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INFLAMMATION IS A
KEY DRIVER OF DRY EYE4
Stress to the ocular surface can cause an overexpression of inflammatory mediators, like ICAM-1. ICAM-1 binds to LFA-1, a cell surface protein found on T cells5,6
This interaction can lead to activation of T cells at multiple sites, migration of T cells to the ocular surface, and release of proinflammatory cytokines, triggering a vicious cycle of inflammation, which can lead to chronic tissue damage3,5,6
Up to 65% of patients with dry eye disease may have clinically significant ocular surface inflammation7
COMMON SYMPTOMS2,8
Patients living with dry eye disease may experience the following:
Redness
Burning
Irritation
Ocular pain
Visual
fluctuation
Foreign-body sensation
Symptoms such as ocular discomfort and signs such as conjunctival hyperemia, corneal and conjunctival staining, tear hyperosmolarity, and a positive MMP-9 test may indicate the presence of ocular surface inflammation3,9
RISK FACTORS9
- Autoimmune conditions (eg, Sjögren’s syndrome and rheumatoid arthritis)
- Environmental factors (eg, low humidity and high winds)
- Lifestyle factors (eg, wearing contact lenses or prolonged device time)
- Aging (eg, individuals over 50 are at greater risk)
- Medications (eg, antihistamines, hormone replacements)
- Ophthalmic surgery (eg, laser vision correction and cataract procedures)
Symptoms and risk factors of dry eye disease are not limited to those listed above.
Identifying Inflammation
The following scenarios include 3 hypothetical patients living with dry eye inflammation.
See how they may compare to patients in your practice
MEET SUZY
Age 58CURRENT SYMPTOMS
- Burning and itchy eyes
- Foreign body sensation
- Ocular pain
MEET SUZY • Age 58
Avid artist and piano player
- Diagnosis: Previously diagnosed with dry eye disease and signs of inflammation
- Medical History: Hashimoto’s disease, postmenopausal
- Current/Prior Treatments: Three brands of artificial tears cycled continuously
MEET SUZY • Age 58
MEET jules
Age 71CURRENT SYMPTOMS
- Eye dryness
- Diffuse redness
- Ocular pain
MEET jules • Age 71
Retired nature lover
- Diagnosis: Dry eye disease with clinically significant ocular surface inflammation
- Medical History: Postmenopausal, systemic hypertension, ocular hypertension
- Current/Prior Treatments: Brimonidine, warm compresses, artificial tears
MEET jules • Age 71
MEET BRIAN
Age 64CURRENT SYMPTOMS
- Conjunctival hyperemia
- Vision disturbances
- Burning and itchy eyes
MEET BRIAN • Age 64
Carpenter and bookworm
- Diagnosis: Dry eye disease due to Sjögren’s syndrome with a high risk of inflammation
- Medical History: Primary Sjögren’s syndrome
- Current/Prior Treatments: Topical cyclosporine 0.05% cycled multiple times, artificial tears
MEET BRIAN • Age 64
Not actual patients.
MEET SUZY
Age 58Avid artist and piano player
CURRENT SYMPTOMS
- Burning and itchy eyes
- Foreign body sensation
- Ocular pain
Diagnosis
Previously diagnosed with dry eye disease and signs of inflammation
Medical History
Hashimoto’s disease, postmenopausal
Current/Prior Treatments
Three brands of artificial tears cycled continuously
Not an actual patient.
AGE 58
MEET JULES
Age 71Retired nature lover
CURRENT SYMPTOMS
- Eye dryness
- Diffuse redness
- Ocular pain
Diagnosis
Dry eye disease with clinically significant ocular surface inflammation
Medical History
Postmenopausal, systemic hypertension, ocular hypertension
Current/Prior Treatments
Brimonidine, warm compresses, artificial tears
Not an actual patient.
AGE 71
MEET Brian
Age 64Carpenter and bookworm
CURRENT SYMPTOMS
- Conjunctival hyperemia
- Vision disturbances
- Burning and itchy eyes
Diagnosis
Dry eye disease due to Sjögren’s syndrome with a high risk of inflammation
Medical History
Primary Sjögren’s syndrome
Current/Prior Treatments
Topical cyclosporine 0.05% cycled multiple times, artificial tears
Not an actual patient.
