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Bausch + Lomb: 170 years of helping people see better, to live better

The 3rd November 2023 marked the 170th birthday for Bausch + Lomb. Since the company was founded in 1853, it has nurtured a reputation for bringing innovation to the market and this is exemplified by advancements in the Viscotears® Brand. This extension of the product range reflects Bausch + Lomb’s commitment to meeting the evolving needs of today’s patients, demonstrating a timeless commitment to finding solutions in the ever changing eye health landscape.

Bausch + Lomb has looked to evolve the Viscotears® portfolio for mirroring advancements in science, technology, and our understanding of dry eye conditions.

Formerly, preservative-free treatments were often delivered in single-wrapped plastic units to ensure sterility.1 However, innovation in the form of preservative-free bottle technologies eliminated this need, offering patients a multidose option.2 Today, Preservative Free Multidose formulations for treating dry eye are commonplace, containing diverse ingredients aimed at alleviating patients’ dry eyes.2

Identifying the specific type of dry eye a patient is experiencing remains a formidable challenge for both patients and clinicians without carrying out a Schirmer test or slit lamp examination.3 Given that 85% of cases are attributed to Meibomian gland dysfunction (MGD).5 The intricacies involved with the inclusion of lipid supplements intensifies the challenge further as one already has to navigate the challenge of trying to differentiate between various aqueous agents like carbomer, sodium hyaluronate, or hypromellose.4 To compound matters, NHS deprescription guidance places the responsibility on patients to manage their condition.5

Figure 1: Adapted from Craig JP, et al., 2017. TFOS DEWS II Definition and Classification Report. There are three main types of dry eye with patients typically falling into one of these three categories.7

Viscotears® Tri Action: Lipid & Aqueous Supplementation in One Formulation8

Recognising these challenges, Bausch + Lomb introduces Viscotears® Tri Action, a preservative-free multidose treatment designed to treat Evaporative Dry Eye, Aqueous Deficient Dry Eye, and Mixed Dry Eye. The product aims to simplify the decision-making process for patients and opticians, offering a comprehensive solution in one formulation.8

Viscotears® Tri Action marks a stride in Bausch + Lomb’s attempt to address the intricate web of factors contributing to the cycle of dry eye disease. The Viscotears® Tri Action’s formulation strategically combines popular ingredients such sodium hyaluronate and trehalose, with a lipid competent comprising from sacha inchi seed oil, aiming to disrupt the inflammatory cascade and facilitate the recovery of ocular cells.8

Figure 2: The ingredients included in Viscotears® Tri Action aim to support all three layers of the tear film and work together to break the vicious circle of dry eye.8

Viscotears® Tri Action: Targeting the vicious circle of Dry Eye

A study by Laihia et al., 2020 sought to measure the impact of Viscotears® Tri Action, aiming to demonstrate simultaneous improvements in each aetiological factor after 30 days of treatment.9 In the realm of dry eye pathophysiology, TFOS DEWS II succinctly identifies three pivotal factors10:

  • Tear Film Instability10
  • Localized Hyperosmolarity10
  • Epithelial Damage and Inflammation10

The study, designed with 52 randomised and blinded patients, divided equally into control (sodium hyaluronate 0.2%) and treatment (Viscotears® Tri Action) groups, conducted baseline ocular assessments on day 1. Both groups applied drops three times a day for 30 days, with subsequent assessments mirroring the baseline evaluations.9

Figure 3: Variables measured to established whether Viscotears® Tri Action could simultaneously target each aetiological factors that causes the vicious circle of dry eye to perpetuate.9

Clinical Evidence Overview:

  1. Stabilising The Tear Film:

Tear film Break Up Time increased significantly by about 50% in subjects using Viscotears® Tri Action compared to a non-significant 25% increase in the control group (sodium hyaluronate 0.2%). Ocular Protection Index scores experienced a significant 57% improvement with Viscotears® Tri Action, demonstrating a significant enhancement compared to sodium hyaluronate 0.2% (p=0.0047).9

2.  Restoring Osmotic Balance:

Viscotears® Tri Action successfully restored tear osmolarity to normal levels, exhibiting a significant reduction in patients with hyperosmolarity after 30 days of treatment (p=0.038).9

3.  Ocular Surface Damage & Inflammation:

Viscotears® Tri Action showcased a significant reduction in corneal staining, a key indicator of ocular surface damage (p=0.014). Furthermore, Viscotears® Tri Action significantly decreased conjunctival and lid redness scores after 30 days (p=0.001 & p=0.012).9

Viscotears® Tri Action – A lipid microemulsion eye drop designed and tested to counteract the major factors that contribute to dry eye.9

In conclusion, Viscotears® Tri Action, after 30 days of consistent use, demonstrating marked improvements in each aetiological factor of dry eye disease. This formulation not only addresses tear film instability, hyperosmolarity, and ocular surface damage but also signifies a paradigm shift in the management of dry eye conditions.9

Viscotears® Tri Action aims to negate the need for patients to purchase separate Aqueous and Lipid supplement eye drops. In a healthcare landscape where consumer choice is abundant but value for money is crucial, Viscotears® Tri Action aims to stand out as the preservative-free multidose treatment of choice that caters to the diverse needs of patients with different types of dry eye.

