Prokera
Dry Eye Center of North Carolina
Prokera®: A Premier Treatment Option for Dry Eye Disease
When your eyes struggle to produce sufficient lubrication due to factors like aging, contact lenses, medications, environmental factors, or autoimmune diseases, dry eye disease can take its toll. Symptoms such as stinging, burning sensations, discomfort, and vision disturbances can significantly impact your daily life.
Prokera®, a leading solution for ocular surface disease, offers a highly effective treatment option. This innovative device, inserted by our skilled professionals in-office and typically worn for 3-5 days, delivers natural healing properties to alleviate dry eye symptoms effectively:
Barrier Protection: Prokera® shields the eye, preserving moisture and safeguarding tears from evaporation.
Natural Healing: Harnessing the therapeutic qualities of amniotic membrane, Prokera® aids in infection prevention, inflammation reduction, and overall comfort restoration.
Regenerative Environment: By stimulating the regeneration of the eye surface, Prokera® plays a crucial role in healing any damage caused by dry eye disease, offering invaluable relief.
Trust the expertise of our team at Dry Eye Center of North Carolina to explore how Prokera® can transform your dry eye management and enhance your eye health.
Prokera® Candidate Eligibility
Prokera® is generally well-tolerated, making it suitable for a wide range of patients seeking relief from various eye conditions. The treatment has shown minimal to no side effects in most cases. However, individuals who are allergic to Ciprofloxacin, Amphotericin B, Glycerol, or DMEM should inform their healthcare provider before undergoing Prokera® treatment. By discussing any existing allergies with your doctor, you can ensure the safe and effective use of Prokera® for your eye health needs.
At Dry Eye Center of North Carolina, we are thrilled to introduce Prokera® to our patients suffering from the discomfort of chronic dry eye. Prokera® stands out as the sole U.S. Food and Drug Administration (FDA)-cleared therapeutic device designed to alleviate inflammation and encourage healing in the eyes.
Through a recent patient survey, we are proud to share that an impressive 93% of individuals with dry eye reported feeling significant relief following treatment with Prokera®. This remarkable feedback underscores the effectiveness and potential benefits of incorporating Prokera® into your dry eye management routine.
If you are seeking a solution to the stinging, burning sensations associated with chronic dry eye, we encourage you to explore the possibilities offered by Prokera®. Experience the difference and embrace the comfort that comes with improved eye health. Contact us at Dry Eye Center of North Carolina to learn more about how Prokera® can transform your dry eye journey.
At Dry Eye Center of North Carolina, we prioritize your convenience and offer streamlined care by conducting most tests and procedures right in our office. By scheduling your visit with us, you can experience the benefit of receiving comprehensive eye care efficiently, often on the same day. Our commitment to providing accessible services underscores our dedication to your eye health and comfort.
Schedule an Appointment with Dr. Hudgins, Our Dry Eye Specialist
If you're experiencing discomfort from dry eye, relief may be just a phone call away. Dr. Hudgins, our esteemed dry eye specialist at Dry Eye Center of North Carolina, boasts extensive experience and a passion for research in the study of dry eye conditions. Her dedication has enabled her to provide effective solutions that help patients find relief and improve their vision.
Dr. Hudgins is currently welcoming new patients and is eager to work with you to devise a personalized care plan. To take the first step towards more comfortable and clearer vision, call us today to schedule your appointment.
Planning for Your Appointment
Office visits at Dry Eye Center of North Carolina are scheduled by appointment only. A comprehensive eye examination typically takes around one hour. During your visit, various assessments will be done, such as taking a history, checking your vision and intraocular pressures, slit-lamp examination, and dilated fundus examination.
Depending on the reason for your visit, additional tests or procedures may be necessary, potentially lengthening your visit. To ensure convenience, most tests and procedures are conducted in-house, often on the same day as your appointment.
After your visit, a detailed report will be sent to your referring doctor to keep them informed about your eye health. We look forward to providing you with the highest quality eye care during your visit.