AGE 64
How Xiidra Works
Xiidra addresses T cells differently to defend against dry eye inflammation6
ICAM-1, intercellular adhesion molecule 1; LFA-1, lymphocyte function-associated antigen 1; MMP-9, matrix metalloproteinase-9.
The exact mechanism of action of Xiidra in dry eye disease is not known.
Indication and important safety information
Indication
Xiidra® (lifitegrast ophthalmic solution) 5% is indicated for the treatment of signs and symptoms of dry eye disease (DED).
Important Safety Information
- Xiidra is contraindicated in patients with known hypersensitivity to lifitegrast or to any of the other ingredients.
- In clinical trials, the most common adverse reactions reported in 5-25% of patients were instillation site irritation, dysgeusia and reduced visual acuity. Other adverse reactions reported in 1% to 5% of the patients were blurred vision, conjunctival hyperemia, eye irritation, headache, increased lacrimation, eye discharge, eye discomfort, eye pruritus and sinusitis.
- To avoid the potential for eye injury or contamination of the solution, patients should not touch the tip of the single-use container to their eye or to any surface.
- Contact lenses should be removed prior to the administration of Xiidra and may be reinserted 15 minutes following administration.
- Safety and efficacy in pediatric patients below the age of 17 years have not been established.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Click here for full Prescribing Information for Xiidra.
References
- Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II definition and classification report. Ocul Surf. 2017;15(3):276-283. doi:10.1016/j.jtos.2017.05.008
- American Academy of Ophthalmology. Dry Eye Syndrome Preferred Practice Pattern®. Accessed April 14, 2025. https://www.aaojournal.org/action/showPdf?pii=S0161-6420(18)32650-2
- Data on file. Bausch & Lomb Inc.
- Bron AJ, de Paiva CS, Chauhan SK, et al. TFOS DEWS II pathophysiology report. Ocul Surf. 2017;15(3):438-510. doi:10.1016/j.jtos.2017.05.011
- Pflugfelder SC, Stern M, Zhang S, Shojaei A. LFA-1/ICAM-1 interaction as a therapeutic target in dry eye disease. J Ocul Pharmacol Ther. 2017;33(1):5-12. doi:10.1089/jop.2016.0105
- Donnenfeld ED, Perry HD, Nattis AS, Rosenberg ED. Lifitegrast for the treatment of dry eye disease in adults. Expert Opin Pharmacother. 2017;18(14):1517-1524. doi:10.1080/14656566.2017.1372748
- Sambursky R. Presence or absence of ocular surface inflammation directs clinical and therapeutic management of dry eye. Clin Ophthalmol. 2016;10:2337-2343. doi:10.2147/OPTH.S121256
- Sullivan DA, Rocha EM, Aragona P, et al. TFOS DEWS II sex, gender, and hormones report. Ocul Surf. 2017;15(3):284-333. doi:10.1016/j.jtos.2017.04.001
- Market Scope. 2023 Dry Eye Products Market Report: Global Analysis for 2022 to 2028. Market Scope®, LLC; 2023. Accessed April 14, 2025. https://www.market-scope.com/pages/reports/411/2023-dry-eye-products-market-report-global-analysis-for-2022-to-2028-november-2023
Indication and important safety information
Indication
Xiidra® (lifitegrast ophthalmic solution) 5% is indicated for the treatment of signs and symptoms of dry eye disease (DED).
Important Safety Information
- Xiidra is contraindicated in patients with known hypersensitivity to lifitegrast or to any of the other ingredients.
- In clinical trials, the most common adverse reactions reported in 5-25% of patients were instillation site irritation, dysgeusia and reduced visual acuity. Other adverse reactions reported in 1% to 5% of the patients were blurred vision, conjunctival hyperemia, eye irritation, headache, increased lacrimation, eye discharge, eye discomfort, eye pruritus and sinusitis.