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ST-100 shows promise as a fast-acting treatment for dry eye disease, offering rapid relief and unique collagen repair mechanisms.

Phase 3 clinical trial results for ST-100 (vezocolmitide) ophthalmic solution, a novel dry eye candidate

Vision Expo, which has been traditionally split into regional East and West meetings, will transition to a single annual meeting that will rotate locations.

Vision Expo announces move to a single annual event in 2026

The PanOptix Pro lens is available in Canada through Alcon in the single-use Clareon AutonoMe preloaded delivery system.

Alcon's Clareon PanOptix Pro IOL now available in Canada

A $2.5 million endowment establishes the Herbert Simon Chair in Glaucoma Research and Innovation, advancing treatments and research led by renowned glaucoma researcher Alon Harris, PhD, MS, FARVO.

Glaucoma Foundation receives $2.5 million gift from the Herbert Simon Family Foundation

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Results from the EAGLE and ZAP clinical trials provide answers to lingering questions.

How to manage the angle closure spectrum

The Contact Lens Institute (CLI) has published a new comprehensive report investigating how and why individuals seek information about contact lenses through online resources.

 The Digital Discovery: Consumer Searches Reveal Contact Lens Realities report is the latest of CLI’s 

“Patients are posing questions about contact lenses to search engines, artificial intelligence [AI] platforms, and social channels that they may never raise in the exam chair. By understanding what’s being asked, eye care practitioners and staff can reconsider how they’re presenting contact lens wear, care, and purchase options,” said Stan Rogaski, CLI’s executive director, in the release. “Based on preliminary findings that we shared earlier this year, some practices are already adjusting how they’re communicating with and educating wearers, plus evolving their practice management techniques. This report goes much further, with perspectives that are broadly applicable.”

The report examined the most common contact lens searches via Google auto-complete results, 65% of which were reported as purchase driven. Not only were search behaviors examined in the US and Canada, but common questions asked by patients were also researched to reveal patient challenges. These may suggest that the contact lens community could benefit from increased focus on health and safety, cost, wear and care, and how brands differ, the release stated. The report also relayed the importance of optimizing a practice’s website for location-based search, in addition to liberally include the term 

into digital content, which is reported as the preferred shorthand used by patients when searching for clinical sources online regarding contact lenses.

Large language models including ChatGPT, Copilot, and Gemini were also assessed in the adoption of AI platforms in how they handle contact lens queries. CLI’s report found that AI platforms’ ability to provide the best sources of information is often inconsistent. Therefore, the organization recommended that eye care providers have preemptive conversations concerning AI-generated results with patients who frequently use AI platforms. According to the National Bureau of Economic Research, 40% of US adults aged 18 to 64 years use generative AI, with Leger reporting that 47% of Canadian adults have used AI tools.

The report also examined searches made for different contact lens modalities, insertion and removal guidance, part-time contact lens and glasses wear, regional and global differences on X (formerly Twitter), and the use of non-English languages. The report also included “how to” columns from 16 CLI Visionaries in order to offer practical advice on using the data and insights from the report in practice.

“Our latest report delivers a snapshot of what may be on the minds of the person considering contact lenses for the first time as well as new and longtime wearers, helping the thousands of professionals in eye care remain 1 or more steps ahead as the ultimate experts,” Rogaski said in the release.

New report investigates why consumers search online for contact lens information. News release. Contact Lens Institute. June 23, 2025. Accessed June 23, 2025.

The report examined the most common contact lens searches via Google auto-complete results, 65% of which were reported as purchase driven. 

New CLI report investigates the "how" and "why" of online searches for contact lens information by patients

Aldeyra Therapeutics has resubmitted a new drug application (NDA) to the FDA for topical ocular reproxalap for the treatment of signs and symptoms of 

Previously, Aldeyra had received 2 complete response letters (CRL) from the FDA in 

 In the CRL at the end of 2023, the FDA identified no safety or manufacturing issues with reproxalap but noted the NDA did not demonstrate “efficacy in treating ocular symptoms associated with dry eyes” and that “at least 1 additional adequate and well-controlled study to demonstrate a positive effect on the treatment of ocular symptoms of dry eye” should be conducted.

In the NDA issued in April 2025, again the FDA found no manufacturing or safety issues with reproxalap but noted the NDA “failed to demonstrate efficacy in adequate and well-controlled studies in treating ocular symptoms associated with dry eyes” and that “at least 1 additional adequate and well-controlled study to demonstrate a positive effect on the treatment of ocular symptoms of dry eye” should be conducted, mirroring the prior CRL.

