Product Playbook · Rx Education
Prescription and Advanced Treatments
When over-the-counter care is not enough, the prescription and procedure side opens up. This is a plain-language map of where Rx fits, the advanced procedures that pair with it, and the supporting products that make any of it work. Prescribing decisions are always yours.
Key Takeaways
- The prescription side sorts into a few jobs: control inflammation, treat MGD evaporation, clear Demodex, and stimulate tears.
- Immunomodulators are the long-term backbone; a short steroid course can settle a flare before they take hold.
- Newer targeted agents address specific drivers: anti-evaporative for MGD, an anti-mite drop for Demodex, and tear-stimulating options.
- Advanced procedures, thermal expression, IPL, membranes, and scleral lenses, handle what drops cannot.
- Rx and procedures work far better with a solid OTC and in-office support layer behind them, which is where DER fits.
Quick Answer
Match the prescription to the driver. Inflammation-led disease leans on immunomodulators, with a short steroid course for flares. Evaporative, MGD-driven disease has a dedicated anti-evaporative Rx. Demodex blepharitis has a dedicated anti-mite drop. Low tear production has nasal and topical tear-stimulating options. Advanced procedures handle obstruction and severe surfaces. Below is the map, plus the support layer DER carries that makes all of it hold. Prescribing and procedure decisions rest with you.
The Prescription Landscape
A plain-language map for reference. Indications, dosing, and suitability rest on the current FDA labeling and your judgment.
| Job | Class and representative agents | Where it fits |
|---|---|---|
| Control inflammation, long term | Cyclosporine (Restasis, Cequa, Vevye) and lifitegrast (Xiidra) | Inflammation-led dry eye needing sustained immunomodulation; the long-term backbone |
| Settle a flare, short term | Topical corticosteroid such as loteprednol (Eysuvis) | Short courses to calm an acute flare, often while an immunomodulator takes effect |
| Treat evaporation in MGD | Perfluorohexyloctane (Miebo) | The first FDA-approved Rx for dry eye associated with MGD; anhydrous and anti-evaporative |
| Clear Demodex blepharitis | Lotilaner (Xdemvy) | The first FDA-approved Rx specifically for Demodex blepharitis |
| Stimulate tear production | Varenicline nasal spray (Tyrvaya) and the TRPM8 agonist acoltremon (Tryptyr) | Patients with low tear production who need stimulation rather than only replacement |
| Adjuncts for MGD and blepharitis | Oral low-dose doxycycline or azithromycin, used off-label | Adjuncts some clinicians add for meibomian and lid disease, at the prescriber's discretion |
Anti-inflammatories, immunomodulators, and tear stimulators are the current standard of prescription care for dry eye, and perfluorohexyloctane (Miebo) is the first FDA-approved prescription medication for dry eye associated with meibomian gland dysfunction (American Academy of Ophthalmology; Bausch + Lomb labeling). Confirm all indications and dosing against current FDA labeling.
Advanced and In-Office Procedures
What drops cannot reach, procedures can. A reference for where each one fits.
| Procedure | What it does | Where it fits |
|---|---|---|
| Thermal expression | Heats and expresses obstructed meibomian glands in office | Obstructive MGD that home heat does not clear |
| Intense pulsed light (IPL) | Targets periocular inflammation and vascular contributors | Inflammatory MGD and rosacea-associated disease, in a course |
| Amniotic membrane | Regenerative support for the ocular surface | Severe or compromised surfaces not responding to standard care |
| Scleral lenses | Vault the cornea in a fluid reservoir | Severe surface disease and aqueous deficiency needing constant protection |
| Punctal occlusion | Conserves the patient's own tears | Aqueous-deficient surfaces after inflammation is controlled |
The Support Layer DER Carries
Prescriptions and procedures hold up far better with the right products behind them. This is the layer that pairs with Rx, and what DER stocks for it.
Comfort and tolerability
PF Tears Alongside Rx
Preservative-free lubricants reduce surface insult and cover the gaps between Rx dosing.
Lid disease support
Hygiene and Heat
HOCl, tea tree, and heat masks support Demodex and MGD therapy and maintain results between visits.
Long-term adjunct
Omega Nutrition
A daily omega adjunct supports the surface alongside any prescription plan.
Confirm and treat
In-Office Testing and Treatment
Point-of-care testing and in-office lid treatment to confirm inflammation and reset the margin before and during Rx.
Send the Support Layer With Every Rx
A prescription holds up better when the patient also has the right tears, hygiene, and heat. RescueLink sends that support layer by text or email with one-tap ordering and same-day shipping, so the OTC side of the plan never falls through.
DER Clinical Pearl
Most immunomodulators take weeks to feel like they are working, which is where patients quit. Bridge that window with a short steroid course where appropriate and a strong OTC support layer, then set the expectation clearly. The patients who stay on long enough are the ones who get the result.
Frequently Asked Questions
Where do immunomodulators fit?
As the long-term backbone for inflammation-led dry eye. They take weeks to reach effect, so set that expectation and support the patient through the window.
When is a steroid appropriate?
For short courses to settle an acute flare, often while an immunomodulator takes hold. Use per labeling and monitor as you would any topical steroid.
What changed for MGD-associated dry eye?
There is now a dedicated FDA-approved anti-evaporative Rx for dry eye associated with MGD, which targets evaporation rather than inflammation alone.
Is there an Rx specifically for Demodex?
Yes, a dedicated anti-mite drop is FDA-approved for Demodex blepharitis, used as a course. Pair it with tea tree home hygiene.
What about stimulating tear production?
There are nasal and topical options that stimulate tears rather than only replacing them, useful when low production is the driver.
Does DER sell these prescriptions?
This page is educational. DER carries the Rx-adjacent medical supplies, diagnostics, and the OTC support layer that pairs with prescription care, not patient prescriptions themselves. Questions go to providers@dryeyerescue.com or (561) 468-8747.
How do procedures and Rx work together?
They layer. Procedures handle obstruction and severe surfaces, Rx handles inflammation and specific drivers, and OTC care maintains the result between visits.
What is the easiest win to add today?
A strong OTC support layer behind every prescription. It improves tolerability and compliance, and it is the part you can send through RescueLink in seconds.
Back Every Rx With the Right Support
Browse Rx and medical supplies at wholesale, or activate RescueLink to send the OTC support layer with every prescription.
Continue through the Dry Eye Product Playbook
Part of the Dry Eye Product Playbook. This page is educational and does not recommend, promote, or provide prescribing guidance for any prescription medication. Brand names are referenced for identification only. All prescribing and procedure decisions rest with the treating eye doctor, based on current FDA labeling and individual patient assessment. Dry Eye Rescue is a distributor of medical supplies and over-the-counter products and does not dispense patient prescriptions.