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The solution was approved by the US Food and Drug Administration in late May 2025.

Alcon commercially launches Tryptyr (acoltremon ophthalmic solution) 0.003% for signs and symptoms of DED in the US

The new facility has opened just in time to see its first classes held in the fall semester.

NSU Oklahoma College of Optometry opens new facility 

Vizz (Lenz Therapeutics) is the first and only aceclidine-based eye drop for presbyopia and is also the first daily solution to correct vision for up to 10 hours.

FDA approved Lenz Therapeutics’ VIZZ for the treatment of presbyopia

In this podcast, Marjan Farid, MD; Beeran Meghpara, MD; and John Hovanesian, MD; review the role of neuromodulation in the pathogenesis of dry eye disease (DED). Additionally, the expert panel discusses a case study of a typical patient presenting with DED and reviews current and newly available treatment options. 

The Neural Network: Exploring The Role of Neuromodulation in Dry Eye Disease Management

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View patients as missed opportunity, not lost cause 

Biotechnology company Exonate has announced plans to initiate its phase 2b clinical trial for its lead candidate EXN407, a twice-daily topical formulation for treating nonproliferative diabetic retinopathy (NPDR) and diabetic macular edema (DME).

 The Clinical Evaluation of a New Drop for Alleviating Retinopathy in Diabetic Eye Disease (CLEAR-DE) trial will evaluate the clinical efficacy, optimal dosing, and safety profile of EXN407 in patients with NPDR, according to a news release.

“The phase 1b/2a data demonstrated the clear potential of EXN407 as a noninvasive treatment for diabetic eye disease,” said Catherine Beech, MB, ChB, OBE, CEO of Exonate, in the release. “This therapy could transform the treatment landscape for early-stage disease by providing clinical benefit while avoiding the burden of injections, representing a significant advancement for patients and physicians. We’re excited to progress to the CLEAR-DE phase 2b trial and are actively seeking strategic partners to support its execution.”

The phase 2b study follows the company’s phase 1b/2a study from March 2024, which resulted in EXN407 meeting its primary safety and tolerability end points, with no drug-related serious adverse events and high patient adherence. “Importantly, exploratory efficacy signals showed a reduction in vascular leakage, a key pathological driver in diabetic retinopathy,” the release stated. The phase 2b trial is planned to begin in early 2026, with 140 patients currently enrolled across several sites in Australia, China, and countries in the Middle East.

EXN407 is a first-in-class topical formulation of a selective SRPK1 inhibitor, providing a minimally invasive approach that can potentially become the first effective eye drop therapy for NPDR and DME. The formulation works by selectively inhibiting the proangiogenic isoforms that drive disease progression and cause abnormal and leaky blood vessel formation in the retina. EXN407 is designed to modulate the expression of vascular endothelial growth factor via alternative mRNA splicing, according to the company.

“[EXN407] has the potential to become the patient's treatment of choice in an area of high medical unmet need,” the company stated.

Exonate plans ‘CLEAR-DE’ phase 2b clinical trial of lead candidate EXN407 for diabetic eye disease. News release. Businesswire. July 29, 2025. Accessed July 29, 2025. 

https://www.businesswire.com/news/home/20250728228819/en/Exonate-plans-CLEAR-DE-Phase-IIb-clinical-trial-of-lead-candidate-EXN407-for-diabetic-eye-disease

Pipeline Overview. Exonate. Accessed July 29, 2025. 

The first-in-class, twice-daily topical formulation is intended for the treatment of nonproliferative diabetic retinopathy and diabetic macular edema. 

Exonate plans to initiate phase 2b CLEAR-DE trial for EXN407 topical formulation for NPDR

Optical retailer National Vision has awarded a total of $7000 in scholarships to 3 optometry students as part of the National Optometric Student Association (NOSA) scholarship program.

 Dominica Dzakah, Antoinette Kanayo, and Monica Thu Do were chosen from a pool of applicants who submitted essays and videos that answered a prompt regarding exploring the link between vision health and success in school and the workplace, particularly in underserved communities, according to a news release.

