Piezo-print technology directs a precise stream of micro-droplets to the ocular surface—in less than a blink of an eye.
From my perspective, first as an ophthalmologist and as someone who has brought many innovative technologies into our field, I have come to realize how antiquated and inadequate is the existing paradigm of topical drug delivery.
There is virtually no other situation in medicine where physicians prescribe a therapeutic to patients knowing that, most of the time, they do not receive the correct dose. In the case of pills and injectable drugs, we know that if have prescribed 250 mg of Augmentin or 10 units of insulin, for example, and that is what the patient gets.
When clinicians prescribe one drop of timolol twice a day, however, studies have demonstrated that patients get a drop into their eye only about half the time. When they do manage to get drops in the eye, patients often administer between 2 and 7 drops, or a 100% to 600% overdose.1–7 Much of this excess goes directly into the blood stream through nasolacrimal drainage, explaining not only the high incidence of ocular side effects, but in the case of cardiotropic drop therapies like beta-blockers, systemic ones as well (eg, slowing heart and respiratory rates).
Another concern patients have about their drops is the frequency with which they run out of their medication because of the overdosing. This concern has been voiced by consumer advocacy groups who say patients are paying too much for wasted medication. They make the case that companies have a responsibility to provide drugs in accurate dosing containers which can deliver smaller drops, precisely as prescribed. This was escalated recently all the way to the Supreme Court which refused to consider industry’s appeal.8
Sean Ianchulev, MD, MPH
E: [email protected]
Dr. Ianchulev is professor of ophthalmology and director of innovation and technology at New York Eye and Ear Infirmary of Mount Sinai. Dr. Ianchulev reports he is founder of Eyenovia and Iantech Technologies; chairman of the board for Iantech Technologies and on the board of Eyenovia; and the CEO of Eyenovia.
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14. American Optometric Association. State of the Optometric Profession. 2013. Available from: https://www.aoa.org/Documents/news/state_of_ optometry.pdf. Accessed July 3, 2018.