Nicotine eye patch hits ophthalmic nerve

The data are convincing-to me at least. No matter how effective pressure-lowering topical ophthalmic medications might be in clinical trials for patients with glaucoma, they very often fail in the real world. Roughly 50% of patients have been found not be adherent to their medication over 75% of the time.¹

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It is a challenge for elderly glaucoma patients to reliably and correctly administer their glaucoma medications in the manner and at the time that they should.

As a result, sustained-release devices are now in trials. Punctal plugs are being used to deliver anti-inflammatory agents after cataract surgery and pressure-lowering drugs in patients with elevated IOP. Retina specialists have been ahead of the curve with drug-delivery devices, inserting through the pars plans implants that release ganciclovir and fluocinolone to treat cytomegalovirus retinitis and uveitis, respectively.

Similarly, retina specialists have found that intravitreal injection of anti-vascular endothelial growth factor agents has revolutionized the treatment of age-related macular degeneration, and again has removed the patient from the drug-delivery equation (except that the patient actually has to keep his/her appointment).

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Representing a conceptual leap forward is the recent announcement that a nicotine patch, applied to the eye, can be used to treat a non-ophthalmic condition (i.e., the addiction to cigarettes) rather than an eye disease.

According to a recent news report,² the Nicoderm Eye Patch is an effective and convenient means to help patients quit smoking.³

These discreet and easy-to-use eye patches allow users to curb their cigarette cravings by delivering a steady flow of therapeutic nicotine directly into the bloodstream through the optic nerve,² said company spokesperson Caitlin Timmons, adding that the user simply removes the backing from the patch and applies the adhesive layer directly on their exposed cornea.³

How it works

How it works

Individuals can choose to place the patch on the left eye or right eye, and the extended-release technology will reduce withdrawal symptoms for up to 72 hours. It is recommended, however, that users not put on more than one patch at a time.²

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A strong believer in the wisdom of using sustained-release drug delivery devices as an alternative to relying on patients to remember to apply eye drops, I nonetheless question the use of the cornea and eye as the route of administration of drugs to treat non-ophthalmic disorders.

In these clinical trials, have the investigators carefully evaluated the potential negative impacts of unilateral ocular occlusion and also proven that the drugs, such as nicotine, do not negatively affect the cornea or other ocular structures?

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Also, I worry when I read that this spokesperson “recommends”  . . . “users don't put on more than one at a time.” Occlusion of both eyes with patches to achieve smoking cessation-does that really make sense?

References

1. Okeke CO, Quigley HA, Jampel HD, Ying GS, Plyler RJ, Jiang Y, et al. Adherence with Topical Glaucoma Medication Monitored Electronically: The Travatan Dosing Aid Study. Ophthalmology. 2009;116:191­199. [PubMed]

2. http://www.theonion.com/article/nicoderm-introduces-new-nicotine-eye-patch-52243

3. Dear Ophthalmology Times reader: This Editorial is an April Fools’ Day joke! Did you fall for it?