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Emerging Dry Eye Treatment Options (Last Updated: November 2024)
The world of Dry Eye Disease (DED) & Ocular Surface Disease (OSD) is complex, multi-factorial, chronic and progressive. Thankfully, the last decade has brought us a variety of new research and treatment options to provide relief for patients. With a thorough understanding of DED & OSD, a properly trained and experienced dry eye specialist can customize an ideal therapeutic protocol.
At Beverly Hills Optometry: Advanced Dry Eye Center, our philosophy is patient education and empowerment. We take a holistic and root cause approach to managing our patients condition(s). In fact, a majority of our patients respond well to their initial therapeutic plan but some may need adjustments along their journey to success. Below we layout a comprehensive list of non-surgical treatment options that are currently available.
- In-office Treatments:
- MicroBlepharoExfoliation (MBE): BlephEx or ZEST
- Advanced Thermal (Heat) Expression/Pulsation: Lipiflow, iLux 2, TearCare, Miboflo
- Lumenis OptiLight Intense Pulse Light (IPL)
- Meibomian Gland Probing or Maskin Probing
- Prokera Cryo-Preserved Amniotic Membrane
- Punctal Plugs (offering Collagen, Silicon, and Lacrifill)
- Scleral Lenses
- iLightPro Low Level Light Therapy (LLLT)
- Lumenis OptiPLUS (NuEra Tight) Radio Frequency (RF) Thermal Treatment
- Dilation & Irrigation (D&I)
- Rinsada - High Flow Irrigating Lid Retractor
- Optivize (coming soon)..
- At-Home Treatment Devices:
- At-Home Advanced Ocular Therapy Eye Drops:
- RegenerEyes (Pro vs Lite)
- Autologous Serum Tears
- Platelet Rich Plasma (PRP)
- Mucomyst (N-acetylcysteine) - compounding pharmacy
- Pharmaceuticals:
- Prescription Eye Drops (Immunomodulators): Restasis, Cequa, Xiidra, Klarity-C, Vevye (below #8)
- Prescription Eye Drops (Steroidal Anti-Inflammatories): Eysuvis, Flarex, Lotemax, FML, Klarity-L, Pred Forte, Dexamethasone, Durezol
- Tyrvaya Nasal Spray - Neuro-Stimulation of Tears:
- Oxervate Eye Drop – Neurotrophic Corneal Pain
- Low Dose Naltexone (LDN) - Neupathic Con
- Oral Antibiotic/Steroids: Azithromycin (Zpack), Minocycline, Doxycyline (Oracea or Targadox), Prednisone, Augmentin, Cephalexin
- Topical Creams/Gels (external use): Ivermectin 1% (Soolantra), Oxymetazoline 1%, Azelaic Acid 10%, MetroGel, Zilxi (Minocycline gel), Triple Cream (Ivermectin, Niacinamide, and Oxymetazoline vs Azelaic Acid), Testosterone Cream.
- FDA Approved (as of 2023): MIEBO eye drop (100% perfluorohexyloctane) which is also sold internationally as EvoTears or Hycosan Shield
- FDA Approved (as of 2023): VEVYE eye drop (0.1% cyclosporine ophthalmic solution)
- FDA Approved (as of 2023): Xdemvy eye drop (0.25% Lotilaner) Eye drop for Demodex blepharitis
- FDA Phase 3: AR-15515 (Acoltremon 0.003%), a topical transient receptor potential melastatin 8 (TRPM8) agonist, is a first-in-class product candidate for the treatment of the signs and symptoms of dry eye disease; the TRPM8 ion channels are expressed on corneal cold thermosensory neurons and are responsible for regulating tear production (most recent studies are COMET-2 and COMET-3)
- Eye Care Products:
- Eyelid Hygiene: Optase Tea Tree Oil Wipe/Gel, Avenova HOCL spray, ZocuShield Gel, Ocusoft or Zoria wipe/foam (Original, Plus, Platinum, Oust Demodex)
- Medical Grade Nutritional Dry Eye Supplements: PRN DE3, HydroEye, MaxiTear, Nordic Naturals ProOmega, EyePromise, B&L Blink NutriTears
- Warm compress (OcuSci/Optase/Bruder), moisture chamber googles (TranquilEyes), TearRestore Open Eye mask, Repose (single-use)
- Cold Compress mask (Optase)
- Preservative-Free Artificial Tears (PFATs): Optase MGD, Retaine MGD, Oasis Tears, Systane Hydration PF, iVizia
- Nighttime relief/therapy: HyloNight Vitamin A Ointment, EyeSeal 4.0, SleepTiteSleepRite (Obstructive Sleep Apnea/CPAP, noctural lagophthalmos)
- SkinCare/Cosmetics: Eyes Are the Story, Twenty/Twenty Beauty, Epionce, Oculaire, BeautyCounter, Eminence Organic Skin Care (Stone Crop Gel Wash), Round Lab Birch sunscreen, Beauty of Joseon sunscreen, EltaMD sunscreen, KINeSYS Fragrance Free sunscreen (Limit Retinol/Retin-A/Tretinion products orally or topically especially near the orbital rim).
- Eyelash Serum: Olaplex Lashbond Building serum, Dr Loara Devgan Platinum Long Lash, The Ordinary Multi-peptide lash serum
- Lumify OTC (Eye Whitening) - for occasional use (preservative-free option coming soon)
- Allergy eye drop - Alaway PF, Optase Allegro, Pataday, Patanol, Pazeo, Zaditor, Zerviate
- Lifestyle Consideration:
- Anti-inflammatory diet/elimination diet/Whole30 diet/AIP diet, food allergies/sensitives (avoid/limit caffeine, refine sugars, processed foods, dairy, gluten)
- Moderate exercise (ie yoga, walking, weight-lifting, swimming, tennis),
- Consistent sleep pattern and sleep position,
- Stress management (mindnessfulness meditation and breathing exercises),
- Managing systemic conditions,
- Certain systemic and topical medication side effects,
- Control digital device overuse, blink exercises/blink breaks, 20/20/20 rule,
- Proper contact lenses habits (consider premium daily, single-use),
- Application/removal of cosmetics and avoid toxic ingredients,
- Eliminate/limit smoking/alcohol consumption
- Blood Workup:
- Consider full lab workup to rule out systemic conditions: Thyroid Panel (TSH/T3/T4/TSI), Auto-immune (ANA/RF/HLA-B27/SS-A/SS-B), Lipid Panel, Vitamin Deficiencies (A & D), CBC, CMP, CRP, ESR, heavy metal testing (ie mercury), hormone level testing, and Omega-3 Index Basic Test (OmegaQuant),
At Beverly Hills Optometry, we are here to serve you and to help you see better, feel better and look better. For a virtual or in-person advanced dry eye consultation, schedule a visit with our office today.