Q. I am using Refresh eye drops for five years. Will it be a problem?

Answered by Dr. Manjunath Natarajan and medically reviewed by iCliniq medical review team.


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Hello doctor,

I am a 66-year-old male with no hypertension and non-diabetic. Since many years I have the dry eye problems and have been using Refresh tears drops or Refresh Liquigel. Last year, I developed frequent twitching of eyes and eye specialist prescribed the same eye drops and fish oil 1200 mg that contains 360 mg of omega 3. Since then, the dry syndrome improved a lot. I am continuing to take the fish oil one gel a day soon after lunch. My eye pressure is normal (L 14 R 17) and no glaucoma. I have mild cataract formation in my right eye and I am advised to wait for another year for its removal. I use only reading glasses. However, one and a half years ago, one eye doctor who checked me for the change of eyeglasses suspected that I may have an open-angle problem and graded it as grade II. But in later check up with another doctor, it was ruled out. My cornea is fine and nerves are fine too. My height is 172 cm and weight 68 to 70 Kg.

Current problem and symptoms are as follows:

  1. I have again twitching (not as frequent as it was during last year).
  2. Dryness in both eyes.
  3. Burning sensation especially during or after computer work.
  4. Mild pain on eyebrow area (occasionally).
  5. No discharge in both eye and no redness except one mild blast in the right eye extreme left the bottom corner.
  6. Normal Vision.
  7. No problem in eye rotation.


  1. I am using the refresh eye drops for more than five years. Will it be a problem?
  2. Using GenTeal gel continuously for past two months. Will this be of any problem?
  3. Taking one capsule a day of fish oil (1200 mg of which 360 mg are omega 3). Will that be good as I am taking it for more than seven months now? Can I continue to take this? Seeking advise for improvement of my present condition or symptoms as mentioned above.

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Dr. Manjunath Natarajan
Ophthalmology (Eye Care


Welcome to icliniq.com.

You seem to be suffering from what we call myokymia. It is a benign twitching of the eyelids. It has been known to be associated with dry eye and other ocular surface disorders. The other know factors which cause and aggravate it are drinking coffee or tea, working outdoor or exposure to pollution, and less sleep.

So my advice to you:

  1. Continue all the medication you are on currently. The season now is very hot and arid and can aggravate dry eye, so there is nothing wrong with you needing more lubricant and using them.
  2. Avoid coffee or tea.
  3. Get at least eight hours of sleep a day.
  4. Give hot fomentation to both eyes over closed eyelids.
  5. Continue taking omega 3 fatty acid capsules, they are a diet supplement and are safe to take.

I would recommend seeing a doctor in case:

  1. Your eyelid twitching becomes worse over time with no improvement.
  2. In case other parts of your face and body start moving out of your control along with your eyelid.
  3. In case the twitching becomes severe enough that even with your best efforts you are not able to open your closed eyelid.

I hope you get well soon.

The Probable causes:

Dry eyes.

Investigations to be done:

Tear film analysis, slit lamp exam, CT scan for facial nerve compression.

Differential diagnosis:

Blepharospasm, facial nerve compression.

Probable diagnosis:

Benign myokymia.

Treatment plan:

Treatment of dry eye.

Preventive measures:

Avoid outdoor exposure to wind and dust.

Regarding follow up:

For more information consult an eye care ophthalmologist online.--->https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist


Hi doctor,

Thanks a lot. Actually, the problem is more than normal winking of eyes. That is to say, the upper lids close and opens more frequently. Probably I used the wrong word in my query earlier. I do not have any problems in opening the eyes. However, I get burning sensation in both eyes especially while reading on a smartphone screen and on a computer screen. I drink only tea two cups one before breakfast and one after. I drink one liter of water in empty stomach soon after raising. Other times I drink health drinks. Refresh gel is fine as I use it now for over five years. But I need your advice on the continuous use of GenTeal gel one drop at night before bed. It was prescribed for burning sensation. Now, I am in a cold station.


Dr. Manjunath Natarajan
Ophthalmology (Eye Care


Welcome back to icliniq.com.

I completely understand what you are trying to say, I also have an answer to your query regarding the same. The condition is myokymia or eyelid twitching. I have only mentioned that you need to see a doctor only if it is blepharospasm, you will have problems opening your eyes. GenTeal gel (Carboxymethylcellulose sodium, Phosphoric acid, etc.) is safe to use.

For more information consult an eye care ophthalmologist online --> https://www.icliniq.com/ask-a-doctor-online/eye-care-ophthalmologist

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