Additionally, in the most recent CRL, the FDA noted that it had identified “concerns with the data from the trial submitted to the NDA [in November 2024] that may have affected interpretation of the results,” which the FDA stated may be related to methodological issues, including a difference in baseline scores across treatment arms.

The most recent NDA includes new clinical data from the 

 The dry eye chamber trial was statistically superior to the vehicle in terms of ocular discomfort, and although the field trial missed statistical significance for the primary end point, the company noted it was consistent with previous field trials.

 the FDA accepts chamber trial results per its draft guidance for dry eye drug development, but they are rare for dry eye clinical trials. Also called a challenge-model trial, this trial design uses a controlled chamber to regulate temperature, airflow, humidity, and other environmental factors.

 All other dry eye disease therapeutics on the market today have used a more traditional environmental exposure study, marking Alderya’s trials as particularly unique.

Todd C. Brady, MD, PhD, president and CEO of Aldeyra, commented on the resubmission in a news release from the company.

“Consistent with a number of clinical trials that suggest the potential of reproxalap to rapidly improve the symptoms of dry eye disease, we believe the clinical trial results included in the resubmission announced today are robust,” said Brady. “Based on the lack of notable baseline differences across treatment arms and the highly statistically significant achievement of the prespecified primary end point in favor of reproxalap over vehicle, in conjunction with recent FDA discussions, we believe that previous concerns raised by the FDA have been addressed.”

The Prescription Drug User Fee Act target guidelines for NDA resubmissions include acknowledgment of acceptance for review within 30 days of submission by the FDA and completion of submission review within 6 months.

Aldeyra Therapeutics Resubmits Reproxalap New Drug Application for the Treatment of Dry Eye Disease. Published June 17, 2025. Accessed June 17, 2025. 

https://ir.aldeyra.com/news-releases/news-release-details/aldeyra-therapeutics-resubmits-reproxalap-new-drug-application-0

FDA issues Complete Response Letter to Aldeyra Therapeutics for resubmitted New Drug Application of reproxalap. Published April 3, 2025. Accessed June 17, 2025. 

https://www.ophthalmologytimes.com/view/fda-issues-complete-response-letter-to-aldeyra-therapeutics-for-resubmitted-new-drug-application-of-reproxalap

Maharjan EK. Aldeyra Therapeutics hits primary end point in 1 of 2 phase 3 trials for reproxalap. Published May 7, 2025. Accessed June 17, 2025. 

https://www.ophthalmologytimes.com/view/aldeyra-therapeutics-hits-primary-end-point-in-1-of-2-phase-3-trials-for-reproxalap

Aldeyra resubmits NDA for reproxalap, aiming to address FDA concerns and demonstrate efficacy in treating dry eye disease symptoms.

Canonical

Aldeyra submits third reproxalap new drug application for the treatment of dry eye disease

At this year’s Association for Research in Vision and Ophthalmology (ARVO) meeting in Salt Lake City, Kayla Karpuk, OD, presented compelling new research on the impact of perfluorohexyloctane (PFHO) ophthalmic solution (Miebo; Bausch + Lomb) on preoperative biometry and intraocular lens (IOL) power calculations. Her poster, titled “The Impact of a Single Drop of Perfluorohexyloctane Ophthalmic Solution on Biometry Measurements and Intraocular Lens Calculations,” addressed a timely and clinically relevant question: Can a drop of PFHO, known to persist in the tear film, influence the precision of keratometry and ultimately affect surgical planning?

Karpuk’s prospective observational study investigated this by analyzing biometry measurements in subjects with dry eye before and after a single instillation of PFHO. With both OCT-enhanced and Scheimpflug imaging used to track changes at 15 and 60 minutes post-instillation, the findings offer reassurance for surgeons—demonstrating that PFHO has no significant impact on preoperative measurements critical for successful cataract outcomes.

In this Q&A, Karpuk shares insights into the study design, clinical implications for cataract and refractive surgeons, and how this research contributes to the growing body of dry eye science showcased at ARVO.

For those who weren’t able to attend ARVO this year, can you detail the parameters and methods of the research featured in this poster?

This prospective study looked at pre-operative biometry measurements of approximately 60 eyes of 30 subjects with healthy dry eye parameters at baseline. Biometry measurements were obtained prior to instillation of PFHO and compared to measurements obtained 15- and 60-minutes post instillation. Keratometry measurements were obtained using both an automated OCT-enhanced method as well as Scheimpflug corneal images.

How did the actual performance of preoperative PFHO compare to your expectations?