“These students exemplify what it means to lead with both clinical skill and compassion,” said Alexander Smith, OD, head of Doctor Network at National Vision, in the release. “Their ideas reflect the real-world challenges people face when vision care is out of reach, and the incredible potential optometrists have to bridge that gap.”

Dzakah, of Pennsylvania College of Optometry’s Class of 2025, took first place with a scholarship of $4000; Kanayo, of University of Houston College of Optometry’s Class of 2027, took second place with $2000; and Thu Do, of UC Berkeley Herbert Wertheim School of Optometry & Vision Science’s Class of 2027, took third place with $1000. The winners were awarded their scholarships during this year’s National Optometric Association (NOA) Convention, held July 17 to 20 in Columbus, Ohio.

“This scholarship is about more than financial support — it’s about investing in future doctors who are already stepping up to make a difference,” Smith added in the release. “We can’t wait to see what these students accomplish next.”

National Vision launched the scholarship in 2015 and works to honor NOSA members for their academic excellence, community involvement, and dedication to serving minority and underserved populations.

National Vision has segmented its corporate responsibility into social, employees, environment, and governance pillars in its SEE+G framework. National Vision also publishes an Impact Report that focuses on the company’s philanthropic efforts and sustainability assessments to identify areas of focus and opportunities each year. The company is focused on expanding its remote care initiative to improve access to care for underserved areas, supporting the next generation of optometrists by donating to optometry schools, beginning waste and energy audits of the company’s lab and distribution facilities, and maturing the supply chain risk management. Since 2016, National Vision has donated over $1.5 million to optometry schools.

As part of its social impact initiatives in 2022, the company joined VisionSpring on a trip to Ghana to assess the vision crisis in the country. Following the trip, National Vision donated $100,000 to VisionSpring’s Livelihoods in Focus initiative, which provides eye care and eye wear to low-income workers. The program intends to correct the vision of more than 6 million people by 2030.

National Vision celebrates 11 years of supporting NOSA students with $7000 in scholarships. News release. Businesswire. July 29, 2025. Accessed July 29, 2025. 

https://www.businesswire.com/news/home/20250729262639/en/National-Vision-Celebrates-11-Years-of-Supporting-NOSA-Students-with-%247000-in-Scholarships

We’re on a mission to make a difference in the world. National Vision. Accessed July 29, 2025. 

https://www.nationalvision.com/corporate-responsibility/

A total of $7000 in scholarships was awarded to 3 optometry students as part of the National Optometric Student Association (NOSA) scholarship program.

National Vision awards scholarships to optometric students during NOA Convention 2025

Recent results from a phase 3 study assessing LUMIFY Preservative Free redness reliever eye drops (preservative-free brimonidine tartrate ophthalmic solution 0.025%, Bausch + Lomb) in comparison with LUMIFY redness reliever eye drops demonstrated that the preservative-free drops are statistically noninferior to LUMIFY in reducing ocular redness in adults. The results from the randomized, active-controlled, multicenter study were published in 

The primary objective of the study was to demonstrate that LUMIFY Preservative Free is noninferior to LUMIFY in reducing ocular redness. The primary efficacy end point was an investigator-assessed ocular redness score 8 timepoints from 5 minutes to 240 minutes after drop administration on day 1. Finally, the secondary objective was the compare the safety of both drops.

“Since launching in 2018, LUMIFY has been the No. 1 doctor-recommended redness reliever brand, known for delivering noticeable results in 1 minute and lasting up to 8 hours,”

 said John Ferris, president of consumer at Bausch + Lomb, in a news release from the company. “This study demonstrates that our new LUMIFY Preservative Free eye drops reduce redness quickly and are just as safe and effective as the original LUMIFY, providing a needed option for patients with eye sensitivities.”

The study included 380 participants with ocular redness, who were given either LUMIFY Preservative Free or LUMIFY in a single drop 4 times daily for 4 weeks. Study results show that the primary objective was met, with day 1 analysis of all 11 time points (1 minute to 480 minutes post administration) supporting these findings. Additional secondary efficacy end point data from 1 minute, 360 minutes, and 480 minutes post administration demonstrated that the LUMIFY Preservative Free drops perform similarly to the LUMIFY drops.

