EnVision 2026: Emerging treatments and the pipeline for dry eye disease

At the 2026 EnVision Summit, Optometry Times spoke with Rahul S. Tonk, MD, MBA, a cornea, cataract, and refractive surgeon at Princeton Eye Group and Wills Eye Hospital, who provided a forward-looking overview of the rapidly evolving ocular surface landscape. One of the sessions he presented in emphasized how dry eye disease (DED) is increasingly understood as a spectrum disorder, a concept reinforced by the updated TFOS DEWS III report released late last year. Tonk highlighted the importance of improved screening and diagnostic strategies, specifically encouraging clinicians to incorporate the OSD-6 questionnaire into routine practice as a streamlined way to identify symptomatic patients earlier and more consistently.

Tonk also reviewed several recently available therapies reshaping treatment paradigms. He discussed the utility of a TRPM8 receptor agonist designed to stimulate basal tear secretion while providing a cooling sensation that may benefit patients with neuropathic ocular pain features. He additionally highlighted perfluorohexyloctane as an “evaporation shield” therapy that can be layered with topical anti-inflammatory and immunomodulatory agents, reflecting a more mechanism-based, combination approach to care.

Looking ahead, Tonk expressed enthusiasm about reproxalap, a RASP inhibitor anticipated to enter the commercial market pending regulatory clearance. He noted its potential to act upstream of traditional anti-inflammatory agents, possibly offering more rapid symptomatic relief. Finally, he pointed to advancements in quality-controlled autologous serum tears, including room-temperature–stable formulations, as a meaningful innovation for patients with advanced disease. Collectively, Tonk’s remarks underscored a treatment pipeline that is expanding in both mechanistic diversity and clinical practicality.