MILAN — Applying a compounded testosterone cream on the eyelids offers patients long-lasting relief from dry eye symptoms, according to one speaker.
At the OSN Italy meeting, Brian S. Boxer Wachler, MD, encouraged his colleagues to “keep an open mind” and try this simple solution for the benefit of their patients.
Meibomian gland dysfunction (MGD) is the most common cause of dry eye, present in about one-third of adults over 40 years of age. Correlation with testosterone deficiency was proved 17 years ago by David Sullivan, PhD, who published 24 papers on this topic, Boxer Wachler said.
“Once the diagnosis of MGD is confirmed, which can be done by simply pressing on the eyelids to squeeze out gland secretions, I treat my patients in two steps,” he said. “First, I clean out the meibomian glands with LipiFlow (TearScience). It is a 12-minute procedure, extremely safe and effective. Then, I prescribe a 10% testosterone cream from the pharmacy to apply on the eyelids every night at bedtime or twice a day for advanced cases.”
This treatment may require about a month to show improvements, but it is effective, according to Boxer Wachler.
“I have used it for over 11 years, and I have seen it work in 95% of my patients, getting relief after 5, 10, even 20 years of suffering,” he said.
He dispelled concerns about side effects, such as hirsutism in women, which occurs in five out of 1,000 cases and is reversible by lowering the dose. Only prostate cancer is a contraindication, he said. – by Michela Cimberle