“At visit 1, there was no significant difference between treatment groups in the number of participants achieving total clearance at any time of the 11 timepoints from 1 to 480 minutes post instillation, 2 participants from each treatment group had total clearance of ocular redness,” the study authors, led by Melissa Toyos, MD, partner at Toyos Clinic in Nashville, Tennessee, stated. “While not statistically significant, the percentage of patients with total clearance of ocular redness was numerically greater for the [LUMIFY Preservative Free, or] BTOS-PF 0.025% group than for the LUMIFY 0.025% group at the majority of timepoints from visit 1 to visit 3.”

The overall safety profile of the preservative-free drops was also favorable and comparable to LUMIFY, with a low incidence of adverse effects recorded when used as directed. These adverse effects could include rebound redness and loss of efficacy over time.

 Rates of ocular rebound redness were reported in 1.8% in the preservative-free group and 0.6% in the LUMIFY group. Adherence was reported to be high in the treatment groups, with preservative-free at 96.8% and LUMIFY at 97.9%.

“The results show that LUMIFY Preservative Free is a well-tolerated alternative option for consumers with ocular redness who have sensitivities to preservatives or are at increased risk of ocular surface disease,” said Toyos in the release.

For the preservative free and LUMIFY groups, the drops were defined by participants as “comfortable” by 50% and 51.1% of the group respectively, “refreshing” by 20.2% and 20% respectively, and “cool” by 14.4% and 11.6% respectively.

Study authors noted that limitations of the study included the absence of statistical inference possible for all secondary outcomes due to preplanned hierarchical analysis. “Although similar proportions of participants in the BTOS-PF 0.025% and LUMIFY 0.025% groups had dry eye at baseline, impact of baseline dry eye severity and lubricating drop use on redness response and/or tolerability assessments cannot be discounted,” the authors stated. They noted that investigating the short-term effects and longer-term outcomes, including additional assessment visits after discontinuing treatment beyond the 7-day mark, could be avenues for future studies.

Bausch + Lomb announces publication of phase 3 data on LUMIFY Preservative Free redness reliever eye drops. News release. Bausch + Lomb. July 29, 2025. Accessed July 29, 2025. 

https://www.bausch.com/newsroom/news/?id=277

Toyos M, DiVito M, Messmer EM, et al. A multicenter randomized double-masked study comparing preservative-free brimonidine tartrate ophthalmic solution 0.025% with LUMIFY 0.025% for ocular redness in adults. 

2025. https://doi.org/10.1007/s40123-025-01194-z

The study's primary objective was to demonstrate that LUMIFY Preservative Free redness reliever eye drops are noninferior to LUMIFY redness reliever eye drops in reducing ocular redness. 

Phase 3 study assessing LUMIFY Preservative Free and LUMIFY eye drops meets primary end point

 caught my attention with the provocative title

Impact of bodyweight loss on type 2 diabetes remission: a systematic review and meta-regression analysis of randomised controlled trials.” The authors define “complete remission of diabetes” as a glycated hemoglobin level (HbA

) less than6.0% and/or a fasting glucose level less than100 mg/dL with no use of glucose-lowering drugs at one year after weight loss. They define “partial remission” as HbA

less than6.5% and/or fasting glucose less than126 mg/dL with no glucose-lowering drugs, again one year after initial weight loss.

