Better Vision: Dry Eye Products

Is your client the odd man out in a movie theater full
of people quietly sobbing through the latest tear-jerker?
If he has the only dry eyes in the house, he could soon be
among the patients who spend $3.8 billion a year in the
U.S. on dry-eye relief.

When people seek dry-eye relief, most ODs start with
diagnostic testing like a Schirmer-type test to measure
and record the volume of tears being produced, then
suggest treatments ranging from drops and plugs to
moisture goggles and eyelid scrubs. With dry-eye awareness
on the rise, more products are coming to market,
including the VeraPlug from Lacrivera, a permanent,
silicone punctal plug that is placed in either the lower or upper puncta of the eyelid to help retain tears. It is a
non-invasive procedure that only takes a few minutes.

Restasis from Allergan has long been the go-to
prescription eye drop, but two new Rx medications in
development may give it strong competition. Novaliq
has begun enrolling patients in a Phase 2 clinical trial to
evaluate the safety of CyclASol which is a clear, ophthalmic
solution of cyclosporine. Shire is developing Lifitegrast,
currently under FDA review. Eventually, about
one-third of people suffering dry eye seek professional
help, so it pays to stay on top of the many ways you can
help them find relief. — CAROL GILHAWLEY

This article originally appeared in the April 2016 edition of INVISION.

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SMART WAYS TO SELL

DRY EYE PRODUCTS

DR. JOE COLLINS

Jacksonville, AR

➤ I think there’s an
epidemic of dry eye
which is underdiagnosed
by eye doctors.
I’ve been prescribing
punctal
plugs in patients’ eyes for 36 years
now and I’ve used Lacrivera’s VeraPlug
since it came to market. The
fastest way to diagnose dry eye is
with lissamine green staining. Using
my slit lamp, I take a digital image of
the eye and when dry spots show up,
patients see their diagnosis right in
front of them. It’s a practical “show
and tell” solution. They see the
problem, and I provide the treatment.
The easiest first treatment is
a punctal plug. Once the plug is in
your eye, it’s in for a lifetime. But,
we can reverse the procedure and
remove the plug in about 10 seconds
if needed. Eye doctors could take
more care of people with dry eyes
with this simple lissamine green
test. By doing lissamine green on all
patients over 40, they could likely
double their dry-eye income.

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DR. BENJAMIN GADDIE

Gaddie Eye Centers Louisville, KY

➤ Our practice uses
a questionnaire that
patients can complete
in about 60
seconds. This helps
us identify patients
with dry-eye symptoms who might
otherwise not have said anything.
There is only one medication approved
for dry eyes in the U.S. and
that’s Restasis. But there are about
50 over-the-counter products available,
which I prescribe and sell. We
don’t have a rigid treatment protocol
for every patient. We run an
Ocular Surface Disease Clinic most
Wednesdays, where we can provide
a comprehensive evaluation of the
ocular surface and lids. These are
patients we identify during their
annual eye exam who report dryeye
symptoms. Generally we use
tear osmolarity and InflammaDry
to look at tear chemistry and tear
inflammation. We employ infrared
imaging to see if there’s a blockage
in the Meibomian glands. If there is,
I will do a LipiFlow procedure to
improve gland function. Most patients
are already on Restasis so I
will send the patient away with an
oil-based tear drop and an Omega-3
tablet.

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