NameIngredients8Trade Price11
Viscotears® Tri ActionTrehalose 2% Sodium Hyaluronate 0.2% Sacha Inchi Seed Oil 0.1% Glycerol£8.99
Figure 4: Viscotears® Tri Action from Bausch + Lomb. Available for order at your local optometric wholesaler.

Beyond the Drop – A commitment by Bausch + Lomb

The founders’ spirit lives on within our organisation, continually seeking new ways to enhance the value we provide. The journey to health doesn’t end with product receipt. Navigating a new product can be daunting, and at Bausch + Lomb, we recognise the vital role of patient education. Our commitment goes beyond product provision; we aim to equip patients with a comprehensive understanding of their conditions, offering simplified explanations of our product science.

With a 170-year legacy, Bausch + Lomb acknowledges the pivotal role of well-informed patients in managing conditions effectively. In line with this commitment, we’ve crafted an insightful 8-page product guide specifically designed for patients. Embedded within are QR code links providing access to enlightening explainer videos. These videos cover diverse facets, from fundamental disease origins to a concise exploration science behind how Viscotears® Tri Action aims to break the vicious circle of dry eye.8

Viscotears® is a trademark of Bausch & Lomb Incorporated or its affiliates. © 2023 Bausch & Lomb Incorporated or its affiliates. Please see Instructions for Use (IFU) for full ingredients, storage conditions, warnings and cautions.


  1. Latham, S.G., Williams, R.L., Grover, L.M. et al. Achieving net-zero in the dry eye disease care pathway. Eye (2023).
  2. Association of British Dispensing Opticians 2014. Dry Eye Preparations: An Update. Accessed 1st November 2023 from: 17&sk=&cvid=3273D1ACF3E04B1FB521E4DCA7ED7942&ghsh=0&ghacc=0&ghpl=#:~:text=https%3A//
  3. National Eye Institute. 2021. Accessed on 1st November from: eye/testing-dry-eye
  4. Findlay Q, Reid K. Dry eye disease: when to treat and when to refer. Aust Prescr. 2018 Oct;41(5):160-163. doi: 10.18773/austprescr.2018.048. Epub 2018 Oct 1. PMID: 30410213; PMCID: PMC6202299.
  5. NHS England. 2018. Conditions for which over-the-counter items should not routinely be prescribed in primary care: Guidance for CCGs Accessed 1st November from:
  6. Goodhew & Hguyen 2020. What are the different types of dry eyes?. Accessed on 2nd February 2023 from: types-of-dry-eyes/
  7. Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, Liu Z, Nelson JD, Nichols JJ, Tsubota K, Stapleton F. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017 Jul;15(3):276-283. doi: 10.1016/j.jtos.2017.05.008. Epub 2017 Jul 20. PMID: 28736335.
  8. Viscotears Tri Action IFU. V1.2. 09/2022
  9. Laihia J, Järvinen R, Wylęgała E, Kaarniranta K. Disease aetiology-based design of multifunctional microemulsion eye drops for moderate or severe dry eye: a randomized, quadruple-masked and active-controlled clinical trial. Acta Ophthalmol. 2020 May;98(3):244-254. doi: 10.1111/aos.14252. Epub 2019 Oct 3. PMID: 31579987; PMCID: PMC7216857.
  10. Nelson, J. D., Craig, J. P., Akpek, E. K., Azar, D. T., Belmonte, C., Bron, A. J., … & Sullivan, D. A. (2017). TFOS DEWS II Introduction. Ocular Surface.
  11. NHSBSA, 2023. Viscotears Tri Action eye drops preservative free. Accessed on 1st November from: https://dmd- xzZSZoaWRlUGFyYWxsZWxJbXBvcnQ9ZmFsc2UmaGlkZVNwZWNpYWxPcmRlcj1mYWxzZSZoaWRlRGlzY29udGludWVkSXRlbXM9ZmFsc2U%3D

Ross Mcluckie – Rx Marketing Manager. Bausch + Lomb UK ltd.

November 2023/Vis.0021.UK.23