After evaluating 2847 eligible subjects in 22 randomized controlled trials for diabetes remission as a function of weight loss from baseline, the authors found that, on average across all trials, subjects with less than 10% of body weight loss achieved total remission (TR) and partial remission (PR) rates of 0.7% and 5.4%, respectively. For subjects with a 10% to 19% weight loss, PR rates were 48.4% (no studies analyzed considered TR for this range of weight loss). TR and PR rates were 49.6% and 69.3%, respectively, for a 20% to 29% weight loss and 79.1% and 81.5% for subjects losing more than 30% of their baseline body weight. Of note, every one percentage point decrease in body weight increased the probability of TR by 2.17% and the probability of PR by 2.74%; these effects were not impacted by age, gender, race, diabetes duration, baseline body mass index (BMI), HbA

level, insulin use, or type of weight loss intervention (eg, pharmacotherapy, caloric restriction, bariatric surgery or a combination of interventions).The most interesting finding is the exponentially increased success of weight loss for purposes of diabetes remission with the degree of weight loss achieved, with a threshold weight loss greater than10% required for meaningful population levels of remission, signaling “a robust dose-response relationship between bodyweight loss and diabetes remission.”

Remission of diabetes should be of considerable interest to all health care providers, including optometrists, because studies show that even brief periods of remission (ie, 6 months) significantly reduce the risk of vascular diabetes complications by 11% to 35%, including major adverse cardiovascular events (eg, stroke, heart attack, congestive heart failure and cardiovascular death) as well as incidence of diabetic retinopathy (DR) and nephropathy.

 Though some studies have shown that sudden reductions in mean blood glucose levels may exacerbate preexisting retinopathy (eg, with bariatric surgery, initiation of insulin therapy or potent glucagon-like peptide [GLP-1] receptor agonist drugs such as semaglutide),

 this phenomenon, sometimes referred to as diabetic reentry retinopathy or early worsening phenomenon, is typically short-lived, and the long-term benefits of primary DR prevention via diabetes remission will almost certainly yield a massive public health benefit if remission can be sustained.

All this begs the question: How realistic is achieving diabetes remission with currently available weight loss strategies? Specifically, can sufficient weight loss be achieved to induce meaningful population-level reductions in overweight and obesity and thus type 2 diabetes prevalence? Bariatric surgery results in a greater than 10% weight loss in virtually all patients, with mean body weight reductions of 15% to 30%, depending on baseline patient characteristics and the specific procedure chosen. However, it does carry surgical risk as well as increased risk of nutrient malabsorption.

Bariatric surgery is typically covered by insurance for type 2 diabetes only when the BMI is above 35 kg/m

 Nonetheless, roughly 60% to 70% of patients with obesity with type 2 diabetes mellitus (T2DM) experience remission after 5 years, including those with a BMI less than 35 kg/m

GLP-1 or dual GLP/glucose-dependent insulinotropic polypeptide (GIP) therapies typically result in 5% to 10% reductions in body weight, depending on the specific drug, but a majority of patients regain weight after drug cessation.

 The most effective currently available medication is tirzepatide (marketed as Mounjaro for type 2 diabetes and as Zepbound for overweight/obesity; Eli Lilly). Three-year data from the SURMOUNT-1 trial (

) of 2359 subjects with obesity (40% with prediabetes) showed 12.3%, 18.7%, and 19.7% reductions in body weight with weekly tirzepatide injections of 5 mg, 10 mg, and 15 mg, respectively, compared with a 1.3% mean weight loss in the placebo group.

Pooled analysis showed that tirzepatide increases the likelihood of type 2 diabetes remission (defined as HbA

less than 5.7%) by 16-fold, though there is no evidence that remission is extended without ongoing drug therapy.

GLP-1 therapy is relatively expensive and has been linked to both worsening DR (especially in patients using insulin) and increased risk of non-arteritic anterior ischemic optic neuropathy, particularly with large, rapid reductions in mean blood glucose

; GLP-1s also are associated with excess muscle loss (sarcopenia). One analysis found a 30% or more loss of muscle fiber volume with semaglutide.

 Recently, the SURMOUNT-3 MRI substudy found that tirzepatide did not cause excess sarcopenia compared with that seen with conventional weight loss strategies, such as diet, exercise, and/or bariatric procedures.

What about fasting regimens? Meta-analysis comparing alternate daily fasting (ADF), 5:2 fasting (no food intake 2 days/week with a typical diet 5 days/week), caloric restriction (typically less than 750 kcal/day), and time-restricted eating (usually a “feeding window” of 8 hours) shows that each of these typically results in a 5% to 12% weight loss, with most data favoring ADF to achieve a more than 10% weight loss.

