![]() Red eye reducers on the market thus far affect the α-1 receptors alone or α-1 and α-2 receptors non-selectively. ![]() ![]() 2-4 Researchers realized reducing the concentration four- or eight-fold avoids IOP changes while enhancing the whitening effect. The higher dose is associated with hyperemia and allergic dermatitis or ocular allergy very low doses, however, are known to have a whitening or blanching effect. However, the concentration of Alphagan P is 0.1% and generic forms are 0.2%. It is the active ingredient in Alphagan P (Allergan), for example. We’ve had almost 20 years of experience with high doses of brimonidine tartrate when managing glaucoma patients. As an aside, a non-ocular formulation exists, 0.33% brimonidine gel, for the treatment of persistent facial erythema secondary to rosacea. It is approved for ages five and older, works within 30 to 60 seconds and lasts six to eight hours with no known rebound hyperemia or tachyphylaxis. Recently FDA-approved for the relief of ocular redness due to minor eye irritations, Lumify is a low-dose (0.025%) brimonidine tartrate and is a highly selected α-2 adrenergic receptor (AR) agonist. This patient’s red eyes cleared up after instilling Lumify, and they can expect the effects to last six to eight hours. The new red eye reducer I used was Lumify (brimonidine tartrate ophthalmic solution 0.025%, Bausch + Lomb), which could have significant implications for many of your patients. Although just one anecdotal experience with a plethora of underlying factors at play, it exemplifies the significant personal and social connotations of chronic red eyes for our patients. I had her try a new over-the-counter red eye reducer-one I’ve been involved with as a consultant for Bausch + Lomb-and she reported being offered a job after her very next interview. One patient told me that she had more than 35 interviews for a job and felt she was well qualified, but that her chronic red eyes prevented her from being hired (whether it was affecting her confidence or the interviewer’s perception). Many patients have told me their red eyes have kept them from going out with friends or family, and they were tired of being asked if they were crying, drinking, sleep-deprived or on drugs.
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