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    Glaucoma, dry eye drugs center of pharmaceutical opportunities



    Ocular surface disorders affect up to 75% of glaucoma patients. More than half of adults in the United States complain of dry eye symptoms and a quarter are getting anything more potent than artificial tears.

    “Neurostimulation may be an option for dry eye,” said Aziz Mottiwala, vice president of marketing, U.S. Eye Care. “Neurostimulation is one of the fastest growing segment of healthcare as it addresses adherence and other challenges of traditional treatment and taps into a natural response.”

    Allergan is introducing an intranasal tear stimulator, which temporarily increases tear production through neurostimulation. (FDA approved the device in April 2017 since Glaucoma 360).

    Dry eye begins with the lacrimal functional unit (LFU). All elements of tear production in the LFU, lacrimal gland, goblet cells, and meibomian gland are linked to the central nervous system by the trigeminal nerve. A large portion of tear production is intended to facilitate the passage of air through the nasal mucosa, which puts the trigeminal nerve within easy reach through the nasal cavity.

    Stimulating the trigeminal nerve can trigger production of complete and natural tears, including the lipid layer, aqueous layer, and mucin layer.

    “The ability to tap into the natural response and create a natural tear on demand can be a compelling option for patients with dry eye, particularly those with a high burden of topical medications,” Mottiwala said. “Neural stimulation is an approach that comes at 90º degrees from the usual approach, a unique an innovative way of treating a problem that so many clinicians see is so many of their patients.”


    Fred Gebhart
    The author is a correspondent for Urology Times, a sister publication.

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