Options for extending the duration of tear film protection in dry eyes include artificial tear formulations with enhanced viscosity/polymeric systems, ocular ointments and gels, and, recently, the hydroxypropyl cellulose ophthalmic insert (Lacrisert(R); distributed by Aton Pharma, Inc., Lawrenceville, NJ, USA). The goal in using these agents is to achieve a balance between maximizing tear film stability and ocular surface retention, while simultaneously maintaining or improving vision, comfort, and convenience. In this article, various agents are reviewed, and findings are presented from a retrospective study of patients who used hydroxypropyl cellulose ophthalmic inserts within the previous 2 years. The median length of therapy with the insert was 5.3 years, and nearly 65% of patients had used it for more than 2 years. Findings suggest that the hydroxypropyl cellulose ophthalmic insert is a relatively safe, tolerable, and effective therapy for dry eye, either alone or in conjunction with other therapies.