How does hypochlorous acid help dry eye syndrome (DES)?

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Last updated: March 16, 2025View editorial policy

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From the Guidelines

Hypochlorous acid is not significantly effective in treating dry eye syndrome (DES) caused by Demodex blepharitis, as shown by a study that found 0.01% hypochlorous acid spray had minimal effect on Demodex 1.

Mechanism of Action

Hypochlorous acid works as an antimicrobial agent, targeting bacteria and other microorganisms that can contribute to dry eye symptoms. It disrupts bacterial cell walls and neutralizes inflammatory toxins without damaging healthy tissue, making it gentler than traditional antibiotics or harsh cleansers.

Treatment of Dry Eye Syndrome

However, in the context of Demodex blepharitis, which is a common contributor to dry eye, hypochlorous acid has been found to have minimal effect 1. Other treatments such as topical tea tree oil, oral ivermectin, and topical lotilaner ophthalmic solution have shown more promise in treating Demodex blepharitis 1.

Alternative Treatments

For dry eye syndrome caused by meibomian gland dysfunction, treatments such as intense pulsed light (IPL), meibomian gland probing, and vectored thermal pulsation therapy have shown efficacy in improving meibomian gland function and reducing dry eye symptoms 1.

Key Points

  • Hypochlorous acid has minimal effect on Demodex blepharitis 1
  • Alternative treatments such as topical tea tree oil, oral ivermectin, and topical lotilaner ophthalmic solution may be more effective for Demodex blepharitis 1
  • Treatments such as IPL, meibomian gland probing, and vectored thermal pulsation therapy may be effective for meibomian gland dysfunction 1

From the Research

Mechanism of Hypochlorous Acid in Dry Eye Syndrome

  • Hypochlorous acid has been shown to have a positive effect on dry eye syndrome (DES) by reducing inflammation and improving the health of the meibomian gland 2.
  • The use of hypochlorous acid through ultrasonic atomization has been found to improve the symptoms of DES, including reducing conjunctival and corneal staining, and increasing Schirmer's test and tear break-up time (TBUT) 2.
  • Hypochlorous acid has also been found to have antimicrobial properties, which can help to reduce the bacterial load on the ocular surface and improve the overall health of the eye 3.

Clinical Outcomes of Hypochlorous Acid Treatment

  • Studies have shown that hypochlorous acid can improve clinical outcomes in patients with DES, including increasing non-invasive keratograph break-up time (NIK-BUT) and tear film BUT (TF-BUT), and reducing ocular surface disease index (OSDI) 2, 3.
  • Hypochlorous acid has also been found to improve meibomian gland function, including increasing meibum secretion and reducing meibomian gland dysfunction 2, 3.

Comparison with Other Treatments

  • Hypochlorous acid has been compared to other treatments for DES, including hyaluronic acid wipes, and has been found to have similar or superior clinical outcomes 3.
  • Hypochlorous acid has also been found to have a longer duration of action compared to other treatments, including cyclosporine A eye drops 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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