Common Causes of Dry Eye: Medications and Health Conditions
Medications: Certain drugs can contribute to the discomfort of dry eye, such as sedatives like Benadryl, sleep aids, cold remedies, or anxiety pills. Additionally, allergy pills, blood pressure medications, and medicated eye drops containing preservatives can also exacerbate dryness. Your ophthalmologist can assist in pinpointing any medicines that might be triggering your symptoms.
Health Conditions: Various health conditions can also play a role in causing dry eye. These include diabetes, thyroid dysfunction, rheumatoid arthritis, Parkinson’s disease, rosacea, as well as previous eye surgery. If you are experiencing persistent dry eye symptoms, it is essential to consult with your ophthalmologist for a comprehensive evaluation and personalized treatment plan.
Intense Pulsed Light Therapy for Meibomian Gland Dysfunction
Intense Pulsed Light (IPL) therapy, originally FDA-approved for treating skin conditions like rosacea, has shown promise in addressing Meibomian Gland Dysfunction (MGD) through an off-label application. This innovative approach involves the direct application of infrared light to the eyelids using a handheld device.
By targeting the root cause of MGD, IPL therapy helps reduce inflammation and unclog blocked meibomian glands, promoting healthier tear film quality. It is essential to note that this therapy may not be suitable for individuals with darker or more pigmented skin tones due to the way light interacts with skin melanin.
Treatment sessions are quick, typically lasting around 10 minutes, and a series of four sessions per year are recommended for optimal results. The cost of each IPL session for MGD is approximately $400. Embracing advancements in IPL therapy opens new possibilities for managing MGD effectively and enhancing overall eye health.
Prokera by BioTissue, Inc: A Revolutionary Treatment for Eye Health
Prokera by BioTissue, Inc. is a cutting-edge lens that harnesses the healing power of donated amniotic tissue to provide relief for a variety of eye conditions. This futuristic lens is designed to be placed over the cornea with a small ring, offering a sensation akin to wearing a large contact lens.
The amniotic tissue, sourced from placenta donations, works wonders in promoting the healing of the cornea. Patients typically wear Prokera for a period of three days, during which the tissue gets to work in restoring eye health. Studies have demonstrated that Prokera can effectively alleviate discomfort from severe dry eyes for months post-removal, making it a preferred choice for long-lasting relief.
Beyond dry eyes, Prokera is a versatile solution used in treating keratitis, corneal scars, chemical burns, and various eye diseases characterized by inflammation. Additionally, depending on your insurance plan, coverage for Prokera treatment may be available, making this advanced therapy accessible to more individuals seeking relief and recovery for their eye health. Trust Prokera by BioTissue, Inc. to pave the way for a clearer, more comfortable future for your eyes.
Existing Treatments for Dry Eye
Current treatments for ocular surface disease encompass a variety of options addressing different aspects of the condition. Lifestyle modifications, punctal plugs, deep-cleaning devices, and specialized contact lenses are among the non-pharmacological interventions.
FDA-approved prescription medications play a crucial role in managing dry eye symptoms. Tyrvaya, a novel nasal spray by Oyster Point, stands out as a unique approach to stimulating tear, oil, and mucin production. In contrast to traditional eye drops, Tyrvaya offers a convenient application method and minimizes discomfort typically associated with ocular therapies.
Medications such as Restasis and Cequa, containing cyclosporine, target inflammation-related dry eye to enhance tear production over time. Xiidra, utilizing lifitegrast as an active ingredient, provides an alternative anti-inflammatory solution with potential side effects such as eye irritation and an unusual taste sensation. Eysuvis, an ocular corticosteroid by Kala Pharmaceuticals, offers rapid relief for dry eye flares but is limited to short-term use due to steroid-related adverse effects.
Each of these FDA-approved medications contributes uniquely to the treatment landscape for dry eye, offering tailored solutions to address the diverse needs of patients experiencing ocular surface disease.
Existing treatments for dry eye
Current treatments for ocular surface disease include lifestyle changes, a nasal spray, punctual plugs, anti-inflammatory medications, deep-cleaning devices and specialized contact lenses.
