Miebo Brands Compared: Evotears, Omega, Hylo, & More
speciality medications
Dry eye disease may have met its match.
Especially the type of dry eye disease that’s been linked to meibomian gland dysfunction (or MGD).
If you or a loved one has MGD-based dry eye disease, you may have heard about a new class of drops built around a unique ingredient: perfluorohexyloctane.
In the U.S., this medication is sold as Miebo. Internationally, the same active ingredient appears under brand names like EvoTears, NovaTears, and Hycosan Shield. These meds are all part of a growing lipophilic (or “oil-loving,” or oil-based as opposed to water-based) category of eye drops that help stabilize the tear film rather than simply adding more water to the eye.
These oil-based formulations are relatively new.
They’re also very different from traditional artificial tears.
Which means that curious patients will have questions.
For example:
What’s the difference between Miebo, EvoTears, Omega versions, Hylo formulations, or other brands sold internationally?
Are they interchangeable?
And which one is best for evaporative dry eye?
This guide breaks everything down clearly and simply, comparing each brand, how they work, what makes them unique, and how to choose the right option with your eye care provider.
What Is Miebo (Perfluorohexyloctane)?
Miebo is the first regulator-approved prescription drug to contain the active ingredient “perfluorohexyloctane” in the United States. (More on why perfluorohexyloctane is so important in a moment.)
Instead of behaving in a similar way to other more traditional tear supplements, Miebo works by stabilizing the lipid (or oily) layer of your tear film.
Here’s why that works:
- Most dry eye sufferers have evaporative dry eye, which means their tears evaporate too quickly.
- This is usually caused by MGD, where the oil layer of the tears becomes thin or unstable.
- By forming a lightweight, breathable barrier over the tear film, Miebo helps prevent excessive evaporation, improving comfort and reducing dry eye symptoms.
Because it is water-free and preservative-free, Miebo spreads smoothly over the ocular surface and does not cause stinging the way some aqueous drops do.
It’s typically used four times daily.
Internationally, that same active ingredient – perfluorohexyloctane – appears as:
- EvoTears (Germany, Canada)
- NovaTears (Australia, New Zealand, Europe)
- Hycosan Shield (various European markets)
These products may vary slightly in branding or packaging, but they operate using the exact same core technology.
Miebo vs EvoTears: What’s the Difference?
EvoTears is, essentially, the international version of Miebo.
Both contain 100% perfluorohexyloctane, without added oils, preservatives, surfactants, or emulsifiers.
Wondering how these two medications differ?
Here’s a quick list:
Their regulatory classification. Miebo is an FDA-approved prescription medication in the United States.
EvoTears, on the other hand, is often sold as a medical device or OTC product depending on the country (but not in the United States).
Their branding and packaging. What’s on the outside will likely look at least a little different, but the formula inside should be identical.
Their availability. EvoTears is available through licensed Canadian pharmacies (including some online Canadian pharmacy and international drugs websites), while Miebo is U.S.-prescription only.
EvoTears vs. EvoTears Omega: How They Compare
Those researching Miebo alternatives like EvoTears might find another option in the mix: EvoTears Omega.
EvoTears Omega is sometimes mistaken for a stronger or upgraded version of EvoTears, but that’s not exactly accurate.
Instead, EvoTears Omega is a parallel formulation that includes omega-3–rich oils in addition to perfluorohexyloctane.
This gives it a slightly richer feel, and it may offer additional ocular surface nourishment for people who feel like they have very, very dry eyes or mild eye surface inflammation.
Miebo/EvoTears vs. Hylo Drops
The Hylo family of eye medications are sodium hyaluronate-based lubricating drops, not lipid-layer protectants.
This makes them useful for aqueous-deficient dry eye rather than primarily evaporative dry eye.
Here are the key difference between Hylo Drops and Miebo or EvoTears:
- Hylo drops are water-based, gel-like moisturizers.
- Miebo/EvoTears are lipid-layer stabilizers, replacing the oily layer missing in MGD.
You might choose one of the Hylo Drops formulations if you struggle with:
- Dryness from contact lens wear
- Post-surgical dryness
- Mild to moderate dry eye needing hyaluronic acid hydration
Alternatively, you might choose Miebo/EvoTears if you struggle with:
- MGD
- Evaporative dryness
- Lid margin disease
- Burning that worsens in wind, A/C, or screen-heavy environments
Many patients ultimately don’t choose and decide to use both!
They take a hyaluronic acid drop for hydration, plus a lipid drop to lock moisture in.
NovaTears: Another International Equivalent of Miebo
NovaTears is another international brand of perfluorohexyloctane. It’s sold in Australia, parts of Europe, and select other regions.
Its formulation is identical to EvoTears, simply marketed under a different name.
Benefits of NovaTears include:
- Bottle design that dispenses microdroplets precisely
- Zero preservatives
- Rapid comfort without blur
- Long wear time—often requiring fewer drops per day
For Americans comparing Miebo vs. NovaTears vs. EvoTears, the core ingredient is identical. Cost, bottle size, and availability differ slightly, but performance does not.
Hycosan Shield: A Longer-Lasting Feel for Patients in the UK/EU
Hycosan Shield, an EU-market perfluorohexyloctane product, comes with a high-precision bottle pump system that helps maintain sterility even as you’re giving yourself multiple doses.
Patients who prefer Hycosan Shield often report:
- A feeling of longer-lasting protection on the eye surface
- A slightly thicker sensory experience (though still water-free and non-blurring)
- A more ergonomic bottle that helps achieve consistent drop size
Which Version Should You Choose?
Because the active ingredient is the same across Miebo, Evotears, NovaTears, and Hycosan Shield, your decision between your options will likely come down to availability, cost, bottle design preferences, or personal comfort with the medication’s texture.
