What's New In Dry Eye Medications?

Dry Eye Disease (DED) is a multifactorial eye disease that causes damage to the ocular surface and instability of the tear film. In layman’s terms, your dry, itchy, watering eyes may be due to your tear film not functioning properly. This can then lead to damage of the front of the eye. For over a decade, medications such as Restasis and Xiidra have been available to improve tear production in patients with DED. Within the past few years, new medications have been approved. FINALLY! 

Receiving FDA approval in the fall of 2021, Tyrvaya (Varenicline) was introduced as the first nasal spray to treat the signs and symptoms of DED. Tyrvaya activates the trigeminal sympathetic pathway in the nose that innervates the lacrimal gland. This improves natural tear production without using an eye drop! In other words, the spray activates a pathway in the nose that triggers an increase in your tear production. Tyraya is used twice daily, ~12 hours apart. Clinical research has shown an improvement in dry eye symptoms, such as, burning, stinging, scratchy/gritty eyes, in as little as three weeks! Common side effects of Tyrvaya include: sneezing, coughing, and throat and nose irritation. 

Vevye (0.1% cyclosporine) was released in May 2023 as an eye drop to improve tear production in DED. The active ingredient, cyclosporine, is the same ingredient in Restasis but twice as strong! Another distinction that differentiates Vevye from Restasis is the exclusion of water! Vevye uses a lipophilic vehicle which helps dissolve the lipophilic cyclosporine to more evenly spread the medication across the surface of the eye. This improves the penetration of cyclosporine to maximize the effects of the medication. The lipid-loving vehicle also improves side effects with less than 1% of patients experiencing burning on instillation! Vevye is used twice daily with relief from DED in the first two weeks of use! 

In May of 2023, another new medication, Miebo (perfluorohexyloctaneis) received FDA approval. Miebo has taken a different approach and is the first and only prescription eye drop that directly targets tear evaporation. This single ingredient medication is preservative and steroid free. Miebo works by preventing the tears from drying up by mimicking the oil layer of the tears. This medication is taken four times per day with minimal side effects. Only 2% of patients report temporary blurred vision, while less than 1% of patients had burning, stinging or pain. 

Tyrvaya, Vevye, and Miebo have been great additions to our dry eye treatment repertoire. The vast differences and innovative designs have given a whole new outlook on the way we treat our dry eye patients. If you feel you may be suffering from dry eye, call our office to schedule an appointment today!