Recent advances have enhanced our knowledge of the aetiology, diagnosis and treatment of dry eye disease. For many years, the mainstay of treatment has been artificial tears. Those now available offer a great range of treatment options and provide better-quality replacement tears.1 The Dry Eye Workshop Report 2007 highlighted the features of the ideal lubricant as preservative-free and similar to tears in electrolyte composition, pH and osmolarity.2 Artificial lubricants are used in a wide variety of conditions in many patients worldwide, and attempts to provide the ideal product have led to the development of a vast array of options. Perhaps the most critical advance has been the elimination of preservatives, enabling patients to administer lubricants more frequently without the associated preservative toxicity.2 Many non-preserved preparations are now available.2 These are designed for single use, but some patients ignore manufacturers’ advice and use these more …