I'm trying to re-add detail underneath the eye after a remesh and it's looking all pixelated even if I use the smallest draw sharp brush size, and smooth brush isn't doing anything but destroying the geometry also
what am I missing?
Looks like you have Dynamic Topology off, at least in the screenshot. Make sure it's on. After that the usual suspects are using a low detail size in the subdivide edges and making sure your geometry underneath it's ok. If not remember the trick Kent uses of using the inflate brush at a low power just to generate geometry and then smoothing.