The Role of TRPM8 Agonists in Dry Eye Disease

In this segment, the expert faculty explore the mechanism and clinical role of Acoltremon, a newly available dry eye therapy that targets sensory innervation to stimulate basal tear production. The panel highlights that Acoltremon is the first agent of its class and functions by activating TRPM8 receptors—cold-sensing nerve endings on the ocular surface responsible for detecting evaporative cooling with each blink. By stimulating these receptors, the medication triggers the lacrimal functional unit to produce a sustained increase in natural basal tears, rather than reflex tearing.

The experts emphasize that this represents a novel therapeutic avenue distinct from anti-inflammatory or evaporative control treatments. They note that patients often appreciate both the innovation and the mechanism, especially when clinicians explain the expected cooling sensation upon instillation. The panel also discusses how setting expectations improves adherence and how patients who previously struggled with other therapies often respond positively to this new mode of action.