It was an important concept to better understand; we know from the rabbit PK data the PFHO molecule was detectable in the tears for up to 6 hours post-instillation. We wanted to better understand how a drop that is made from 100% of a single molecule, such as MIEBO, and detectable in the tears for a prolonged period of time, would impact measurements. The results of this study were consistent with what we expected—use of PFHO and presence of the PFHO molecule in the tears does not have an impact of biometry as a majority of patients in the study did not demonstrate a significant change in keratometry measurements 60 minutes post-instillation.

This is a prospective, observational study. What are the next steps in this research? 

The value of treating the ocular surface prior to any cataract or refractive cataract procedure is well established and future research could involve evaluating perioperative use of PFHO in these patients to better understand the value of this treatment option.

What immediately-applicable clinical advice does this research yield, especially for cataract/refractive surgeons who hope to limit the prevalence of dry eye disease among their patients?

I think this particular study provides strong evidence that use of MIEBO preoperatively does not negatively impact biometry measurements and ultimately does not lead to less predictable IOL power calculations for patients.

It helps to rule out that changes seen in pre-operative corneal measurements would be due to the treatment, or molecule itself per se, but rather stabilizing the underlying disease state is what helps ensure we are getting the most reliable results ultimately leading to successful cataract patient outcomes.

What was the response to these findings at the meeting? How do you think this research fits into the broader landscape of clinical dry eye research presented at ARVO, especially this session?

Dry eye disease is a hot topic and the interest in dry eye was palpable at ARVO. We are very fortunate to have had multiple new topical therapies come to the market in recent years with more on the horizon. As new treatment options are introduced, it is critical to better understand what patients would benefit from each treatment option to tailor and further individualize approaches to treatment of dry eye.

Can a drop of perfluorohexyloctane, known to persist in the tear film, influence the precision of keratometry and ultimately affect surgical planning?

Conference

Evaluating the effects of perfluorohexyloctane on biometry: A Q&A with Kayla Karpuk, OD, from ARVO 2025

There is always a balance when it comes to acquiring new technology for an optometric office. Practitioners have to consider the clinical value of new technology, its cost and reimbursement level (if any), as well as space and time constraints in the office. Although that is already a lot to weigh, I would suggest that most clinicians do not pay enough attention to their medicolegal risks in making these decisions. There is a misconception that newer technology might introduce medicolegal risk and that doing what you have always done is the safe path. In fact, the opposite may be true.

As physicians, we have a duty to provide our patients with high-quality care. There is a strong legal precedent for this concept in eye care. In a 1974 court case, 

, the Washington State Supreme Court ruled in favor of a woman who developed severe vision loss due to glaucoma. At that time, IOP was not typically measured in patients younger than 40 years.

 Over the course of a decade, her physicians had never checked her IOP, instead attributing her visual complaints to complications of rigid contact lens wear. The court recognized that even if a given practice (eg, IOP measurement in younger patients) is not universally followed, a duty of care can still exist if the failure to perform a simple test leads to serious harm.

This case is the reason we now test IOP in patients of all ages, but its broader implications are sometimes ignored. For example, we have technology (corneal topography) that can detect changes in the cornea indicative of keratoconus, a sight-threatening disease. As corneal topography has become more affordable and accessible, with built-in algorithms that make it easier to interpret, the argument for integrating it into routine eye examinations has become stronger. In my practice, I use the multifunctional Topcon KR-1W, which combines aberrometry, topography, keratometry, pupillometry, and autorefraction in a single unit. All the data are captured during the pretest process for every patient, but the topography is only uploaded for me to review and interpret when there is some clue to keratoconus, such as high cylinder or a significant power differential between the 2 eyes. If I cannot refract the patient’s vision to 20/20 or if I find something else of concern during my examination, I can acquire the corneal topography report with just a few clicks. This capability helps me to uncover diseases earlier than I would otherwise (

For example, I can detect keratoconus earlier and monitor for progression, including seeing young patients with suspicious findings in a few months instead of a full year to repeat the topography. Once there is any sign of progression, I can refer the patient for corneal cross-linking (iLink; Glaukos) to halt the progression and stabilize the cornea before vision is permanently lost. I find that having a single, integrated device makes me more efficient, and it ensures we are screening all patients effectively. Some practices rely on a standalone topographer and order testing when indicated, but using the topographer more broadly might help to uncover more issues. At minimum, optometrists need to refer for topography when there are red flags. Ignoring those red flags because the technology to investigate further is not available in the office is not acceptable.

Similarly, we have a duty to carefully evaluate any patient with cataracts to determine whether they also have ocular hypertension or any signs of glaucomatous damage. If so, they should be offered minimally invasive glaucoma surgery at the time of cataract surgery because it is a one-time opportunity to address IOP with a combination procedure.

