Article Date: 2/1/2001

DRY EYE UPDATE
DRY EYE UPDATE

Part I of this two-part series highlights new research and products.
By Barbara Caffery, O.D. Toronto, Canada

As eyecare practitioners, you probably know that an estimated 59 million Americans suffer from dry eye. You're also most likely aware that dry eye syndrome has many causes, ranging from the normal aging process to environmental conditions to computer work and contact lens wear. In fact, because so many people experience dry eye symptoms and because so many factors come into play with this syndrome, it's one of the most common problems you treat.

With this in mind, it's only logical that you need to become aware of all the treatment options available. In this update, we'll let you know what's going on around you in the area of dry eye. First we'll take a look at some areas of research from the past year, then we'll review some of the newer products on the market.

We'll come back again in April with Part II, which will include punctal occlusion questions answered by an expert, an interesting proposed method to treat dry eye, highlights from the first clinical conference on Sj�gren's syndrome and much more.

Dry Eye Research

A look at some exciting new research from the past year.

Dry eye is an area of interest for a growing number of researchers. Let's look at some of the more interesting research findings reported in 2000.

Although many of these concepts are unproven, it's important to keep abreast of the latest thinking in this area. They'll change our concepts of many diseases and improve our treatment tactics.

Dr. Caffery practices in a group setting in Toronto, Canada. Her practice is dedicated to contact lenses and dry eye research.

New Product Overview
Here's a quick look at some of the new dry eye products that are available and those that are on the way.

Moisture chamber

Here's a way to help your patients with moderate to severe dry eyes retain the available moisture on their eyes. Curtailing the rate of moisture evaporation is of particular value when the patient lives in arid or windy areas. EagleVision Moist Eye Moisture Panels can be fitted to most any configuration of eyewear, between the lens and frame, to create a moisture chamber around each eye.

For additional information, contact the company at (800) 222-7584 or visit www.eaglevis.com.

Nutritional products

In-office tear analysis

Touch Scientific, Inc. manufactures the Touch Tear MicroAssay System, an in-office method of molecular tear analysis. The information is helpful for separating dry eye into specific etiologies.

Specific tests include lactoferrin (reimbursed under CPT code 83520) and IgE (reimbursed under CPT code 82785) for determining "at risk" patients for giant papillary conjunctivitis and other allergic responses.

The average test reimbursement is $25, and it costs you less than $10. The system is designed to use all future tests, including Gram-positive and negative, HSV Adenovirus and long-term hypoxia. You can lease it for about $299 per month.

For more information, call (919) 872-4445 or visit www.touchscientific.com.

Lubricant gel

Cynacon/Ocusoft recently introduced Tears Again Gel-Drops, a lower viscosity alternative to the company's Tears Again Night & Day Lubricant Gel. It's the same water-based formula as the Night & Day version, but the Gel-Drops have half the viscosity. It comes in a 15-ml dropper bottle and lasts 4 to 6 hours. Patients use one drop in the morning and one in the evening.

For samples or more information, call (800) 233-5469 or visit www.ocusoft.com.

In the pipeline

Inspire Pharmaceuticals, Inc. has initiated the Phase III clinical program for the P2Y (2) receptor agonist INS365 Ophthalmic for the treatment of dry eye in the United States.

INS365 Ophthalmic is a small-molecule drug that stimulates the P2Y (2) receptor, a key mediator of mucosal-surface hydration and lubrication.

Based on the results from the Phase II program, the company expects this new approach to enhance the eye's natural cleansing and protective systems by stimulating the release of salt, water, mucus and other natural tear components, providing hydration and lubrication of the ocular surface.

The Phase III program consists of two pivotal clinical trials designed to enroll a total of approximately 1,000 patients with dry eye in 60 ophthalmology centers.

Both studies are double-masked comparisons of two concentrations of INS365 Ophthalmic and a placebo to evaluate the efficacy of the product on a chronic basis. Both objective ocular-surface measurements and subjective assessments have been incorporated into the study design, based on discussions with the FDA.

The company has target dates for its new drug, but they aren't set in stone. It hopes to finish the Phase III program in the first half of 2002 and to file a new drug application (NDA) in the second half of 2002. It's also looking to launch INS365 Ophthalmic in mid-2003.

The company has entered into a development and commercialization alliance with Santen Pharmaceutical Co. Ltd. for this product.

For more information, call (919) 941-9777 or visit www.inspirepharm.com.

Free Continuing Education

Are you aware that the periocular skin significantly contributes to the health and function of the eye and influences a patient's ability to see? Well, it does. It even acts as a barrier against evaporative tear loss. Periocular skin care is an important aspect of comprehensive eye care.

To learn more about this topic, see this month's continuing education article, "Ophthalmic Management of the Periocular Skin Leads to Better Patient Care," in this month's issue.



Optometric Management, Issue: February 2001