A burning or scratchy sensation in your eyes can be the result of the eye’s tear ducts not being able to provide an adequate flow. If this persists and is not only being triggered by seasonal or environmental conditions, it can be a warning sign of dry eye disease, and it’s best to take some steps to beat it before there is permanent damage.
Tears are the eye’s natural lubricant, and the flow can be disturbed for many reasons. The effect can be made worse because the body’s natural reaction to a sense of irritation on the highly sensitive front surface (the cornea) is to either blink rapidly, or to rub the eyes, and both of these can make matters even worse when there’s no liquid film to smooth the action. It’s like activating a car’s windshield wipers when there’s no water on the glass – jumping, scratching and smearing dust all over the windscreen.
Dry eyes may occur either from lack of tears, or when the tears don’t contain the right mixture. The most important thing is to not ignore the problem, because the consequences can be serious. That’s why we are pleased to introduce an innovative but simple new product called Miebo (marketed in some countries as EvoTears).
We have written before (read our blogs Out of Tears and Dry Eyes in Summer) about how difficult it can be to have to live with persistent dry eye disease. In those days, Miebo was just a glimmer of new hope just emerging from years of research. Now we can confidently say that customers have been thanking us for bringing Miebo onto our shelves.
What makes Miebo eye drops/EvoTears so special?
Miebo is a product that has been specifically designed to address the condition when naturally formed tears are either not being produced in enough volume, or are not properly constituted. Unlike the more common solutions on offer, they are not designed to boost tear flow (like antihistamines or artificial tears), but are a substitute that helps natural tears work better. Miebo delivers an active ingredient called perfluorohexyloctane, and its unique mechanism creates a protective layer over the existing tear film, preventing evaporation so that natural tears remain in place for longer and can do their proper job. This is different from traditional artificial tears that simply wet the eye.
Is there a difference between Miebo and EvoTears?
Miebo eye drops and EvoTears are the same medication, perfluorohexyloctane, but they are sold under different brand names in different regions. Miebo is the brand name in the United States and Canada, and we can only supply Miebo eye drops to customers in those countries with a prescription, while EvoTears is the name used in Europe and is available from us over-the-counter. The difference in prescription status is due to different regulatory approvals in the different countries.
What are tears supposed to do when they work properly?
Healthy eyes produce tears in the tiny lacrimal glands that lie in between the eyes next to the nose. Every time a person blinks, the tears are swept from the lacrimal gland, across the eye, to lubricate the cornea and outer layer (the sclera), and also wash away any foreign bodies. They then drain through the lacrimal caruncle and tear ducts into the nose.
Tears are clear fluids made up of water, salt, oil and mucus. The right mix of these ingredients is also important – too much salt, too little oil or any other imbalance can make them ineffective – most importantly, can cause rapid evaporation which makes the eyes feel dry quickly.
Tears have several important functions:
- They keep the cornea healthy. The cornea is the most sensitive surface in the body, but it carries no internal blood flow to oxygenate and lubricate its cells. Tears help stop the surface of the cornea from drying out and shriveling.
- Blinking allows the eyes to wash away dirt
- Salty tears can repel bacteria and germs, preventing infections
Causes and symptoms of dry eye disease
Dry eye disease (DED) is a common eye disorder that can be caused by many different factors. Most often, DED is linked with meibomian gland dysfunction (MGD), a chronic condition where the meibomian glands, located in the eyelids, fail to produce enough oil (meibum), or the oil is missing some essential ingredients. MGD leads to a disruption in the tear film which results in an excessive evaporation of tears, resulting in dry eye symptoms, which usually affect both eyes.
Signs and symptoms of DED include:
- Stringy mucus in or around the eyes
- Excessive sensitivity to light
- Redness
- A sensation of having some foreign bodies in in eyes
- Watery eyes
- Blurred vision
- Eye fatigue
People can also have difficulty wearing contact lenses, and driving in the dark.
What else can cause dry eyes?
Dry eyes are usually caused by something that limits the volume of tears being produced by the lacrimal glands, or disrupts the delicate balance of the ingredients of the tear film, which mixes oil, water, salt and mucus.
- Tear production naturally decreases with age, usually beginning around 50.
- Women are more likely to be affected, particularly during pregnancy, menopause, or when using birth control pills.
- Excessive exposure to wind or smoke.
- Dry air in summer or air conditioning can increase tear evaporation.
- Excessive close screen time, such as computers, phones, or tablets, and concentrated reading can cause a person to blink less often, which increases tear evaporation.
- Some prescribed medicines can reduce tear production. If a person is taking antihistamines, decongestants, antidepressants, and some blood pressure medications, it’s important to ask the prescribing doctor whether DED could be a result of these treatments. Often, simple substitution of alternatives can solve the problem, and if not, a non-invasive treatment like Miebo/EvoTears can be safely used because it introduces no chemicals that could interfere with the other medications.
- Some specific autoimmune diseases, like Sjögren’s syndrome, lupus, and rheumatoid arthritis, as well as thyroid disorders and diabetes, can either cause or exacerbate dry eye disease.
- Other eye conditions, like eyelid inflammation (blepharitis) or clogged eyelid oil glands (meibomian gland dysfunction) can affect the oil layer of tears, causing them to evaporate too quickly. Long-term contact lens use, especially hard lenses, can trigger DED.
FAQ about dry eye disease and Miebo
Should I see a doctor for dry eye disease?
If the symptoms of dry, scratchy, irritated or red eyes are persistent, becoming more frequent or getting worse, it’s time to consult with a healthcare provider. Family doctors should be able to help as the first-line source of care. It may not be necessary to consult with an ophthalmologist unless the doctor feels that there may be some other underlying conditions that require specialist care.
What makes perfluorohexyloctane different?
Perfluorohexyloctane reduces tear evaporation by forming a lightweight, stable barrier over the eye’s surface. Miebo doesn’t contain water or preservatives, making it suitable for sensitive eyes.
Is Miebo a cure for dry eye disease?
No. The role of perfluorohexyloctane is to stop evaporation of natural tears. It relieves symptoms, but it doesn’t cure the underlying cause of dry eyes.
How to use Miebo / EvoTears correctly?
Read the information leaflet that comes with the medication.. Please consult a doctor or pharmacist if you have any questions before using any medication.
The usual dosage is one drop in each eye four times daily. Before administering, remove contact lenses; they should be kept out for at least 30 minutes afterward.
The solution should be stored at room temperature, away from direct light or heat. Don’t share the medicine with others – it can cause bacterial infections to spread.
Follow the label instructions about whether to use an open bottle for longer than thirty days
Do I need a prescription to buy Miebo/EvoTears?
EvoTears is available from IsraelPharm over the counter, but Miebo may require a prescription depending on the patient’s location.
Has Miebo been clinically tested for effectiveness and safety?
Clinical trials have measured the effect of perfluorohexyloctane on tear film thickness (TFT) and lipid layer thickness (LLT), the two most important measures of tear health. To summarize, the findings were that a single drop containing perfluorohexyloctane temporarily increased TFT immediately and multiple dosing over time gradually increased TFT all through the study. LLT values almost doubled. These results demonstrate that perfluorohexyloctane eye drops increase TFT as well as LLT over time, and help avoid tear evaporation through stabilization of the lipid layer.
