If you have been researching treatments for evaporative dry eye, you may have come across three products that sound completely different: NovaTears, EvoTeas and Miebo. This guide explains what each one is, how they compare, and what to expect if your prescription is filled internationally.

What they all contain

All three products are 100% perfluorohexyloctane (also written as F6H8). There is nothing else in the bottle — no water, no preservative, no phosphate, no emulsifier.

Perfluorohexyloctane is a semifluorinated alkane: a clear, oily, water-free liquid. It works differently from a traditional artificial tear. Instead of adding water to the eye, it spreads across the surface of the tear film and forms an ultra-thin barrier that slows evaporation. That is why it is used for evaporative dry eye and dry eye linked to meibomian gland dysfunction (MGD), where the oily layer of the tear film is not doing its job.

Because the formula contains no water, no preservative is needed to keep it sterile. It also has a very low surface tension, so each drop is roughly 10 µL — about four times smaller than a conventional eye drop. That means less spill-over and, for most people, no stinging and no blurring.

The underlying technology, branded EyeSol®, was developed by Novaliq GmbH in Heidelberg, Germany. All three products trace back to that single origin. What changed was which company licensed it for which part of the world.

Product breakdown

NovaTears is positioned as a lubricating eye drop and tear film stabiliser. It has been listed on the Australian Pharmaceutical Benefits Scheme since September 2018, so it can be either purchased over the counter or prescribed. A companion product, NovaTears® + Omega-3, adds plant-derived omega-3 fatty acid esters — that is a different formulation, not the same product in a different box.

EvoTears launched in Europe in October 2015 and is now sold in roughly 17 countries. In some markets it carries a local name — HYLO LIPID™ in France and Hycosan Shield™ in the United Kingdom, for example. Those are the same product with local branding. EvoTears® OMEGA is a separate formulation with added omega-3.

Miebo is the only one of the three that went through a full drug approval pathway. It was studied in two Phase 3 trials — GOBI and MOJAVE — enrolling more than 1,200 patients with dry eye disease and clinical signs of MGD. Both trials met their primary endpoints for corneal staining and patient-reported eye dryness. The most common side effects were blurred vision and eye redness, each in roughly 1–3% of patients.

How they compare

What is identical

• The active ingredient and its concentration — 100% perfluorohexyloctane, single-ingredient formulation
• The mechanism — reduces tear evaporation by forming a protective layer over the tear film
• Water-free, preservative-free, phosphate-free
• The dosing — one drop per eye, four times daily
• The bottle volume — 3 mL
• The developer and the technology — Novaliq's EyeSol® platform, Germany
• The tolerability profile — mild, temporary irritation or redness is the usual complaint; blurring is uncommon because the refractive index is close to that of tears

What differs

The differences are almost entirely regulatory, not chemical. A device approval asks whether a product is safe and performs as described. A drug approval asks whether it treats a disease, and requires controlled clinical trials to prove it. Novaliq chose the device route in Europe and Australasia and the drug route in North America — which is why the same clear liquid sits behind a pharmacy counter in one country and on an open shelf in another.

Can these products be interchanged?

Brand names change at borders. The medication does not.

This happens constantly in pharmacy and has nothing to do with quality or potency. Dapagliflozin is sold as Farxiga in the United States and Forxiga in Canada, Europe and most of the rest of the world — same manufacturer, same molecule, same strength, different name on the carton. Perfluorohexyloctane follows exactly the same pattern: Miebo in North America, EvoTears across Europe, NovaTears in Australia and New Zealand.

A licensed physician reviews the prescription in the dispensing country

When a prescription written in one country is filled in another, it is assessed by a physician licensed where the pharmacy operates. That physician reviews the order and authorizes the product that is approved and available in that jurisdiction. If the name on the box you receive differs from the name your own doctor wrote, that is expected — the prescribing physician has determined the two to be essentially equivalent for your treatment.

Equivalence here is unusually clear-cut

With most cross-border equivalents, a prescriber is comparing two products from the same manufacturer under two brand names. With this one, there is only a single ingredient in the bottle and no formulation to compare. All three are 100% perfluorohexyloctane and nothing else, developed from the same technology by the same German company. There is no filler, no preservative and no buffer that could differ between them.

You will still need a prescription

Perfluorohexyloctane is available without a prescription in some countries and by prescription only in others. When more than one country is involved in filling an order, a legitimate online pharmacy defaults to the strictest rule that applies — not the most permissive one.

In practice that means this: because perfluorohexyloctane is a prescription-only medication in the United States, Jason's Canada Drugstore requires a valid prescription for it, regardless of which partner pharmacy dispenses your order or which country it ships from. The fact that a product is sold over the counter in Australia or Germany does not change what is required to send it to you. The same principle works in reverse: where a medication carries tighter controls in the dispensing country than in yours, those tighter controls are the ones that apply.

A few practical differences to know about

Because the product is licensed to different companies in different regions, the patient leaflet in your box may be worded differently from what you read online. Read the leaflet that comes with your bottle, and raise these points with your optometrist, ophthalmologist or pharmacist if they apply to you.

1. Contact lenses. The North American label permits lens wear with a 30-minute gap after instillation. The European and Australasian labels advise against use in lens wearers altogether. If you wear contacts, ask for direct guidance rather than assuming the labels agree.
2. Discard dates. Six months after opening for NovaTears and EvoTears; the expiry date on the bottle for Miebo. Do not carry one product's rule over to the other.
3. The omega-3 versions are different products. NovaTears + Omega-3 and EvoTears OMEGA contain added ingredients. They are not one-for-one replacements for the standard versions.
4. The bottle technique is unusual. Because the liquid has such low surface tension, it can run out of the bottle without squeezing. Manufacturers often recommend a "push, turn and release" method: squeeze the upright bottle, turn it upside down while still squeezed, then release. The technique is not the same as a standard eye drop, so read the insert in your box.
5. Spacing from other drops. If you use other eye medications, leave at least 15 minutes between products.

Quick summary

How to tell you are dealing with a legitimate pharmacy

"Buy from a reputable site" is advice that every site claims to satisfy, including the ones you should avoid. These are the things you can actually check before you order.

• The pharmacy is licensed where it operates, and it says so. A legitimate pharmacy holds a licence from the regulator in its own jurisdiction and dispenses under the supervision of licensed pharmacists. Jason's Canada Drugstore is our licensed pharmacy partner located in Canada.
• A valid prescription is always required. This is the clearest single test. Any site willing to sell you a prescription medication without one is not operating legitimately, no matter how professional it looks or which country it claims to ship from.
• You can reach a pharmacist by phone. Not a chatbot, not a sales agent — a licensed pharmacist who will answer questions about your medication before and after you order.
• There is a real address and identifiable ownership. You should be able to find out who runs the pharmacy and where it physically is. Sites that hide both are hiding them for a reason.
• You are told which country your order ships from. A legitimate international pharmacy works with a verified fulfillment network — for us, licensed pharmacies in Canada, Britain, Australia and New Zealand — and will tell you which one is filling your order rather than leaving the source vague.
• The strictest rule is applied, not the loosest. As described above, a legitimate pharmacy will not use a product's over-the-counter status in one country as a way around prescription requirements in yours.

Be cautious of the reverse signals: no prescription required, no phone number, no named pharmacist, no physical address, prices far below every other source, or a site that describes itself as Canadian while shipping from somewhere it will not name.