Knock Knock Eye: Over-the-Counter Redness Relievers: An Ophthalmologist’s Guide

Halloween is around the corner, so here is a little housekeeping. I open with the saga of my HOA fining me for window units during a 117°F Portland heat wave, including the time I taped a photo of Brad Pitt to one to make it “more beautiful.” Then our family’s Star Wars Halloween plan: I was going to hide inside an inflatable Jabba the Hutt until Kristin called me on it, so I’m compromising with a Jawa.

After the break, the real news. The FDA just approved Brightly (Alcon’s apraclonidine 0.125%), the newest over-the-counter redness reliever. I walk through why Visine is the worst thing ever invented, why Lumify is still my go-to recommendation if you absolutely must use one, and why I’m cautious about Brightly, especially around kids. And a reminder: if your eye redness comes with any other symptom, don’t mask it. Go see an eye doctor.

Takeaways:

• Visine’s tetrahydrozoline is a potent vasoconstrictor that causes rebound redness and chronic irritation, and ingesting it can cause life-threatening cardiovascular effects.
• Lumify (brimonidine 0.025%) has been the preferred over-the-counter option since 2017, but overuse can trigger allergic reactions that force patients to stop.
• Brightly (apraclonidine 0.125%), approved October 16, 2026, is Alcon’s new low-dose alpha agonist redness reliever indicated for ages 12 and up.
• Will remains cautious about Brightly for pediatric exposure risks, since full-dose apraclonidine can cause CNS depression in children.
• Age-related eye redness without associated symptoms generally doesn’t need treatment, but redness with burning, discharge, blurry vision, or light sensitivity should be evaluated by an eye doctor.

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