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By Tom Jeter, BS Pharm, R.Ph., CMWA

Director of Clinical Services / Consultant Pharmacist

Dry eyes are an ongoing battle for senior residents-especially during this time of year when the heat is on which makes the air that much dryer. Senior residents are also challenged with a lack of thirst and need to drink which further exacerbates the problems of dehydration and dry eyes. Several products over the years have been used to help with dry eyes.  Some of those products are Over-The-Counter, and others by prescription only. Recently, a new twist in treatment has occurred with the first FDA-approved prescription for ophthalmic corticosteroid for treating dry eyes. The use of Eysuvis (loteprednol 0.25% suspension) is limited for a 2-week period of time, but it can give dramatic relief to the dry eye sufferer. The 2-week limit is established because the long-term use of any ophthalmic steroid can increase the risk of glaucoma or cataracts regardless of the steroid, strength, or formulation.

The cost of Eysuvis is substantial–currently around $470 for an 8.3 ml bottle. Any ophthalmic steroid can help with short-term dry eye relief. Some have been used off-label for years and cost substantially less. One example is Dexamethasone, a 0.1% solution which costs about $35 for 5 mL bottle. So when you see a new order for Eysuvis, realize that there are less expensive alternatives available.

With the FDA approval of Eysuvis, TV advertisements and sales representatives will actively promote this new product. Please be aware that the use of these types of medications are no long-term cure, so don’t jump to Eysuvis if an ophthalmic steroid seems to be what you might need.  It is very important to first maximize the use of artificial tears and humidifiers, limit any TV or computer screen time, quit smoking, etc. Save the use of ophthalmic steroids for severe, acute dry eye flares or as a bridge when starting Cyclosporine (Cequa, Restasis) or Lifitegrast (Xiidra), which can take several weeks to see any benefit.

Always consider asking your Gayco Healthcare consultant pharmacist to review medications that may contribute to dry eyes such as Anticholinergics or Diuretics, and have them suggest alternatives.

-Ophthalmology 2019;126(1): P286-P334
-Cornea Published online Aug 19, 2020; doi:10.1097/ICO.0000000000002452
-J Ocul Pharmacol Ther 2020;36(7):497-511
-Medication pricing by Elsevier, accessed Dec 2020
-Pharmacist’s Letter. January 2021, No. 370109