Question & Answer

What are the side effects, if any, of prolonged use of eyedrops with hyaluronic acid for dry eye?

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The Evidence

  • A systematic review published in 2022, which included 53 studies with 4885 people, found that eyedrops with hyaluronic acid are safe to use for dry eye disease, as they don’t cause any serious harm.
  • Some of the studies found that some people experienced side effects when using hyaluronic acid eyedrops, like dilation of the blood vessels in the eye (conjunctival hyperaemia), inflammation of the eye because of infection or allergy (conjunctivitis), burning sensation and/or discomfort, more blurry vision, and minor and tolerable temporary visual changes.
  • The majority of these 53 studies were randomised controlled trials, which when done well are considered high-quality evidence. However, the authors of the systematic review did not assess or report on the quality of each of these studies.
  • None of the 53 studies lasted longer than 3 months, so we can’t be certain that hyaluronic acid eyedrops are safe or don’t have additional side effects when used for a prolonged time.

Guidelines and recommendations

  • We did not find any guidelines or recommendations on this topic.

Things to Remember

  • In order to get an accurate answer to your question remember to ask yourself if the outcomes that are relevant to you have been assessed.
  • There are very few treatments that are 100% safe and there are generally always some side effects to be aware of.


  • Lead Researcher: Dr Marie Tierney, Postdoctoral Researcher, Informed Health Choices-Cancer project, School of Nursing & Midwifery, University of Galway.
  • Reviewed by: Prof Declan Devane, Professor of Health Research Methodology, Deputy Dean, College of Medicine, Nursing and Health Sciences, University of Galway,
  • Scientific Director, HRB-Trials Methodology Research Network Director, Evidence Synthesis Ireland. Director, Cochrane Ireland.
  • Topic advisor: Dr. Frank Moriarty, Senior Lecturer in Pharmacy at the School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland and visiting research fellow at The Irish Longitudinal Study on Ageing (TILDA).
  • Public and Patient advisor: Anne Daly, Public and Patient Involvement in research (PPI) advisor, PPI Ignite, University of Galway.
  • Journalist Advisor: Dr. Claire O’Connell, PhD in cell biology, Masters in Science Communication. Contributor to The Irish Times, writing about health, science and innovation.

Conflict of Interest Statement: The authors have no financial or other conflicts of interest for this health claim summary.