Restasis: Side effects and what to do about them

Chronic dry eye disease can be more than just a minor annoyance — for many people, it’s a daily struggle that affects work, social life, and overall comfort. Restasis® (cyclosporine ophthalmic emulsion) has been a game-changer for millions of Americans dealing with this condition, offering more than just temporary relief. Unlike artificial tears that only provide short-term moisture, Restasis helps your eyes produce more of their own natural tears by targeting one of the root causes: inflammation in the tear-producing glands.

But like all prescription medications, Restasis comes with its own list of potential side effects. Some are mild and fade with time, while others require more attention. Understanding what’s normal, what’s cause for concern, and how to make the adjustment period easier can make a world of difference in your treatment journey.

In this in-depth guide, we’ll cover the most common Restasis side effects, the rare but serious reactions you need to watch for, and practical tips for minimizing discomfort so you can get the best results from your treatment. We’ll also explore alternative options in case Restasis isn’t the right fit for you.

What Is Restasis and How Does It Work?

Restasis is an FDA-approved prescription eye drop formulated to treat chronic dry eye disease in adults — and in some cases, children — whose tear production is reduced due to inflammation. The active ingredient, cyclosporine, is an immunomodulator that works by calming down the overactive immune response in the tear glands. This allows the glands to recover and start producing tears more effectively.

Why it’s different from artificial tears: Over-the-counter lubricating drops (also known as artificial tears) simply add moisture to the eyes for short-term relief. Restasis, on the other hand, addresses the underlying inflammation, making it particularly effective for people with autoimmune-related dry eye or those whose dryness persists despite using standard lubricants.

How it’s used:

Dosage: Usually one drop in each affected eye twice a day, roughly 12 hours apart.
Form: Comes in single-use vials to maintain sterility.
Onset of relief: Results aren’t instant — most patients start noticing improvements within 3–6 months of consistent use, though some feel changes earlier.

It’s worth noting that Restasis doesn’t work for everyone. Some people find it life-changing, while others may need to try different medications or combination therapies. And like any drug, Restasis can trigger side effects, which we’ll break down next.

Common Side Effects of Restasis

The vast majority of side effects from Restasis are mild, temporary, and not dangerous. They often appear in the first few weeks of treatment and gradually fade as your eyes adjust. These include:

1. Burning or Stinging Sensation

By far the most common side effect, a brief burning or stinging feeling right after applying the drops can take some users by surprise. This happens because the medication is in direct contact with the sensitive tissues of your eye, and its ingredients — especially the active cyclosporine — can cause temporary irritation.

What to expect:

Usually lasts a few seconds to a few minutes.
Tends to become less noticeable over time.
Many patients report that after 4–6 weeks, the burning sensation is minimal or completely gone.

Tip to manage: Some people refrigerate their vials for a few minutes before use (not long-term storage) because cooler drops often feel gentler on application.

2. Redness and Mild Irritation

A temporary increase in redness after applying Restasis is another common reaction. This redness usually fades within 15–30 minutes and is simply part of your eyes adjusting to the new medication.

Example: If you’ve ever had shampoo in your eyes, you know redness doesn’t always mean something is seriously wrong — it’s just your body reacting to a foreign substance. In Restasis’ case, it’s the medication doing its work.

Tip to manage: Avoid rubbing your eyes after application, as this can make redness worse and potentially introduce bacteria.

3. Watery Eyes

Ironically, a drop meant to treat dry eyes can cause excess tearing at first. This happens because your tear glands may “wake up” abruptly as the inflammation begins to subside.

What to expect:

May occur in the first week or two.
Usually resolves naturally as your tear production balances out.

Tip to manage: Blot gently with a clean tissue instead of wiping, which can irritate the eye.

4. Blurred Vision

Blurred vision immediately after applying Restasis is typically short-lived — often less than 10 minutes. It happens because the medication forms a thin film over your eye’s surface before it’s absorbed.

Tip to manage: Apply your drops when you don’t need to read or drive immediately afterward. Some people prefer applying them right before bed for this reason.

5. Foreign Body Sensation

Some patients describe the feeling of having “a grain of sand” in the eye after using Restasis. This can be due to temporary irritation or the texture of the emulsion.

Tip to manage: Keep using preservative-free artificial tears between doses (wait at least 15 minutes between different eye medications). This helps wash away residual particles and keeps the eye comfortable.

6. Morning Eye Discharge

A small amount of sticky or stringy discharge, especially upon waking, isn’t uncommon in the first weeks of treatment. This is often the eye’s natural cleaning mechanism kicking in.

Tip to manage: A warm, damp washcloth in the morning can help clean away discharge without irritating the delicate skin around the eyes.

💡 Key Takeaway: Most Restasis side effects are not harmful and improve with time. The biggest factor in success is sticking with your prescribed schedule, even if the first few weeks feel uncomfortable.

Serious Side Effects to Watch For

While most people using Restasis experience only mild discomfort, there are rare but potentially serious reactions that require immediate attention. Recognizing these early can help prevent lasting damage.

1. Severe Allergic Reactions

Although extremely uncommon, some individuals may develop an allergy to cyclosporine or other ingredients in Restasis. Symptoms of a severe allergic reaction can include:

Sudden swelling of the eyelids, face, or lips
Difficulty breathing or swallowing
Severe itching or rash around the eyes or on the body
Feeling faint or dizzy

What to do: Stop using Restasis immediately and seek emergency medical care. Allergic reactions can escalate quickly and should never be ignored.

