmacotherapy, 9(8), 1431–1436. https://doi.org/10.1517/14656566.9.8.1431