Prescription and Advanced Treatment Categories

The chart below groups the most common prescription and advanced options by how they work. Brand names are listed only as examples within each category, not as recommendations. Your eye doctor may discuss one or more of these depending on what is driving your dry eye.

Anti-Evaporative Treatment

Many people with dry eye lose their tears too quickly to evaporation, often linked to meibomian gland dysfunction. MIEBO (perfluorohexyloctane) is a water-free, preservative-free prescription drop that forms a thin layer on the surface of the eye to slow that evaporation. It is taken as one drop in each eye four times a day, and it is something an eye doctor may discuss if evaporation is a major driver of your symptoms.

MIEBO was the first FDA-approved dry eye treatment that works by directly targeting tear evaporation, and its label calls for one drop four times daily. Source: U.S. FDA prescribing information for MIEBO (perfluorohexyloctane ophthalmic solution).

Immunomodulators

Chronic dry eye often involves inflammation on the surface of the eye. Immunomodulator drops work to calm that inflammation and support healthier tear production over weeks of regular use, so they are taken as an ongoing therapy rather than for instant relief. Examples your eye doctor may discuss include Restasis (cyclosporine 0.05%), Cequa (cyclosporine 0.09%), and Vevye (cyclosporine 0.1% in a water-free vehicle), which are calcineurin-inhibitor cyclosporine drops, and Xiidra (lifitegrast 5%), which works on a different inflammatory pathway. These are used under medical supervision, and they commonly take several weeks to show their full effect.

Vevye (cyclosporine 0.1%) is FDA-approved for the signs and symptoms of dry eye disease and is dosed twice daily, while Xiidra (lifitegrast) is also FDA-approved for the signs and symptoms of dry eye disease. Source: U.S. FDA prescribing information for VEVYE and XIIDRA.

Short-Term Anti-Inflammatory Options

When dry eye flares, a doctor may prescribe a short course of a steroid to settle the inflammation quickly. EYSUVIS (loteprednol etabonate 0.25%) is a corticosteroid approved specifically for short-term use, and other ophthalmic steroids such as Lotemax (loteprednol etabonate) may be used under a doctor's supervision. Because steroids can raise eye pressure and carry other risks, they are kept brief and monitored. Separately, doctors sometimes prescribe antibiotics like doxycycline or azithromycin for their anti-inflammatory effect in meibomian gland dysfunction, blepharitis, or ocular rosacea. All of these are physician-directed.

EYSUVIS is approved for the short-term treatment, up to two weeks, of the signs and symptoms of dry eye disease, which is why steroid courses are kept brief. Professional guidance also notes that topical or oral antibiotics, with or without a steroid, can play a role in treating blepharitis. Sources: U.S. FDA prescribing information for EYSUVIS; American Academy of Ophthalmology Blepharitis Preferred Practice Pattern.

Neuromodulators and Tear Stimulators

A newer approach prompts the body to make more of its own tears rather than adding moisture from a bottle. TYRVAYA (varenicline solution) is a nasal spray that activates a nerve pathway reached through the nose to increase natural tear production, used as one spray in each nostril twice daily. TRYPTYR (acoltremon) is an eye drop that stimulates nerve endings on the surface of the cornea to do something similar. Both are options an eye doctor may discuss, particularly for people who struggle with drops or want to support their own tear production.

TRYPTYR (acoltremon) was approved by the FDA in 2025 as a first-in-class TRPM8 receptor agonist that stimulates corneal nerves to increase natural tear production, and TYRVAYA (varenicline), approved in 2021, works through the trigeminal nerve pathway accessed through the nose. Both are indicated for the signs and symptoms of dry eye disease. Source: U.S. FDA prescribing information and manufacturer approval announcements.

Treatment for Demodex Blepharitis

Some eyelid irritation and dry eye symptoms are driven by Demodex mites along the lash line, a condition called Demodex blepharitis. XDEMVY (lotilaner 0.25%) is a prescription drop that targets those mites, used as one drop in each eye twice daily for six weeks. Good daily lid hygiene, including tea tree and hypochlorous acid cleansers, is often part of managing and maintaining lid health, and your eye doctor can confirm whether mites are part of the picture.

XDEMVY (lotilaner) was the first FDA-approved treatment to directly target the Demodex mites that cause Demodex blepharitis. Source: U.S. FDA prescribing information for XDEMVY.

Biologic Drops: Serum Tears and PRP

For severe or stubborn ocular surface disease, a doctor may consider drops made from a patient's own blood. Autologous serum tears and platelet-rich plasma (PRP) drops are prepared by specialty pharmacies and contain natural growth factors that support healing of the ocular surface. These are advanced, physician-directed therapies rather than products you can buy, and they are typically reserved for cases that have not responded to standard treatment.

Blood-derivative products such as autologous serum and platelet-rich plasma are used in ophthalmology for ocular surface disease, prepared and overseen by clinicians rather than sold over the counter. Source: American Academy of Ophthalmology EyeWiki, Blood Derivatives in Ophthalmology.

Neurotrophic Keratitis Therapy

Neurotrophic keratitis is a distinct and serious condition in which the cornea loses its nerve supply and protective sensation. It is not the same as ordinary dry eye, though it can look similar at first. OXERVATE (cenegermin) is a lab-made form of human nerve growth factor, given as an eye drop, that supports corneal nerve healing. It is diagnosed and managed by an eye doctor, and it is included here so you know advanced options exist when a routine dry eye plan is not the right fit.

OXERVATE (cenegermin) is a recombinant human nerve growth factor and was the first topical biologic approved in eye care, indicated for neurotrophic keratitis rather than ordinary dry eye. Source: U.S. FDA prescribing information for OXERVATE.

When Over-the-Counter Care May Still Help

A prescription rarely works alone. Supportive over-the-counter routines often stay part of the plan to keep the eyes comfortable, protect the ocular surface, and support the glands. Your eye doctor can tell you which of these fit alongside your prescription.

Important Disclaimer

This page is educational and does not replace medical advice from your eye care professional or healthcare provider. It does not recommend any specific prescription medication. Dry Eye Rescue does not sell, dispense, or prescribe prescription treatments. Prescription decisions, including starting, stopping, or changing any medication, should be made only with a licensed eye doctor after an examination. Drug names and descriptions reflect FDA-approved labeling at the time of writing and may change; always refer to current prescribing information and your doctor's guidance. MIEBO, RESTASIS, CEQUA, VEVYE, XIIDRA, EYSUVIS, LOTEMAX, TYRVAYA, TRYPTYR, XDEMVY, OXERVATE, and other brand names referenced are trademarks of their respective owners.

Frequently Asked Questions