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Dry eye disease (DED) is a pervasive condition impacting millions globally, and recent data suggests around 86% of dry eye patients exhibit meibomian gland dysfunction (MGD) and resulting excessive tear evaporation as a core cause. As patient needs and lifestyles evolve, it’s clear that OTC artificial tears alone may not address the issues underlying evaporative dry eye. In this article, we will explore how specialists like Dr. Mila Ioussifova are helping improve dry eye management by prioritizing patient-centered approaches, deploying advanced diagnostics, and prescribing MIEBO for rapid, sustained relief.*
Understanding the Complexity of DED
Dry eye symptoms vary in severity but typically include fluctuating vision, irritation, and burning. Common causes of dry eye include environmental factors, increased screen time, systemic health issues, and certain medications.
Evaporative DED develops when the lipid layer of the tear film is compromised, leading to excessive tear evaporation and an unstable tear film. This desiccating stress then triggers a vicious cycle of inflammation and tissue damage, which exacerbates symptoms and the disease if left untreated. Given the high prevalence of evaporative dry eye, professionals should routinely check for MGD in every patient.
A Patient-Centered Approach to Evaporative DED Diagnosis
Dr. Ioussifova’s practice exemplifies an advanced approach to evaporative DED management. Through specialized patient consultations, she establishes a rapport that enables her team to provide tailored care. Initial screening begins at the patient’s first call to the office, where trained staff ask about daily symptoms and screen for potential dry eye conditions. This structured intake ensures that each patient’s visit is customized for a routine eye exam or dry eye treatment. Dr. Ioussifova’s team creates a supportive environment by emphasizing individualized care from the outset, fostering trust and patient satisfaction.
The Role of Meibography and Advanced Diagnostic Tools
Early detection of MGD is critical, so Dr. Ioussifova incorporates meibography and meibomian gland expressibility tests into every dry eye consultation. With these tests, practitioners can view gland structures and assess their functionality. This data is invaluable for explaining evaporative dry eye to patients, showing them clear images of gland conditions, and helping them understand the importance of early intervention.
MIEBO: The Only Rx Eye Drop for DED That Directly Targets Tear Evaporation
MIEBO is a different kind of eye drop because it directly targets tear evaporation. MIEBO mimics key functions of natural meibum, addresses damage by promoting healing on the ocular surface, and may reduce friction. The exact mechanism of action for MIEBO in DED is not known.
In clinical trials, MIEBO was shown to improve both signs and symptoms of dry eye disease in ~2 weeks—with continued improvement through ~8 weeks—when administered 4 times daily. The efficacy of MIEBO may appeal to patients who have experienced limited success with standard treatments.
How MIEBO Fits Into Treatment Plans
MIEBO is composed of only one ingredient—100% perfluorohexyloctane—making it vehicle-, preservative-, steroid-, and water-free. It may be the right treatment option for many patients, including those who are still looking for relief after trying OTC artificial tears. MIEBO is believed to work by inhibiting tear evaporation, which is a key function of natural meibum.
In a pharmacokinetic rabbit study, MIEBO was shown to reside in tears for at least 6 hours.† This extended residence time is different from traditional water-based drops, which typically only last for minutes. The clinical significance of this in vitro data has not been established.
Additionally, Dr. Ioussifova mentions how she doesn’t hesitate to introduce MIEBO early into patients’ treatment plans, especially when doing point-of-care testing and measuring the osmolarity level. She says, “If [levels] are elevated, we know we have an unstable tear film.”
Educating Patients and Promoting Compliance
A significant part of Dr. Ioussifova’s patient education approach involves listening to patients’ experiences, mapping out symptom patterns, and allowing them to “discover” the causes of their dry eye. This patient-led discussion often reveals factors, such as prolonged screen time, fan exposure, or air conditioning, that exacerbate symptoms. By actively involving patients in identifying these triggers, eye care professionals can help them become more compliant and invested in their treatment.
Dr. Glover highlights the benefits of a follow-up schedule that reinforces treatment adherence. By seeing patients regularly, providers can monitor improvements and address any issues early. Ensuring patients maintain dosing MIEBO 4 times daily per the indication is essential for achieving optimal results.
Future Directions: Comprehensive Evaporative DED Management
Managing evaporative DED often requires a multifaceted approach, especially in advanced cases where corneal nerves may be affected. Dr. Ioussifova emphasizes the importance of addressing each component of dry eye—from diet to in-office procedures like intense pulsed light (IPL) and tear duct expression. For severe cases, autologous serum or platelet-rich plasma (PRP) drops may offer additional relief, especially in patients with significant nerve involvement.
Dr. Ioussifova—along with thousands of other eye care professionals—prescribes MIEBO as a first-line Rx because she has reviewed the clinical data and is also receiving positive feedback from her patients every day. Just listen to the podcast and hear it from the expert herself.
*MIEBO demonstrated significant improvements in total corneal fluorescein staining and eye dryness in ~2 weeks, with ongoing improvement through the end of the pivotal trials (Day 57, primary endpoint).INDICATION
MIEBO® (perfluorohexyloctane ophthalmic solution) is indicated for the treatment of the signs and symptoms of dry eye disease.
IMPORTANT SAFETY INFORMATION
- MIEBO is contraindicated in patients with known hypersensitivity to perfluorohexyloctane
- MIEBO should not be administered while wearing contact lenses. Contact lenses should be removed before use and for at least 30 minutes after administration of MIEBO
- Instruct patients to instill one drop of MIEBO into each eye four times daily
- The safety and efficacy in pediatric patients below the age of 18 have not been established
- In pivotal trials, the most common ocular adverse reaction was blurred vision (1% to 3% of patients reported blurred vision and conjunctival redness)
Please see full Prescribing Information for MIEBO at MIEBO-ECP.COM.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