 A Chinese study of the 5:2 diet in T2DM showed superior reductions in weight loss (4 kg or 8.2 lb difference) and HbA

level (- 0.3% to 0.4% difference) compared with metformin or empagliflozin over 16 weeks, but did not report on diabetes remission.

Meaningful population-wide remission of type 2 diabetes appears to exponentially correlate with the degree of weight loss, with a 15% reduction in body weight required to achieve one-year partial or total remission rates approaching 50%. Various strategies are available to achieve this end, with bariatric surgery being most effective, followed by potent GLP-1/GIP therapy, followed by caloric restriction/intermittent fasting, based on my review of available evidence. Primary prevention with a focus on environmental contributors to diabetes

 (eg, food insecurity, taxation policies that discourage consumption of sugar-laden foodstuffs, particulate air pollution, neighborhood walkability, etc) is ideal, but awareness of and education about remission strategies to help patients currently living with type 2 diabetes are within our reach.

Kanbour S, Ageeb RA, Malik RA, Abu-Raddad LJ. Impact of bodyweight loss on type 2 diabetes remission: a systematic review and meta-regression analysis of randomised controlled trials. 

. 2025;13(4):294-306. doi:10.1016/S2213-8587(24)00346-2

Dambha-Miller H, Hounkpatin HO, Stuart B, Farmer A, Griffin S. Type 2 diabetes remission trajectories and variation in risk of diabetes complications: a population-based cohort study. 

. 2023;18(8):e0290791. doi:10.1371/journal.pone.0290791

Bain SC, Klufas MA, Ho A, Matthews DR. Worsening of diabetic retinopathy with rapid improvement in systemic glucose control: a review. 

. 2019;21(3):454-466. doi:10.1111/dom.13538

Lupoli R, Lembo E, Saldalamacchia G, Avola CK, Angrisani L, Capaldo B. Bariatric surgery and long-term nutritional issues. 

. 2017;8(11):464-474. doi:10.4239/wjd.v8.i11.464

Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery. 

. 2023;33(1):3-14. doi:10.1016/j.soard.2022.08.013

Zhou X, Zeng C. Diabetes remission of bariatric surgery and nonsurgical treatments in type 2 diabetes patients who failure to meet the criteria for surgery: a systematic review and meta-analysis. 

 2023;23(1):46. doi:10.1186/s12902-023-01283-9

Wilding JPH, Batterham RL, Davies M, et al; STEP 1 Study Group. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. 

. 2022;24(8):1553-1564. doi:10.1111/dom.14725

Jastreboff AM, le Roux CW, Stefanski A, et al; 

. Tirzepatide for obesity treatment and diabetes prevention. 

. 2025;392(10):958-971. doi:10.1056/NEJMoa2410819

Fujihara K, Matsubayashi Y, Kitazawa M, et al. Achieving normoglycaemia with tirzepatide: post hoc exploratory analysis of the SURPASS J-mono and J-combo studies. 

. 2024;26(11):5304-5311. doi:10.1111/dom.15887

Vilsbøll T, Bain SC, Leiter LA, et al. Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy. 

. 2018;20(4):889-897.doi:10.1111/dom.13172

Amini A, Hamann S, Larsen M. Semaglutide and non-arteritic anterior ischaemic optic neuropathy: review and interpretation of reported association

. Published online March 8, 2025. doi:10.1111/aos.17473

Neeland IJ, Linge J, Birkenfeld AL. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. 

. 2024;26(suppl 4):16-27. doi:10.1111/dom.15728

Sattar N, Neeland IJ, Dahlqvist Leinhard O, et al. Tirzepatide and muscle composition changes in people with type 2 diabetes (SURPASS-3 MRI): a post-hoc analysis of a randomised, open-label, parallel-group, phase 3 trial. 

. 2025;13(6):482-493. doi:10.1016/S2213-8587(25)00027-0

Elortegui Pascual P, Rolands MR, Eldridge AL, et al. A meta-analysis comparing the effectiveness of alternate day fasting, the 5:2 diet, and time-restricted eating for weight loss. 