2. Significant Eye Pain or Swelling

Mild discomfort is expected during the adjustment phase, but sharp or worsening pain, or noticeable swelling that doesn’t go away, may indicate infection or another complication.

Example: If your eye feels hot, swollen, and painful even hours after applying the drops, it’s time to call your eye doctor — this isn’t a normal Restasis side effect.

3. Sudden Changes in Vision

Temporary blurriness right after application is normal, but persistent vision loss, double vision, or flashing lights are not. These symptoms could point to serious eye conditions that need immediate evaluation.

What to do: Stop using the medication until you’ve been examined by a healthcare provider.

Managing Restasis Side Effects Effectively

The good news is that most Restasis side effects can be managed or even prevented with the right strategies.

1. Perfect Your Application Technique

Applying the drops correctly is your first line of defense against irritation. Here’s the step-by-step method most eye doctors recommend:

Wash your hands thoroughly with soap and water.
Tilt your head back and look upward.
Gently pull down your lower eyelid to create a small pocket.
Hold the vial above the eye without letting it touch your skin or lashes.
Squeeze one drop into the pocket — not directly onto the cornea.
Close your eyes gently (don’t squeeze) and keep them closed for 1–2 minutes.
Press lightly on the inner corner of your eye to prevent the medication from draining into your tear duct too quickly.

This method reduces wastage, ensures better absorption, and minimizes irritation.

2. Time Your Doses Wisely

Since Restasis is taken twice a day, about 12 hours apart, many people choose a morning and evening schedule. If you experience vision blurriness or stinging, applying your drops before bed can make these effects less noticeable.

3. Use Preservative-Free Artificial Tears

These can be a lifesaver in between Restasis doses. They keep the eyes moist and help wash away debris. Just remember:

Wait at least 15 minutes after using Restasis before applying any other eye drops.
Always choose preservative-free formulas to avoid added irritation.

4. Try the “Cool Drop” Method

Briefly placing the single-use vial in the refrigerator for a few minutes before application can make the drops feel more soothing. This method works for many patients who experience burning.

5. Add Warm Compresses to Your Routine

Applying a warm, damp cloth to closed eyes for 5–10 minutes can help improve oil gland function, reduce inflammation, and soothe irritation.

When to Contact Your Doctor

Even though most side effects fade with time, certain symptoms should prompt you to reach out to your eye care provider right away:

Side effects that worsen instead of improving after a few weeks
Burning or stinging lasting more than 15–20 minutes after application
Thick, yellow, or green discharge, which may indicate infection
Severe redness, swelling, or pain
Any sudden or unexplained changes in vision

Alternative Treatments for Dry Eye Disease

Restasis is just one tool in the dry eye treatment toolbox. If side effects make it difficult to continue, your doctor may suggest alternatives.

1. Other Prescription Eye Drops

Xiidra (lifitegrast): Works by blocking a protein involved in inflammation. Some patients tolerate it better than Restasis.
Cequa: Another cyclosporine-based drop but with a different formulation that may be easier on the eyes.

2. Artificial Tears and Lubricants

High-quality, preservative-free artificial tears can be used multiple times a day. Gel or ointment formulas work well at night for extended moisture.

3. Punctal Plugs

These tiny devices block tear drainage, keeping natural moisture in the eyes longer. They’re quick to insert and reversible if needed.

4. Lifestyle Adjustments

Sometimes small changes can have a big impact:

Use a humidifier indoors, especially in dry climates or during winter.
Follow the 20-20-20 rule for screen use (every 20 minutes, look at something 20 feet away for 20 seconds).
Drink enough water throughout the day to maintain hydration.
Wear wraparound sunglasses outdoors to protect against wind and dust.

5. Advanced Treatments

For stubborn cases, eye doctors may recommend:

Intense Pulsed Light (IPL) therapy for meibomian gland dysfunction
Autologous serum eye drops made from your own blood serum for severe dryness
Scleral contact lenses that create a moisture reservoir over the cornea

Making an Informed Treatment Decision

Restasis can be life-changing for people with chronic dry eye, but patience is key. Side effects in the early weeks are common, temporary, and usually manageable. The key is to communicate openly with your doctor, follow application instructions carefully, and make supportive lifestyle changes to maximize comfort.

For many, the payoff — improved tear production, reduced irritation, and better quality of life — far outweighs the initial adjustment period.

Conclusion

Dry eye disease can seriously impact daily life, but effective treatments like Restasis offer real hope. While side effects are possible, understanding what’s normal, taking proactive steps to manage discomfort, and knowing when to seek help can make your treatment journey much smoother.

Remember: The first few weeks are often the hardest, but with persistence and proper care, Restasis has helped countless patients regain comfort and clarity in their vision.

FAQs

1. How long does it take for Restasis side effects to go away?
Most mild side effects like burning or redness fade within the first few weeks, though full adaptation can take up to a month or two.

2. Can I use Restasis with other eye drops?
Yes, but always wait at least 15 minutes between applying Restasis and any other drops to avoid dilution.

3. Will Restasis work if I only use it once a day?
It’s best to use it exactly as prescribed — typically twice daily — to ensure the medication reaches effective levels.

4. Is Restasis safe for long-term use?
For most people, yes. Many patients use it for years without serious problems, but regular check-ups with your eye doctor are essential.

5. What if Restasis doesn’t work for me?
If you don’t see improvement after 6 months, your doctor may suggest alternative prescription drops, punctal plugs, or other treatments tailored to your needs.

Restasis: Side effects and what to do about them

What Is Restasis and How Does It Work?