Q&A: 2023 will be ‘an exciting year’ with new dry eye disease treatments in the pipeline
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Healio spoke with Leslie O’Dell, OD, FAAO, medical director and director of clinical research at Medical Optometry America in Shrewsbury, about research needs and upcoming treatment options for patients with dry eye disease.
Healio: Where should research in dry eye be focused?
O’Dell: An area where research should be focused, in my opinion, is patient outcomes. With a growing number of therapeutics in our dry eye toolbox, it would be helpful to better understand if specific treatments are superior to others for certain presentations.
One way to do this is through the implementation of a registry, which would allow all pertinent dry eye data from clinics to be analyzed to determine the effect on outcomes for patients. This would also help determine the best treatment for patients with regard to in-office treatments with thermal pulsation, expression and intense pulsed light.
And there is always room for continued research pertaining to cosmetics and the impact their chemical composition, application and removal has on the ocular surface. The questions to consider when learning about new research and treatments are: What impact will a new treatment have on our clinical practice patterns? Will it change how we practice, and will it change patient outcomes?
Healio: Why is this so important?
O’Dell: Continued research and learning are critical to our patient care, as it moves us forward. The more we learn and apply to the patients we care for, the bigger our impact can be.
Healio: What should we look for in the dry eye treatment pipeline?
O’Dell: 2023 will be an exciting year for dry eye doctors: We have many new therapies in the pipeline and my list of my patients waiting for their launch grows each day.
First up is Bausch + Lomb’s NOV03 (perfluorohexyloctane), a first-in-class treatment for the evaporation of tears in patients with meibomian gland dysfunction.
Tarsus’s TP-03 (lotilaner 0.25%) is poised to become our first therapeutic for Demodex blepharitis, a condition prevalent in patients with both dry eye disease and meibomian gland dysfunction. This medication, used twice daily for 6 weeks, improves visible collarette formation as early as 2 weeks.
Alderya continues to push ahead with reproxalap, a first-in-class small-molecule modulator of reactive aldehyde species (RASP), which are elevated in ocular and systemic inflammatory disease. It will be an important addition for our patients with chronic pain associated with dry eye disease.
Healio: What diagnostic tools should be used to assess and manage patients suspected of dry eye?
O’Dell: Keep it simple: Start with your slit lamp and vital dyes, but use them wisely. Begin your exams with patients either looking down or with lids gently closed to allow for observation of lash margins, observing for signs of Demodex blepharitis, as well as inadequate lid seal.
Vital dyes with fluorescein and lissamine green uncover many signs of conjunctival and corneal inflammation, as well as tear breakup time. Utilizing these correctly will improve your diagnostic skills. For example, when looking for fluorescein staining, it is best to wait 90 seconds, and up to 5 minutes, before evaluating the cornea and conjunctiva.
Healio: How can clinicians continue to improve quality of life in patients with dry eye disease?
O’Dell: Understand that ocular surface disease has a negative impact on quality of life for these patients — from reduced ability to read for extended periods to eyes that do not look healthy, hurt and are all-consuming for patients.
Be proactive: Looking for ocular surface disease, like blepharitis, meibomian gland dysfunction and dry eye disease, will improve patients’ quality of life.
References:
- Gonzalez-Salinas R, et al. Pilot study to evaluate the safety and efficacy of TP-03 for the treatment of blepharitis due to Demodex infestation (Mars study). Presented at: Association for Research in Vision and Ophthalmology annual meeting; June 12, 2020 (virtual meeting).
- Tauber J. Efficacy of perfluorohexyloctane on signs and symptoms of dry eye disease associated with meibomian gland dysfunction: The Gobi study. Presented at: American Society of Cataract and Refractive Surgery meeting; April 22-26, 2022; Washington.
For more information:
- Leslie O’Dell, OD, can be reached at drodell@MOAeyes.com.
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