Innovation Spotlight
First oral treatment for dry eye offers patients hope

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by Diane Angelucci Correspondent

	SciencedBased Health's HydroEye

Whether the condition is caused by disease or is a side effect of refractive surgery, patients sometimes become so disappointed with topical treatments and punctal occlusions that they often explore alternative therapies.

However, some ophthalmologists are finding a simpler answer in the first oral formulation for dry eye. HydroEye, a specially formulated nutritional supplement, was introduced by ScienceBased Health, a company founded by ophthalmologists interested in offering nutritional therapies based on scientific knowledge.

Falling short

Although topical treatments soothe dry-eye symptoms, their benefits are short-lived.

"There are three layers of the tear film," said Richard L. Lindstrom, MD, clinical professor of ophthalmology, University of Minnesota, and managing partner, Minnesota Eye Consultants, who is overseeing one of three HydroEye clinical trials. "You have a mucous layer, an aqueous layer, and a lipid layer. When you put a topical lubricant on the eye, you're really only adding fluid to the eye. The mucous layer, which is the baseline layer that basically makes the cornea wettable, isn't really enhanced with a topical lubricant, and the most superficial layer, the lipid layer, which reduces evaporation and helps stabilize the tear film ... isn't helped by that either."

To address these difficulties, researchers at ScienceBased Health searched the literature for nutrients shown to be beneficial and developed HydroEye, which contains omega-6 fatty acids, mucin complex, and various nutrient cofactors.

Reaching the root

"The solution to dry eye is not a solution," said Spencer P. Thornton, MD, chairman, ScienceBased Health Medical Advisory Board. The blend of nutrients in HydroEye addresses the root cause of dry-eye syndrome, he explained. "It helps prevent the drying and atrophy of the tear gland while it supports normal tear secretions by promoting and maintaining the normal structures and function of those glands that support the lacrimal gland."

Thornton advises ophthalmologists who inquire about the supplement to try it on their most difficult cases. He has found approximately four of every five patients who use the supplement find relief, and Lindstrom has had two of every three patients experience improvement. Thornton also recommends the formulation for laser in-situ keratomileusis candidates. "If you can put them on HydroEye a week prior to their LASIK surgery, the complaints [of dry eye] are reduced tremendously in the vast majority of patients."

In addition, HydroEye can benefit certain intraocular lens recipients. The Array Multifocal Lens (Allergan) has been found to require a good corneal surface, said Kevin L. Waltz, MD, partner, Eye Surgeons of Indiana. "A certain percentage of people will have a quality-of-vision concern even though their vision is quite sharp by normal Snellen acuity standards. In those people, I've had very good success in putting them on HydroEye. It has improved the quality of their vision to the point that I've now canceled two YAG capsulotomies I had planned."

Three HydroEye clinical trials recently began. One is assessing the pathology of dry eye, another is studying LASIK patients, and another is examining the effect on lactoferrin.

Simple dosing

One capsule of HydroEye is taken twice a day with meals. Because the medication may increase the effect of anticoagulant drugs, patients taking these medications are advised to have a prothrombin time performed 2 weeks after beginning HydroEye. Pregnant and lactating women should check with their doctors before use.

Patients can obtain HydroEye in two ways. "Until recently, our formulations have only been available through ophthalmologists or optometrists," said Ellen Troyer, MT, MA, director of science and education, ScienceBased Health. "We recently made them available on our web site to the public, but only after they take an assessment.