Just know this, if you find it helpful:
For evaporative dry eye and Meibomian gland dysfunction, all perfluorohexyloctane formulations should offer comparable therapeutic benefit.
Who Benefits Most From Perfluorohexyloctane Drops?
Miebo and its international counterparts (EvoTears, NovaTears, Hycosan Shield) are especially helpful for people who have evaporative dry eye caused by Meibomian Gland Dysfunction (MGD).
If your eye doctor has mentioned that your tear film is “unstable,” that your oil glands are “blocked,” or that your eyes dry out quickly between blinks, this is the category you likely fall into.
Other categories of patients who may stand to benefit from using perfluorohexyloctane drops include:
- Individuals with MGD confirmed by an eye exam
- People whose symptoms worsen during screen use, reading, or driving
- Postmenopausal women, who commonly experience lipid-deficient tear film
- Contact lens users (Miebo itself is not approved for use with lenses, but some international versions like NovaTears may be)
- Patients who haven't responded well to water-based or hyaluronic acid drops
When Miebo Is Not the Best Choice
Some medications just aren’t for everyone.
Miebo (and its various counterparts) are no exception.
There are a handful of circumstances wherein some alternative dry-eye therapy might be more appropriate. Your doctor or healthcare team can help you identify those circumstances, but a few common examples may include…
…When aqueous deficiency is the primary issue.
If your dry eye comes from low tear volume rather than rapid tear evaporation, your clinician may prioritize hyaluronic acid formulations, tear-stimulating prescriptions, or punctual plugs.
…When you need compatibility with soft contact lenses.
U.S.-market Miebo is not approved for use with lenses.Some international versions have broader compatibility, but patients should follow local labeling carefully.
…When inflammation is the root problem.
Conditions such as autoimmune dry eye, ocular rosacea, or post-surgical inflammation may respond better to medications like cyclosporine, lifitegrast, or steroid tapers.…When you require thicker nighttime protection.
Miebo is thin and spreads rapidly; patients needing a gel or ointment for sleep may need additional products.
Wondering How to Choose Between International Versions of Perfluorohexyloctane?
If you do have access to different versions of perfluorohexyloctane, which one is the best for you?
And how can you make that decision?
Here are a few good places to look for the information you’ll need to make a rationalized choice:
Check the medication’s concentration. Most versions contain 100% perfluorohexyloctane.
Check the medication’s preservative status. These drops are typically preservative-free. This is a major benefit for sensitive users, and if your eyes tend to sting or hurt or otherwise react to eye drops, it’s definitely worth keeping an eye out for.
Check any guidance that comes with your contact lenses. If you wear lenses, you should be aware that some forms of perfluorohexyloctane just don’t play nicely with your contacts. (If you don’t have the original documentation that came with your contacts, looking up compatibility online or talking to your eye doctor is probably a good first step.
Look at the medication’s bottle design. Some brands of perfluorohexyloctane use specialized drop delivery systems that minimize contamination and extend shelf life. As you become more familiar with your options, you may realize that you have a preference for some dropper or other administration types.
Buyer’s Guide: Ordering Miebo (or International Equivalents) From a Canadian Pharmacy
No matter which version of perfluorohexyloctane you purchase, you will, clearly, have to contend with price.
And these eye drops can be pricey, especially if you’re buying them from your brick-and-mortar corner store in the United States.
If you’re looking for a less costly alternative, it may be time to consider buying your perfluorohexyloctane drops from a pharmacy in Canada or international drugstore to keep things affordable. This is especially the case if you’re in need of long-term dry eye management, as, clearly, even small upcharges will stack up over time!
We understand that buying medication online can seem risky. It can be!
Unfortunately, there are online so-called “pharmacies” – e.g., the kind that advertise miracle cures, or the ability to access prescription medications without prescriptions – that likely don’t have your best interest at heart.
To make sure you’re able to access cost savings and avoid putting yourself at risk of counterfeit medication or similar dangers, think about completing the following homework steps before you make any orders.
1. Confirm which brand is supplied.
A good online and international pharmacy website won’t be cagey about which type of eye drop you’re getting.
While some international pharmacies may be able to ship several different kinds of perfluorohexyloctane, they should be very clear about the type you’re getting, be it Miebo, EvoTears, Hycosan Shield, or an equivalent.
2. Upload your prescription when required.
In the United States, Miebo is a prescription-only drug.
There may be different rules internationally, but if you’re an American patient, you should need to provide a prescription. And this isn’t just a frustrating obstacle to overcome, as much as that can sometimes seem like the case. Prescriptions are an important part of making sure that patients and their medications are a good match, or, in short, protecting your safety.
If a pharmacy website you’re working with does not require prescriptions or does not make it very easy for you to upload your prescription, that’s not a great sign.
3. Double-check expected shipping timelines.
One of the benefits an in-person pharmacy offers is the ability to get your medication relatively quickly, as long as you’re okay with driving to a physical location, standing in line, talking to a pharmacist, and enduring all the other associated hassles of shopping.
With a little advance planning, though, you can get all of the benefits of online shopping and get your medication on time.
If the pharmacy you’re looking at doesn’t explicitly state its shipping timelines in a very obvious place, talk to their customer service team for more information.
4. See if you can ask a pharmacist.
Got any questions about your medication?
The very best online and international pharmacy websites have available pharmacists that you can speak with to resolve any concerns or answer any questions you may have about your treatment plan.
When you’re ready to purchase your prescription eye drops or dry eye treatment, know that you have affordable options right here, through our online pharmacy website.
The entire team here at NorthWestPharmacy.com looks forward to supporting you and your best eye health.
