When dry eyes are also red, itchy, burning or easily irritated, adding more moisture may not tell the whole story. Thealoz Total was developed to support three needs at once: soothing, protection and hydration.

This guide explains what is in Thealoz Total, who it is intended for, how it differs from a standard lubricating drop and how to use it safely.

A healthy tear film has to spread smoothly, remain stable between blinks and protect the cells of the ocular surface. When that system becomes unstable, increased evaporation or insufficient tears can expose the surface to stress. Irritation can then encourage inflammation, while inflammation may make the tear film even less stable. This is why dry eye can show up as burning, grittiness, redness, fluctuating vision, watering, fatigue or itching—not simply a feeling of “not enough moisture.”

Thealoz Total does not diagnose the cause of those symptoms. Its formula is designed around three complementary functions, which is what distinguishes it from an eye drop whose only stated purpose is lubrication.

What is Thealoz Total?

Thealoz Total is a sterile, phosphate-free, pH-neutral ophthalmic solution supplied in a 10 mL ABAK® multidose bottle. It is indicated for moderate-to-severe dry eye syndrome and is intended to hydrate and soothe itchy, red or irritated eyes.

The bottle uses a 0.2 µm filter to help prevent bacterial contamination without preservatives. The result is approximately 300 drops per bottle, with use permitted for up to three months after opening when stored and handled as directed.

What are the three active ingredients?

Who may find Thealoz Total useful?

The Canadian instructions position it for adults with moderate-to-severe dry eye symptoms such as itchiness, redness and irritation. Those symptoms can be associated with wind, smoke, pollution, dust, sunny or cold conditions, dry heat, air conditioning, flights, long periods at a computer and allergic reactions.

It may be particularly relevant when a person wants a preservative-free drop and their symptoms feel broader than dryness alone. It is compatible with any type of contact lens, although individual lens-care instructions and advice from an eye care professional still apply.

How is Thealoz Total different from a basic artificial tear?

Many artificial tears focus primarily on lubricating the ocular surface. Thealoz Total contains hyaluronic acid for that role, but also includes trehalose for protective and hydrating properties and NAAGA for soothing and anti-inflammatory properties. That does not automatically make it the right product for every dry-eye pattern; it means the formula addresses a broader set of stated needs.

For mild dryness that responds well to a simple lubricant, a more complex formula may not be necessary. When symptoms are moderate to severe, include itch or redness, recur in challenging environments or are not adequately controlled by a current routine, a conversation with an eye care professional can help determine whether the additional ingredients are relevant.

Why does preservative-free matter?

Preservatives help keep a conventional multidose bottle free from contamination, but some people—especially frequent users or those with a sensitive ocular surface—prefer to avoid repeated preservative exposure. The ABAK bottle solves the contamination problem mechanically: the solution passes through a 0.2 µm filter, allowing the formula to remain preservative-free in a multidose format.

Preservative-free does not mean contamination is impossible. The bottle is for one patient only, should not be shared, and the tip must not touch the eye, skin, fingers or another surface.

What did the clinical study find?

A 2024 multicentre study followed 62 adults with moderate-to-severe dry eye who used the hyaluronic acid, trehalose and NAAGA formulation 3 to 6 times daily for 42 days. Participants showed improvements in overall symptoms, OSDI scores and several clinical signs, and the formulation was generally well tolerated.

How do you use Thealoz Total?

1. Wash and dry your hands.
2. On first use, expect the first drop to take longer because of the filtration system.
3. Gently pull down the lower eyelid while looking up.
4. Apply one drop into the eyelid pocket and close the eye gently.
5. Replace the cap without touching the bottle tip to the eye, fingers or another surface.

The recommended dosage is one drop in each eye, 3 to 6 times daily. Wait at least 15 minutes between different eye products. Do not dilute or mix the solution with another product.

What should you expect when starting the bottle?

The first drop can take longer to appear because the ABAK filtration system must prime. That is expected and is not a reason to puncture, cut or open the bottle with a tool. After application, vision may briefly blur; wait until it clears before driving or operating machinery.

The reported side effects for Thealoz Total include blurred vision and photophobia. Similar eye-drop devices have also been associated with allergic reactions and, rarely, irritation, redness or eye pain. Brief burning, stinging or a foreign-body sensation can occur with eye drops. Remove contact lenses and contact a healthcare professional if a reaction is concerning or persistent.

How do you know whether it is the right next step?

• Your symptoms are described as moderate to severe rather than occasional and mild.
• Dryness is accompanied by itch, redness, burning or irritation.
• Wind, smoke, pollution, screens, air conditioning, cold, dry heat or flights make symptoms worse.
• You want a preservative-free multidose drop that is compatible with contact lenses.
• You understand that symptom relief does not replace assessment of the underlying dry-eye pattern.

If several of these points fit, Thealoz Total may be worth discussing. If symptoms are new, one-sided, painful or associated with a meaningful vision change, assessment should come before product experimentation.

Frequently asked questions

Is Thealoz Total preservative-free?

Yes. Its ABAK multidose bottle filters the solution so preservatives are not required.

Can you use it with contact lenses?

Yes. The Canadian instructions state that it is suitable for wearers of any type of contact lens.

How long is the bottle good after opening?

Up to three months after first opening. Store it between 8°C and 25°C, away from direct sunlight and humidity.

Is it for children or pregnancy?

It is for adults. Because clinical data are not available for children, pregnancy or breastfeeding, it should not be used in those populations unless advised by a doctor.

When should you seek care?

Contact a healthcare professional if symptoms worsen or do not improve. Seek prompt care for significant pain, injury, sudden vision changes, marked light sensitivity or discharge.

Can the bottle be shared?

No. It is a single-patient multidose product. Sharing increases the risk of cross-contamination.

Can I keep using it after three months if solution remains?

No. Discard any remaining solution responsibly three months after the first opening, even if the printed expiry date is later.

Sources

• EyeDropShop: Thealoz Total product page
• Canadian Thealoz Total Instructions for Use, version 01-06/2025 (supplied by the manufacturer).
• El Fekih et al., 2024: hyaluronic acid, trehalose and NAAGA formulation in dry eye

This article is educational and is not a diagnosis or a substitute for advice from your optometrist, ophthalmologist or other healthcare professional.