 2023;31(suppl 1):9-21. doi:10.1002/oby.23568

Guo L, Xi Y, Jin W, et al. A 5:2 intermittent fasting meal replacement diet and glycemic control for adults with diabetes: the EARLY randomized clinical trial. 

 2024;7(6):e2416786. doi:10.1001/jamanetworkopen.2024.16786

Chous AP. 5 diabetes truisms that are (at least partially) false. 

 March 25, 2022. Accessed May 20, 2025. https://www.optometrytimes.com/view/5-diabetes-truisms-that-are-at-least-partially-false

What we should be telling our patients about the remission of type 2 diabetes with weight loss.

How much is enough? Seeking remission from type 2 diabetes

indicate that collagen mimetic peptides (CMPs) applied topically to the ocular surface have therapeutic potential for treating ophthalmic diseases by reducing tissue stiffness and integrity caused by ocular stress such as that occurring in myopia. The CMPs bind to and repair disease- and trauma-damaged collagen, according to a press release issued by Stuart Therapeutics Inc.

The company’s PolyCol platform of CMPs is described as synthesized therapeutic polypeptides that target and heal specific areas of collagen damage that are implicated in chronic diseases of the eye. In addition to myopia, the platform also may address dry eye disease, glaucoma, diabetic retinopathy, and recurrent corneal erosion.

The study investigators, led by first author Lauren Wareham, PhD, a research assistant professor at Vanderbilt Eye Institute, Department of Ophthalmology and Visual Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, explained that several chronic ophthalmic diseases cause the cellular release of matrix metalloproteinases (MMPs), enzymes that degrade and remodel collagen proteins.

The effect of MMPs on helical structures decreases their activity as signaling proteins, leading to a cycle of inflammation and further damage. Healthy collagen structures are required for full and healthy recovery of the affected tissues, they explained.

In this study, the researchers measured how stress induced by elevations in intraocular pressure impacts stiffness of the peripapillary sclera and glial lamina in the rat eye and how this was counteracted by topical treatment of a reparative mimetic of type I collagen.

The results showed that with 4 weeks of elevated intraocular pressure, there was a decrease in scleral stiffness that corresponded to an increase in fragmented, or damaged, collagen. During the same period, the application of CMPs to the ocular surface had a concurrently restorative effect on both scleral stiffness and collagen structure.

David Calkins, PhD, vice president for research at Vanderbilt University Medical Center and lead investigator of the study, commented, “Stress-induced reduction in tissue stiffness and collagen damage occur and facilitate disease progression in many conditions that involve the peripapillary sclera, including myopia. While more research is needed, our results suggest that CMPs, when applied to the ocular surface, could promote the restoration of tissue stiffness and integrity challenged by degraded or remodeled collagen, thus helping the eye maintain its ability to respond to disease-related ocular stress.”

The researchers concluded, “We have demonstrated the potential of CMPs to repair intraocular pressure-induced decreases in tissue stiffness, presumably due to fragmented collagen. Since collagen damage in the eye may be evident early in conditions such as myopia and glaucoma, the use of CMPs to repair collagen damaged by tissue strain or stress may be an effective preventive or restorative intervention.”

They believe that the implications of treatment with CMPs to restore scleral stiffness are significant, considering the high percentages of individuals worldwide who are myopic. (Patients with high myopia, defined as -6.0 diopters and higher, are more likely to have retinal detachments, macular degeneration, glaucoma, and other ocular health problems. “A well-tolerated and effective therapeutic for myopia would provide welcome relief to a very large population,” they said.

Wareham LK, Ghanem GOB, Clark KL, Schlumpf E, Del Buono BJ, Calkins DJ. Topical application of a collagen mimetic peptide restores peripapillary scleral stiffness reduced by ocular stress. 

New research reveals collagen mimetic peptides may effectively restore ocular tissue stiffness, offering hope for myopia and other eye diseases.

Crystal Brimer, OD, FAAO

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