A new treatment for dry eye

Dry eye disease is a complex condition with many possible causes. Dry eye comes from an imbalance of the different components that make up your tear film. Symptoms include burning or gritty eyes, blurred vision, tired eyes, foreign-body sensation, and can sometimes lead to sight-threatening conditions. Your immune system plays a role in protecting the surface of your eye through many components including your tear film. When your tear film is not functioning properly this can lead to an increase in inflammatory cells called T-cell lymphocytes causing your eyes to appear red and feel sore.

Cyclosporine is an immunomodulator drug which acts to inhibit the production of T-cell lymphocytes.  Cyclosporine eye drops have been clinically proven to increase tear production, reduce clinical signs of dry eye, and improve the health of cells on the surface of the eye with long term use. 

CEQUA (0.09% cyclosporine eye drops) and Ikervis (cyclosporine 0.1%) are a recent commercial preparation of cyclosporine eye drops.  Previously, cyclosporine eye drops were only available through specific compounding pharmacies making them inaccessible for many people.  CEQUA is the first Therapeutic Goods Administration (TGA)-approved immunosuppressant eye drop used to increase tear volume where lubricant eye drops have failed to treat dry eyes.   A common side effect of cyclosporine eye drops is stinging or discomfort with use. CEQUA’s preparation of cyclosporine eye drops is unique, containing a unique delivery system.  With this delivery system, the cyclosporine molecule is encapsulated with nanomicellar technology that improves the stability and delivery of cyclosporine to the eye’s surface, this creates less stinging and discomfort with use and is better tolerated for many patients. 

Cyclosporin eye drops are only available with a prescription, which can be prescribed by your optometrist or ophthalmologist if you are suitable. Significant clinical improvements in dry eye are typically seen after two months of use with further improvements at the 3 month mark.  The recommended dosage of CEQUA is only 1 drop twice a day approximately 12 hours apart and Ikervis is one drop nightly. Each box of CEQUA comes with non-preserved single use vials. For sufferers of moderate-to-severe dry eye syndrome, CEQUA may be the solution to improving your dry eye symptoms, maintaining a healthy ocular surface, and reducing your dependency on supplementary eye drops throughout the day.  

Alternatively Ikervis is available, and has a once nightly dosing schedule. Most users find that Ikervis stings a ittle less than Cequa, however we have found that it is sometimes less effective that the twice daily Cequa. The stinging (which is transient, only lasting 5-10 seconds) can be reduced by instilling an ocular lubricant 5-10 minutes before using the cyclosporin drops. 

Note: Cyclosporine drops should not be administered while wearing contact lenses. If contact lenses are worn, they should be removed proper to administration of the solution. Lenses may be reinserted 15 minutes following administration of Cyclosporine.  

References:

• https://www.optometrytimes.com/blog/new-cyclosporine-therapy-joins-fight-against-dry-eye-disease

• https://www.optometrytimes.com/modern-medicine-cases/goblet-cells-role-tear-stability-and-ocular-surface-health

Author; Stuart Macfarlane