For millions of Medicare patients, the struggle with dry eye disease (DED) is often an invisible burden, characterized by persistent irritation, blurred vision, and a surprising gap in consistent medical care. New data presented at the 2026 Managed Care Pharmacy (AMCP) conference reveals a troubling trend: while treatments for dry eye are available, a significant number of patients either never start therapy or stop using it prematurely.
The findings, detailed across two research posters, highlight a systemic struggle with dry eye treatment gaps that persist despite the availability of pharmacological interventions. This lack of adherence is particularly striking given the impact DED has on daily quality of life, yet the data suggests that the perceived urgency of treating dry eye often pales in comparison to more “sight-threatening” conditions.
Interestingly, the research offers a silver lining for patients managing multiple ocular conditions. The data indicates that comorbid dry eye disease does not negatively affect adherence to glaucoma medications. This suggests that while patients may struggle to maintain their dry eye regimens, the presence of DED does not derail the critical, daily discipline required to manage intraocular pressure and prevent permanent vision loss.
The Challenge of Treatment Uptake and Persistence
The AMCP 2026 presentations focused heavily on the behavior of Medicare patients, a demographic often dealing with age-related ocular surface disease. The researchers found that treatment uptake—the initial act of filling a prescription and starting a medication—remains suboptimal. Even when patients do commence treatment, the rate of discontinuation is high, creating a “revolving door” effect where patients seek relief but fail to maintain the long-term therapy necessary for chronic management.
As a physician, I find this pattern familiar. Dry eye is often viewed by patients as a nuisance rather than a disease. Unlike a sudden infection or a surgical emergency, the symptoms of DED wax and wane. When a patient feels a temporary reprieve, the incentive to apply drops multiple times a day often vanishes, leading to the discontinuation patterns observed in the Medicare cohort.
Several factors contribute to these gaps in care, including the cost of newer prescription drops, the physical difficulty of administering drops in elderly populations, and a general lack of awareness regarding the progressive nature of the disease. When treatment is viewed as symptomatic rather than therapeutic, persistence naturally drops.
Comparing DED and Glaucoma Adherence
One of the most pivotal takeaways from the posters is the distinction between how patients handle DED versus glaucoma. Glaucoma is widely understood as a “silent thief of sight,” and the stakes of missing a dose are catastrophic. The research confirms that patients with comorbid DED—meaning they suffer from both dry eye and glaucoma—do not show a decrease in their adherence to glaucoma medications.
This suggests a psychological hierarchy of treatment. Patients prioritize medications that prevent blindness over those that improve comfort. While Here’s a victory for glaucoma management, it underscores the need for a shift in how dry eye disease is communicated to patients. If DED is framed not just as “dryness” but as a chronic inflammatory condition that can damage the corneal surface, adherence may improve.
| Condition | Treatment Uptake | Persistence Rate | Impact of Comorbidity |
|---|---|---|---|
| Dry Eye Disease (DED) | Low/Suboptimal | Frequent Discontinuation | N/A |
| Glaucoma | High/Consistent | Strong Persistence | Not negatively affected by DED |
What This Means for Patient Care
The persistence of these treatment gaps suggests that the current clinical approach—prescribing a medication and checking back in six months—may be insufficient for the Medicare population. To close the gap, healthcare providers may need to integrate more robust support systems, such as pharmacy-led adherence programs or the employ of digital health reminders.
For the patient, understanding the “why” behind the treatment is essential. The National Eye Institute emphasizes the importance of comprehensive eye care to prevent long-term complications. When patients understand that chronic inflammation from DED can lead to permanent ocular surface damage, the perceived value of the medication increases.
the data suggests that clinicians should not assume that a patient who is diligent with their glaucoma drops is equally diligent with their dry eye drops. These two medications, though both administered to the eye, occupy different spaces in the patient’s mind. One is for survival of sight; the other is for comfort. Bridging that cognitive gap is the next frontier in ocular pharmacy.
Identifying the Affected Population
The primary stakeholders in this trend are Medicare beneficiaries, who often face a complex intersection of comorbidities. The “treatment gap” is not merely a failure of patient will, but often a failure of the delivery system. Issues such as “prescription fatigue”—where a patient is overwhelmed by the number of daily medications—can lead to the discontinuation of the least “critical” drug, which in this case is typically the DED treatment.
The implications extend to payers and managed care organizations. Low adherence leads to poor outcomes, which can result in more frequent office visits and a higher likelihood of progressing to more expensive, invasive interventions. Improving the initial uptake and long-term persistence of DED therapies is not just a clinical goal, but an economic one.
To further understand the mechanics of ocular health and the importance of medication adherence, patients are encouraged to consult the American Academy of Ophthalmology for evidence-based guidelines on managing chronic eye conditions.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
As the medical community digests the data from AMCP 2026, the next step will be the development of targeted intervention strategies to improve DED persistence. Further updates on medication adherence protocols are expected in upcoming clinical guidelines and pharmacy practice reviews throughout the year.
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