Does Hyaluronic Acid Work to Treat Dry Eye?

Do your eyes often feel irritated or watery or look red? If so, you may be experiencing dry eye syndrome. 

Dry eye syndrome is an uncomfortable — but common — eye condition that affects 16 million adults in the U.S. Without treatment, dry eye can damage the cornea and lead to eye injuries and even vision loss.

Traditional treatment options for dry eye include artificial tears, omega-3 supplements, warm compresses, and medicated drops like Restasis (cyclosporine). Researchers are investigating other treatment options too. Hyaluronic acid is making waves as a potential dry eye treatment. 

But how does it work to treat dry eye? Here’s what to know about hyaluronic acid supplements for dry eye. 

What is hyaluronic acid?

Hyaluronic acid is a substance that’s naturally made by the body. It’s found throughout the body, especially in the eyes, tendons, and ligaments — even in your blood. 

Hyaluronic acid’s structure allows other compounds, including water, to attach onto it easily. Its ability to hold onto water and moisture creates a lubricating and cushioning effect. That’s why hyaluronic acid is such a popular ingredient in skin care products:

• Its moisture-attracting properties help plump skin and reduce the appearance of fine lines. 

• It's also used as an injectable filler in the face and lips. 

• And hyaluronic acid is injected into joints, where it can provide extra cushion and reduce joint pain. 

Can hyaluronic acid help dry eye?

Yes, hyaluronic acid can help treat dry eye. Its moisture-attracting properties help thicken and stabilize the tear film over the eye. It also slows down tears’ evaporation. 

Dry eye can develop when people don’t make enough tears or when tears evaporate too fast. Studies show that hyaluronic acid can help address both of these issues. A stable tear film eases dry eye symptoms. It also nourishes and protects the cornea so it can heal from previous damage from dry eye. 

That’s why many manufacturers now add hyaluronic acid to artificial tears, a mainstay for dry eye treatment.

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Eye drops vs. supplements

Of course, not everyone is a fan of eye drops. They can be cumbersome to use. And you have to remember to apply them throughout the day. 

That’s partly why people want to know whether hyaluronic acid supplements could also help treat dry eye. Taking hyaluronic acid by mouth would eliminate the hassle of an eye drop. 

But unfortunately, oral hyaluronic acid doesn’t work the same way as topical hyaluronic acid. There haven’t been many studies on the topic. One very small study, with only 54 people, looked at whether taking both oral hyaluronic acid supplements and eye drops with hyaluronic acid improved dry eye symptoms. The people who used both forms of hyaluronic acids reported better dry eye symptoms than people who only used eye drops with hyaluronic acid. 

But more research is needed to know for sure whether oral hyaluronic acid supplements can effectively treat dry eye. And no studies have looked at whether it’s safe to replace eye drops with hyaluronic acid with oral topical hyaluronic acid supplements.

How do you take hyaluronic acid to treat dry eye?

Hyaluronic acid is added to artificial tears and sometimes other eye drops. The amount of hyaluronic acid in eye drops can vary from 0.1% to 0.4%. 

Eye drops with more hyaluronic acid (higher concentrations) often last longer. This means you may not need to apply drops as often. But eye drops with higher concentrations of hyaluronic acid can also cause blurry vision. So you’ll need to balance the pros and cons when choosing the best option for you.

It’s not clear how often people should use eye drops with hyaluronic acid to treat dry eye. In studies, people used them anywhere from 2 to 8 times per day. 

Some eye drops also contain preservatives like benzalkonium chloride (BAC). You shouldn’t use eye drops with these preservatives more than 4 times per day.

It’s best to work with your ophthalmologist or optometrist to determine how often you need to use your eye drops. 

How can you tell if hyaluronic acid is working to treat dry eye?

You may notice a change in your symptoms if eye drops with hyaluronic acid are working to treat dry eye. These changes can include:

• Less eye irritation 

• Relief of burning eye sensations

• Improvement in eye redness

• Fewer episodes of blurry vision

These are signs that your cornea is well-lubricated and healing. Your eye doctor will also be able to tell if your dry eye syndrome is getting better by performing special tests during a full eye exam.

Does hyaluronic acid cause side effects?

Eye drops with hyaluronic acid are generally safe based on data from clinical studies. But like all medications, eye drops with hyaluronic acid can cause some side effects, like:

• Conjunctivitis (pink eye)

• Eye redness

• Burning sensation when applying the drop

Let your eye doctor know about any symptoms you experience. They can work with you to determine if you should try another brand of eye drops. 

What other treatments work for dry eye?

Artificial tears and lubricating eye ointments (with and without hyaluronic acid) are an important part of dry eye treatment. But there are many other effective treatments for dry eye, too, including:

• Punctal plugs

• Omega-3 supplements

• Medicated eye drops like Restasis, Xiidra, Miebo, or Cequa

• Autologous serum tears

• Tyrvaya nasal spray

Why trust our experts?

Written by:

Nishika Reddy, MD

Nishika Reddy, MD, is an attending physician at the University of Utah. She provides comprehensive and cornea medical care at the Moran Eye Center and serves as clinical assistant professor.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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