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Innovation improves dry eye therapies
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Curiosity, intellect and the ability to innovate. While perhaps not unique to mankind, they are attributes that have – time and time again – defined our existence.
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Consider, for instance, the history of salicylic acid. In the mid-1800s scientists first identified salicylate-rich willow bark for its ability to quell pain and inflammation. This discovery prompted a chemist named Gerhardt to synthesize the first acetylsalicylic acid compound, which, in turn, led scientists at Bayer to commercialize the drug we now know as aspirin.
From this singular beginning, aspirin has achieved “miracle” drug status. What is even more amazing is the fact that aspirin’s monumental ascent has had more to do with its off-label applications than with its ability to relieve life’s aches and pains. Today, millions of people around the world take low-dose aspirin daily to prevent myocardial infarcts, cerebrovascular accidents and clot formation. Additionally, researchers are now exploring the role of aspirin in mitigating against colorectal cancer as well as certain forms of dementia. Indeed, just another example of mankind’s curiosity, intellect and innovative nature.
Fortunately, curiosity, intellect and innovation influence every aspect of life – including eye care. There is no better place to witness these forces at work than in the area of dry eye. While still considered a complex entity, we now better understand the role inflammation plays in the pathophysiology of dry eye. It is inflammation that seems to adversely influence neural regulation and glandular secretion, ultimately compromising tear production and stability.
While the fundamentals of dry eye treatment remain – risk management, omega 3s, lid hygiene and a good quality artificial tear – we now aggressively manage inflammation. The good news is that we have a wide array of anti-inflammatory agents with which to manage dry eye. Certain drugs, such as topical corticosteroids and cyclosporine, have been developed specifically to treat ocular surface inflammation. Others have arrived by virtue of a more “aspirin-like” route.
This is certainly true of the cycline antibiotics. Initially developed as antimicrobials, tetracycline, doxycycline and minocycline have recently enjoyed a resurgence given their anti-inflammatory capabilities. In a similar fashion, the macrolide antibiotic azithromycin is gaining popularity as a topical anti-inflammatory adjunct in managing eyelid disease. In short, these are excellent drugs enjoying expanded applications by virtue of innovation.
It really was not that long ago when dry eye epitomized frustration. It was frustrating for patients seeking symptomatic relief as well as for eye doctors searching for a treatment that worked. Given the many effective treatments available today, dry eye is no longer a frustration but, rather, a manageable entity … thanks largely to curiosity, intellect and innovation.