Patients want to know about eye-whitening drops, genetic tests, and new glaucoma drugs

It’s an exciting time to be an eye care practitioner. Advancements in diagnosis and treatment are happening all the time. Because patients are more engaged in their health and have access to more information than ever before, it’s important for doctors to stay on top on the latest developments.

Be prepared to discuss emerging technologies with patients and guide them toward the best options. For example:

  • Are you aware that a new OTC eye-redness remover was recently approved by the FDA?
  • Have you heard there is a new genetic test for corneal dystrophies now covered by insurance?
  • Are you familiar with two new topical drugs for glaucoma?

If not, read on for a quick look at these promising new advances in eye care and how I believe they can help your practice.

Reducing red-eye faster and more safely

Patients with chronic red eyes often feel stigmatized by others. Many patients have told me it kept them from going out with friends or family, and they were tired of being asked if they were crying, drinking, high, or lacking sleep.

FDA-approved Lumify can reduce redness within 60 seconds and last for eight hours.

Lumify (Bausch + Lomb) was recently FDA approved for the relief of ocular redness due to minor eye irritations. This low-dose (0.025%) brimonidine tartrate is a highly selected α-2 adrenergic receptor agonist that has the ability to reduce redness within 30-60 seconds and last for eight hours, without rebound hyperemia or tachyphylaxis. Lumify is designed to whiten eyes 300% more than traditional vasoconstrictors like Visine or ClearEyes.

In clinical trials, ocular adverse events were minimal and mild, such as burning on instillation. Patients reported the drop as “very comfortable,” and the FDA deemed it safe for pediatric (age 5 and older), adult and geriatric patients.

Patients interested in eye-whitening may use other products to enhance their appearance, some of which may not be FDA-regulated. To find out more, check out Educating Your Patients About Cosmetics Safety.

Genetic test for corneal dystrophies now covered by insurance

Interest in genetic testing and the availability of genetic tests are increasing. According to the NIH, genetic testing is available for over 2,000 rare and common conditions from over 500 laboratories. Especially in genetic diseases of the eye, it’s crucial to have as much diagnostic capacity as possible.

Most insurance now covers a new genetic test for corneal dystrophies — critical for patients considering refractive surgery.

A major new development is a CPT code–and insurance coverage–for Avellino’s genetic testing for corneal dystrophies. This technology helps identify TGFBI class corneal dystrophies. The importance of this is that these types of corneal dystrophies can progress with UV exposure or refractive surgery. Therefore, differentiating these from EBMD or other dystrophies is critical if the patient is considering refractive surgery. It’s also helpful for prescribing treatments that can slow progression, such as blue light-blocking and UV-protection lenses.

The Avellino genetic test is credentialed in most states and by most payers. Now is the time to incorporate genetic testing into your practice. For more on this topic, see Talking to Your Patients About Genetic Testing.

First new glaucoma drugs in decades

It’s been over 20 years since we’ve had any fundamentally new topical drugs for glaucoma. In 2018, we have had access to not one, but two! What makes Vyzulta (latanoprostene bunod 0.024%, Bausch + Lomb) and Rhopressa (netarsudil ophthalmic solution 0.02%, Aerie Pharmaceuticals) most exciting is that we finally have glaucoma medications that get at the crux of the disease: the TM (or trabecular meshwork).

In my experience, Vyzulta is a superior glaucoma medication in reducing IOP as a first line therapy.

Vyzulta utilizes a prostaglandin analog (PA), which has been around for awhile, but also butanediol mononitrate, which releases nitric oxide (NO), which is something no previous PA has had. NO has been shown to relax the TM to increase outflow, inducing cytoskeletal relaxation. In glaucoma patients, the TM is often compacted, preventing proper aqueous outflow. Studies have also shown that patients with glaucoma have a lower concentration of NO in their eyes due to high concentrations of NO synthase. My own experience shows Vyzulta to be a superior glaucoma medication in reducing IOP as a first line therapy.

Rhopressa is an entirely new class of glaucoma medication known as RhoKinase inhibitors. It specifically targets the TM and can alter the cytoskeleton. Rhopressa would easily make an ideal second medication, but could be a good option as a primary treatment in normal tension glaucoma or early glaucoma in its ability to restructure the TM.  

For a related article, see Six Ways to Improve Glaucoma Awareness

In this era of information on demand for patients, we must continue to be aware of new tests, drugs, and advances in our field. Patients will quickly hear about these options and seek advice and information from their eye care practitioner. Are you prepared?

Get in touch with Rendia today to discuss how to elevate your patient education.