Retinal optical coherence tomography (OCT) and a dark adaptometer are other indispensable tools in my practice for earlier diagnosis of retinal disease. Retinal OCT devices such as Optomap (Optos) or Spectralis OCT (Heidelberg Engineering) are now valued by most optometry clinics for their ability to facilitate a quick assessment of the optic nerve, macula, retinal vasculature, and more. Dark adaptation testing, performed with a wearable device such as Prime (Heru) or AdaptDx Pro (LumiThera) (

), is an easy test that measures impaired rod function, an early sign of age-related macular degeneration (AMD). By detecting AMD before there are clinical signs, we can put patients on the right path to preventing progression of AMD.

In my view, optometrists can and should embrace advancements in technology such as these that allow us to detect, diagnose, and intervene early, when the impact of intervention is the greatest. That does not mean it is malpractice not to have these specific technologies. No court would expect every physician to obtain every possible diagnostic device. However, I believe we all need to think about ways to integrate newer technologies into our clinical protocols so that we are providing the highest level of care for our patients.

 was that the physicians in this case had failed to explore the reasons for their relatively young patient’s vision problems. Any time a patient has reduced vision, we need to determine whether the cornea, lens, optic nerve, or retina is the source of the problem. If you cannot solve the puzzle yourself or do not want to invest in the resources to do so, a referral should be made to someone else who has more advanced diagnostic technology. Skipping this diagnostic step may negatively affect patient treatment outcomes as well as result in practice litigation.

A busy schedule is not a reasonable excuse. “I didn’t have time” is not going to be a very satisfactory answer to a patient who has suffered vision loss—let alone at a deposition for a malpractice case. If you do not have time to effectively screen for a wide array of ocular conditions and diseases, consider how to restructure your schedule or use technology or staffing changes to help you become more effective in the same amount of time. For instance, including topography in all eye examinations may only add 30 seconds to a pretest. For most offices, this may be more efficient than having to schedule separate topography when there is some concern during the examination.

For me, the answer to the perennial time crunch is to have staff collecting all the testing data for me. I have established clear guidance for abnormal values that should be flagged or should generate additional testing. I use advanced imaging not only for diagnosis but also for effective communication with patients and the other physicians to whom I refer. I have invested time in drafting referral templates so that my busy schedule does not become an unnecessary barrier to needed care.

We all want to avoid the emotional and financial costs of a medical malpractice case. Embracing technology and practicing to the highest level of care is a great way to protect yourself while providing optimal patient care.

, 83 Wn2d 514, 519 P2d 981 (Wash 1974). Accessed April 18, 2025. https://law.justia.com/cases/washington/supreme-court/1974/42775-1.html

Embracing new technology is good for patients and provides protection against malpractice claims.

Making the most of advanced technology

The Tear Film and Ocular Surface Society (TFOS) DEWS III Digest Report, published in June 2025 in

has identified key research published since the 2017 TFOS DEWS II Workshop reports in the form of sex, gender, and hormones; epidemiology; pathophysiology; tear film; pain and sensation; iatrogenic; and clinical trial design.

 The report was compiled in an effort to support evidence cited in the TFOS DEWS III Diagnostic Methodology and Management and Therapy reports, and included input from 80 experts in 18 countries, according to TFOS.

Study authors, led by Fiona Stapleton, PhD, MSc, of the School of Optometry and Vision Science, UNSW Sydney in NSW, Australia, outlined advancements in tear film research, a clarification of pathophysiological distinctions between aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE), and ocular pain perception, among others.

For sex, gender, and hormones, study authors focused on studies published after July 1, 2017, and cited significant sex-related differences in the lacrimal gland, meibomian gland, cornea, eye lid blinking, corneal thickness, sensitivity, re-epithelization, pain assessment, hormonal regulation of the ocular surface and adnexa, and dry eye disease (DED)-induced damage, among others.

“There have been significant research advances linking sex, hormones, and gender to DED. Aging, cancer, and hormone therapy increasingly broaden the interdisciplinarity in this field over time,” the report authors stated. “Despite the significant impact of gender-affirming hormone therapy on the entire endocrine system and its effects on physical and mental health, there is limited information on its impact on ocular health. Variations in age, health profile, gender-affirming hormone therapy [adherence], and barriers to accessing regular health care limit the documentation of [adverse] effects. Clinicians and future research should consider these variations, as recommended in a recent systematic review on the medical aspects of the transgender and gender diverse population.”

