Eye drops are the most commonly used preparations in ophthalmology. Preservatives are usually added in order to protect eye drops against pathogenic organisms and increase the solubility of the drugs in multi-dose containers. Ophthalmologists have paid a lot of attention to the preservatives in eye drops because they remain one of the main reasons for ocular surface damage, and even may lead to serious visual impairment in patients with inappropriate use of eye drops. However, it should be noted that the dangers of preservatives become overstated nowadays. It is necessary to completely evaluate the effects of preservatives in ophthalmic preparations, so that ophthalmologists can guide patients to correctly select eye drops containing preservatives and avoid dangerous side effects, according to their eye disease situation, state of tear function and ocular surface changes, cultural background and financial income, cost and benefit and convenience of the use of drugs, and other factors. The direction of the future development in this field is to establish the clinical guideline for use of eye drops containing preservatives, carry out continuing education courses on preservatives and develop ideal preservatives.