There are five FDA-approved prescription medications available today:
Tyrvaya (Oyster Point) — This much-anticipated nasal spray for dry eye was approved by the U.S. Food and Drug Administration in October 2021. The spray, a first of its kind treatment, stimulates tear, oil and mucin production. This nasal spray may be easier to apply than eye drops and it eliminates undesirable ocular stinging and burning sensations.
Restasis (Allergan) and Cequa (Sun Ophthalmics) — These medicines were developed specifically for chronic dry eye where inflammation leads to reduced tear production. The active ingredient is cyclosporine. Patients take one drop in each eye two times per day. The treatment can take 3 to 6 months to begin working, and may cause temporary burning or discomfort.
Xiidra (Novartis) — This is a different type of anti-inflammatory drop that uses lifitegrast as the active ingredient. This medicine can take up to 3 months to relieve symptoms, and up to a quarter of patients experience irritation and an unusual taste sensation.
Eysuvis (Kala Pharmaceuticals) — This is the first ocular corticosteroid (loteprednol) approved by the FDA for treatment of dry eye flares. It can only be used for 2 weeks at a time, due to the side effects of steroids. Patients take four drops a day in each eye. Eysuvis works more quickly than immunomodulator-based medicines, and both may be used in conjunction to alleviate symptoms.
New treatments for dry eye target the underlying problems
Underlying inflammation
Cyclosporine is not a new approach to treating dry eye. But MC2 Therapeutics and Novaliq are testing new cyclosporine-based anti-inflammatory treatments that may be more effective at treating this condition.
Meibomian gland dysfunction
Two new treatments may help people who lack enough healthy oils to keep their tears from evaporating too quickly. These oils are made by the meibomian glands along the edge of the eyelids. Therapies so far have been limited to eyelid scrubs, massage and warm compresses.
NOV03 (Bausch & Lomb) is a preservative-free eyedrop taken four times per day to stabilize tears and stave off evaporation. Patients in a phase 3 clinical trial experienced a rapid decrease in dryness after using the drops. This medicine could become the first FDA-approved prescription medication for this condition.
AZR-MD-001 by Azura Ophthalmics is an ointment that prevents protein buildup in meibomian gland ducts. This buildup blocks oil secretion and leads to dryness. Patients who tested the medication in a phase 2 trial produced healthier amounts of oil and had reduced dry eye symptoms.
New advancements in dry eye treatment are addressing the underlying causes of this common condition.
Inflammation: Companies like MC2 Therapeutics and Novaliq are pioneering new cyclosporine-based anti-inflammatory treatments to combat underlying inflammation, potentially offering improved efficacy compared to traditional approaches.
Meibomian Gland Dysfunction: For individuals struggling with insufficient healthy oils from the meibomian glands, innovative solutions are emerging. NOV03 by Bausch & Lomb is a preservative-free eyedrop administered four times daily to stabilize tears and hinder evaporation. Phase 3 trials have demonstrated a rapid reduction in dryness, positioning this medication as a promising candidate for FDA approval.
Additionally, AZR-MD-001 by Azura Ophthalmics presents another breakthrough. This ointment prevents protein accumulation in meibomian gland ducts, addressing oil secretion blockages that contribute to dryness. Patients in phase 2 trials showed improved oil production levels and decreased dry eye symptoms, hinting at a potential game-changer in dry eye treatment.
With these innovative treatments targeting specific root causes, individuals suffering from dry eye may soon find relief through tailored and effective interventions.
Anterior Blepharitis and Demodex Mites: A Breakthrough Treatment on the Horizon
A new and innovative medicine is being developed to address anterior blepharitis triggered by Demodex mites. These microscopic creatures normally reside on the skin of nearly all individuals without causing harm, but an excessive presence on the eyelids can result in irritation, crusting, and discomfort.
Studies suggest that around half of anterior blepharitis cases are linked to Demodex infestations. Until now, treatment options have been limited to at-home eyelid hygiene practices or professional interventions such as microblepharoexfoliation procedures like the BlephEx device.
