A tiny, high-tech plug to soothe dry eyes could offer an alternative for patients struggling with drops
A tiny plug in a tear duct could mean the end of daily drops for dry eye sufferers.
The high-tech plug – the size of a grain of rice – continuously releases anti-inflammatory drugs for three months. It was developed to treat dry eye (known as dry eye) when there is not enough tear fluid to lubricate and nourish the eye.
Tears are mostly water, with some lipids or fats. Every time we blink, a layer of tears spreads onto the cornea, the eye’s clear outer layer, keeping it clean and moist. Tears are also important for clear vision.
The high-tech plug – the size of a grain of rice – continuously releases anti-inflammatory drugs for three months
But as the eye ages, the eye produces less fluid – dry eye syndrome is more common in those over 50 – with women being particularly affected due to hormonal changes associated with menopause.
Dry eyes can also be a side effect of medications, including some cold and allergy medicines and beta-blockers for high blood pressure, as well as conditions like diabetes — and staring at a screen for too long.
Often the problem is inflammation affecting the cornea, conjunctiva (the outermost layers of the eyes), tear or meibomian glands.
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The tear glands sit above the eyes and produce the watery part of the tears. The meibomian glands, located on the edge of the eyelids, add lipids, or fats, to the tears to lubricate them. (The tears then drain into tear ducts—small holes in the inner corners of the eyes.)
Dry eye symptoms include pain, blurred vision, and a grainy feeling. The eye may appear red and be sensitive to light and more watery than normal. For most people with mildly dry eyes, over-the-counter eye drops are sufficient.
But these don’t fight the underlying inflammation that’s thought to play a role in many cases.
Anti-inflammatory eye drops can be prescribed but are often discontinued: Up to 60 percent of patients prescribed eye drops containing the anti-inflammatory drug cyclosporine for dry eyes stopped treatment before treatment was complete due to a burning sensation. Pain and irritation, according to a 2020 study in the journal Clinical Ophthalmology.
However, if severe cases are not treated, they can lead to damage to the surface of the eye and, if left untreated, to abrasion of the corneal surface, corneal ulcers, and vision loss.
The new treatment could offer an alternative for patients who find eye drops problematic.
The 1mm plug, a composite material with silica, is inserted into the tear duct by a healthcare professional in a procedure that takes less than a minute.
As the manufacturer Eximore explains, by partially occluding the tear duct, the plug helps to “conserve” the tears that are already there and “immediately relieve the burning and pain.”
The combination of plug and automatic release of ciclosporin is intended to bypass patients who do not adhere to the treatment. After three months, the plug is removed and the treatment can be repeated if necessary.
Around 20 patients are taking part in a clinical study with the EXP-TC plug at the Hospital de la Ceguera in Mexico.
Gwyn Williams, a consultant ophthalmologist at Singleton Hospital in Swansea, says: “Many developments in dry eye have not been enough, so we would need to see evidence in large trials that this works before we can see if it is really beneficial might be a wider population.’