BACKGROUND: Although the literature on dry eye is extensive, little has been written about the typical use of tear supplements among the clinical population. METHODS: This study consisted of chart reviews and telephone surveys. Self-reported use of tear supplements was evaluated. RESULTS: At the time of the survey, 63% of those recommended to use artificial tear solutions (114 of 229) continued to do so. The discontinuation rate was higher for ointments, with 53% (47 of 89) having stopped using a recommended ointment. The majority of those continuing to use drops will use one or two drops per day (30 gtts/30 days, +/- 89). In addition to the extreme amount of variability in the number of artificial tears used by any individual, a great deal of day-to-day variability is seen within any individual. CONCLUSIONS: Patients appear to titrate dosage to symptoms on any given day. Given this, there may be little reason to prescribe a specific dosage regimen for the majority of persons using tears. Researchers who are looking at the effectiveness of tear supplements need to take into account the individual variability of use in tear supplements. When prescribing artificial tears, patient education regarding purpose for treatment, specific agent, and dosage used may improve relatively low compliance rates.