TP-03, a cutting-edge eye drop from Tarsus Pharmaceuticals, is applied twice daily to combat the mites and alleviate associated symptoms. In a phase 2b clinical study, this treatment effectively eradicated the infestation in over 80% of patients within 43 days. The anticipated availability of this therapy is as early as 2022, offering hope for individuals grappling with Demodex-related anterior blepharitis.
Summary:
A study conducted by researchers at Washington University School of Medicine in St. Louis has discovered that individuals with dry eye disease are at a higher risk of corneal injuries compared to those with healthy eyes. The research, primarily focusing on mice models, revealed that proteins produced by stem cells responsible for corneal regeneration could potentially be targeted for the treatment and prevention of such injuries.
Through analyzing gene expressions in the cornea of various mouse models with conditions like dry eye disease and diabetes, the researchers identified the activation of the gene SPARC in mice with dry eye disease. Moreover, they observed a correlation between higher levels of SPARC protein and improved healing of the cornea.
The study utilized single-cell RNA sequencing to pinpoint genes crucial for maintaining corneal health. The researchers, led by Joseph B. Lin, an MD/PhD student at Washington University School of Medicine, believe that genes like SPARC could serve as promising therapeutic targets for managing dry eye disease and corneal injuries.
According to a 2024 press release from the University of Houston, current research focusing on blinking, tearing, and pain sensation carries the potential to enhance our comprehension of dry eye disease. The primary objective of this study is to chart the intricate network of nerves linked to the eye, aiming to provide invaluable insights into the structure and functionality of the cornea. These findings may pave the way for a more profound understanding of dry eye disease and neuropathic ocular pain, subsequently enriching clinical and translational research in the field.
Consider the cornea, the transparent front surface of the eye critical for vision. It is densely packed with nerves that play essential roles in maintaining ocular surface health by mediating pain, blink reflexes, and tear production. Due to its high level of innervation, the cornea is significant for understanding sensory functions related to the eye.
Despite its importance, the complex nature of corneal nerves has led to gaps in understanding how they function. To address this, a University of Houston optometry researcher, along with a team at Duke University, is working on mapping and analyzing corneal nerves at morphologic, molecular, and functional levels.
By selectively labeling the neurons innervating the cornea, which represent about 1% of the neurons in the trigeminal ganglia responsible for pain and other sensory functions, the researchers aim to fill these knowledge gaps. Anna Matynia, associate professor at the University of Houston College of Optometry, is leading this effort to expand our understanding of the corneal nerve network.
Summary:
Consider the cornblink reflexes and tear production are crucial for maintaining ocular surface health due to the high innervation of the cornea. Understanding how corneal nerves work is essential for managing conditions like dry eye disease. University of Houston optometry researcher Anna Matynia aims to fill knowledge gaps by mapping corneal nerves to identify those responsible for blinking, tear production, and pain signals. With funding from Duke University, Matynia's team is employing advanced imaging and genetic studies to create a detailed corneal nerve map. This research will enhance insights into ocular pain and dry eye disease, potentially revolutionizing treatment approaches.
Blinking and Natural Tears: A Vital Connection for Eye Health
Blinking and natural tears are essential partners in maintaining healthy eyes. When tears are insufficient, blinking becomes less frequent, leading to potential issues. Conversely, inadequate blinking results in a lack of tears necessary for eye health.
Each blink provides a crucial layer of tears composed of water, oil, and mucus, shielding and nourishing the eyes. The average person blinks 7–10 times per minute, a number that may decrease with prolonged screen time.
Recognizing the link between blinking and tear production, researchers are exploring the benefits of deliberate blinking exercises for managing dry eyes. A recent 2021 study observed improved tear quality and production in participants who performed brief blinking exercises every 20 minutes for four weeks.
While additional research is imperative to understand the full extent of blinking exercises for dry eye relief, their potential for enhancing overall eye health is evident. Individuals, especially those with regular screen exposure, may benefit from incorporating blinking exercises into their daily routine.
To engage in blinking exercises, allot short intervals to blink rapidly up to 50 times in various directions, repeating up to five times daily. Opt for fluttering your eyes instead of complete closure during exercises. Prioritizing these simple yet effective practices can contribute significantly to maintaining optimal eye health.