For epidemiology, DED was found to increase with age and was more common in women than men; signs and symptoms were more common in women with higher rates in younger and older adults. Some of the outstanding questions that remain from the research are issues concerning disease severity, geographic considerations, the generalizability of prevalence measures for DED in children and adults under 40 years of age, and a need for appropriately powered studies to determine risk factors in patients under 40. Researchers noted that a limited number of studies exist that explore the prevalence, risk factors, or natural history by disease severity.

Opportunities for future research concerning tear film were identified in the needed exploration of the relationship between disordered lipids that result in spreading and increased elasticity as compared to ordered lipids that lead to improved resistance to evaporation. Researchers also called for a more detailed understanding of whether tear biomarkers can be used to differentiate subtypes of DED and referenced the society’s recent Diagnostic Methodology report.

“Analyses of microbiome changes across individuals of different ethnicities and countries of residence may provide further insights into its potential role in DED pathogenesis or as a marker for the disease,” the study authors noted. “Understanding the potential role of different microRNAs in DED pathogenesis, DED subtype or as biomarkers could be a highly promising area for future investigation.”

Recommendations for DED management were also suggested by the study authors under iatrogenic, particularly regarding DED implicated in a variety of antiglaucoma topical drugs, preservatives and excipients, antibiotics, and hormone replacement therapy, among others.

“The first step is to investigate which medication is causing DED and try to stop its use. This subtraction can be challenging when discontinuing the treatment, which presents a risk to the eye's health,” the study authors noted. “Sometimes, multiple drugs and components are involved, or adverse effects appear long after treatment initiation, making identification of which is causing DED even more difficult.”

Stapleton F, Argüeso P, Asbell P, et al. TFOS DEWS III Digest Report. 

https://doi.org/10.1016/j.ajo.2025.05.040

TFOS dry eye workshop (DEWS) III: completed! Tear Film and Ocular Surface Society. News release. June 10, 2025. Accessed June 18, 2025. 

https://www.tearfilm.org/dettnews-tfos_dry_eye_workshop_dews_iii_completed/7450_16/eng/

The report categorizes research into 7 categories: sex, gender, and hormones; epidemiology; pathophysiology; tear film; pain and sensation; iatrogenic; and clinical trial design.

New TFOS DEWS III Digest Report highlights relevant research on management, treatment of DED

Nonprofit organization EyeCare4Kids has named Maggie Cline, MPH, its new CEO. Having been promoted to the position earlier this month, Cline initially joined the organization in 2022 and served as Executive Director Utah, where she oversaw the delivery of more than 50,000 vision services annually at school clinics, community centers, and other underserved areas in the state, according to a news release.

Cline succeeds Joseph Carbone, who founded the organization in 2001 and will transition to a role focused on international development.

“The mission of EyeCare4Kids is both professional and personal for me because I used to be one of those kids whose family faced challenges and anxiety navigating the complicated US health and education systems. That’s why I understand how important it is when 1 person or 1 organization offers a hand-up, potentially offering a life-changing impact with one act of kindness,” said Cline in the release. “I look forward to expanding the reach of EyeCare4Kids and thank Joseph Carbone for founding, growing, and leading the organization for so many years.”

As Executive Director Utah, Cline aided in increasing the patient volume at the Midvale clinic owned by EyeCare4Kids and supported the launch of a new clinic in Ogden. She also worked to expand the mobile outreach team and fostered partnerships with school districts, homeless shelters, refugee centers, and other organizations across the state.

In the transition, Carbone also has his own plans for expanding the organization’s reach in Africa. EyeCare4Kids has a goal of providing 1 million vision services to African children by 2030, and currently has a fully operational clinic in Kenya with plans to open another clinic in South Africa this year. Carbone will specifically work to create partnerships in Africa with different countries’ government departments, other NGOs that specialize in vision care, optometrists, clinics, lens manufacturers, universities, and schools. The goal is to develop a collaborative network to support children’s vision health across Africa and to build infrastructure to manufacture, cut, and fit lenses into frames.

“Over the past twenty years, I’ve seen how our work in Africa helps children to see better, do better in school, and set up opportunities to improve their quality of life. I’m very much looking forward to my next chapter when I can focus on building long-lasting relationships that extend the impact of EyeCare4Kids,” said Carbone in the release. “I also congratulate Maggie Cline on her well-deserved promotion. Her hard work, dedication, and resourcefulness, combined with her compassion, will serve EyeCare4Kids well in the future.”

EyeCare4Kids names Maggie Cline as new CEO. News release. EyeCare4Kids. June 4, 2025. Accessed June 17, 2025. 

https://eyecare4kids.org/2025/06/04/eyecare4kids-names-maggie-cline-as-new-ceo/

Maggie Cline, MPH, initially joined the organization in 2022 and served as Executive Director Utah.

Andrew Mick, OD, FAAO

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