Modern OptometryNew Drugs for Dry Eye and Demodex Blepharitis

Increased choices, tailored patient care. Acquaint yourself with what could soon be part of your toolkit.

In the realm of optometry, recent innovations in medication for dry eye disease (DED) and Demodex blepharitis bring about significant advancements in personalized patient care. This evolving landscape paves the way for an even more effective approach to the management of these common ocular conditions.

Key Points:

• Oyster Point Pharma received FDA approval for varenicline solution nasal spray (Tyrvaya) for the treatment of DED signs and symptoms in October 2021. The drug increases natural tear secretion by activating the trigeminal parasympathetic pathway.
• Varenicline nasal spray has shown to improve DED regardless of the initial presenting severity.
• The FDA approved 100% perfluorohexyloctane (MIEBO; Novaliq/Bausch + Lomb) in 2023 to treat DED associated with meibomian gland dysfunction. The drug prevents excessive tear evaporation and restores tear film balance.
• Anticipated FDA approval in 2023 includes lotilaner 0.25% (TP-03, Tarsus Pharmaceuticals), which paralyzes Demodex mites, and 0.25% topical ocular reproxalap (Aldeyra Therapeutics) that reduces ocular inflammation in DED.

Additional Points:

• Studies have demonstrated that up to 58% of patients may have a Demodex infestation, potentially leading to symptoms such as redness, burning, irritation, and dryness.
• A selenium sulfide ophthalmic ointment, AZR-MD-001 (Azura Ophthalmics), is under development, designed to impede hyperkeratinization of the meibomian glands.
• Treating DED often requires multiple forms of treatment due to its multifactorial nature.

Conclusion:

• The treatment landscape for dry eye disease and Demodex blepharitis is rapidly evolving, offering an array of innovative and personalized solutions for optometry practitioners to utilize in enhancing patient care.

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Did You Know?
Demodex mites, a common cause of blepharitis, are found in up to 58% of patients – that’s an estimated 25 million people.