Advancements in Addressing Chronic or Severe Dry Eyes

Explore the experience of chronic or severe dry eyes — including common symptoms like irritation, burning, redness, and blurred vision — and learn what may be causing persistent discomfort. This article discusses underlying factors, when to seek professional care, and a range of therapy options, from lifestyle and environmental changes to therapeutic prescriptions and personalized compounded eye drops designed to support ocular surface moisture and comfort.

 

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Chronic, Severe Dry Eyes

Exploring Autologous Serum Eye Drops (ASED) and other sterile ophthalmic compounding options.

Many people don't realize severe dry eyes can be a chronic condition and that often, conventional medications do not provide relief for patients.


Chronic Dry Eye Causes & Symptoms

Patients suffering with severe dry eyes may not produce enough tears to remain comfortable, and supplementing natural tear production with artificial tears or lubricants is often inadequate. Many people have underlying medical issues which cause or worsen dry eye, including diabetes, rheumatoid arthritis, and thyroid disease. Others take medications which diminish tear production.

The use of a patient's own serum to create a drop for the eye has been reported as a newer option for addressing ocular surface disorders.

Do you have an autoimmune disorder that is causing severe dry eyes? →


How Autologous Serum Eye Drops (ASED) Work

Conventional therapies for severe dry eyes may fail to heal the epithelial cells (the cells on the top layer of the cornea). The dry epithelial cells sometimes fall off of the cornea easily.

Autologous serum comes from the patient's own blood serum and plasma (source: clevelandclinic.org).

The fluid contains epithelium-promoting growth factors and can become a good replacement for tears.


What "Autologous" Means

The meaning of autologous is that the donor and the recipient are the same person.

The eye drops in this case are made from your own blood. Red blood cells and clotting factors are removed, leaving behind blood serum. This is diluted with a sterile, preservative-free solution to produce a tear substitute that is unique to the patient and contains many important growth factors and nutrients normally found in healthy tears.

Since blood and tears have an almost identical salinity and pH, there is typically no issue of burning or stinging upon usage. Because they are non-preserved, the drops are stored in the freezer until you need them.


How the Serum is Made

Upon receipt of the frozen serum, sterile pharmacists allow it to defrost in a controlled environment. Once defrosted, the serum is aseptically processed into eye drops in an ISO class 6 Isolated Clean Room in an advanced laminar flow hood. Eye drops will be 100% concentration, or as prescribed by your physician.

Town and Country Compounding aseptically filters the serum and transfers it into dropper bottles for use. If sufficient serum (48 mL or more) is supplied by the lab, we will typically supply 12 vials containing 4 mL each (approximately a 3-month supply).

How does serum get to the pharmacy? Click Here


Town & Country Compounding Produces Ophthalmic Solutions

Vancomycin Fortified Ophthalmic Solution

We can compound strengths 12.5 mg/mL, 14 mg/mL, 25 mg/mL, 50 mg/mL (BUD = 14 days). Refrigeration required.

Additional ophthalmic medications we commonly compound
Acetylcysteine (5%, 10%) Albumin (4%, 5%) Atropine (0.01%, 0.02%, 0.025%, 0.1%, 0.125%) Cyclosporin MCT (0.1%–0.5%, 1%, 2%) Dexamethasone (0.01%, 0.1%) Glycerin (50%) Mitomycin (0.02%–0.04%) Prednisolone (1%) Timolol (0.5%)

Tobramycin Fortified Ophthalmic Solution

We can compound strengths 13 mg/mL–15 mg/mL (BUD = 14 days). Refrigeration required.

Other anti-microbial ophthalmic medications
Amikacin (2.5%) Cefazolin (50 mg/mL) Ceftazidime (5%) Chlorhexidine Digluconate (0.02%–1%) Polyhexamethylene Biguanide (PHMB) (0.02%) Voriconazole (0.1%–1%)

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