BLOG: Three technologies that will change the future of eye drops

Putting an eye drop in a young kid’s eye is tough. Putting an eye drop in your own young kid’s eye is impossible.

Your own child invokes in you every bit of guilt, pushes every emotional button (which he installed, by the way) and squirms in every anatomically impossible way to prevent you from performing your parental duty. So, how are parents supposed to give daily atropine drops to their youngsters to avoid progressive myopia? How much trauma is really necessary?

Adults, you’re not much better at getting in drops; one study showed 93% of you failed in taking medications for glaucoma. And that’s why some new alternatives to traditional drops may change the future of eye care. Here are three approaches I find interesting.

1. No water. Perfluorocarbon-based topical drops from a German company, Novaliq, now partnered with Bausch + Lomb, will likely soon enter the U.S. market as a treatment for meibomian gland dysfunction. This organic vehicle has huge potential for delivery of difficult-to-formulate drugs like cyclosporine for dry eye and others that once weren’t available for topical use because they don’t dissolve in water. Because of these solvents’ surface tension characteristics, they form drops about one-fifth the size of aqueous-based formulations, and they spread like fine oil across the ocular surface, enhancing absorption. They are preservative free and highly shelf stable. Water-free formulations like this are clearly part of the future of topical therapy.

2. No bottle. Both Eyenovia’s Optejet and Kedalion’s AcuStream are palm-sized devices designed to deliver very small doses of topical drug to the eye, including atropine. Because less drug is delivered, toxicity should be reduced without a sacrifice in local potency. For people who have arthritis problems in their hands or difficulty leaning back their heads, or for my son who became a flailing wolverine when I approached him with drops, this might be much easier.

3. No drop. Some of us are familiar with drugs like Dextenza (dexamethasone ophthalmic insert, Ocular Therapeutix), Dexycu (dexamethasone intraocular suspension 9%, EyePoint Pharmaceuticals), Durysta (bimatoprost implant, Allergan) and Ozurdex (dexamethasone intravitreal implant 0.7 mg, Allergan), which are already FDA-approved drug depots injected or implanted to deliver many weeks of therapy. Many follow-on technologies are in the laboratory or the FDA pipeline to treat every part of the eye with every type of disease. Investors, pay close attention to this space because the collective drug market that will be replaced by these products is in the tens of billions of dollars.

According to author Dave Barry, the secret to success in raising kids is lowering your standards. In treating my son, could I really retain a little bit of self-respect with one of these new drug delivery advances? Probably not, but eye meds might just move from “impossible” to “negotiable.” Now if only they would work for getting him to eat vegetables.