Unavailability of Cyclosporine Poses Serious Health Problem for People with Moderate to Severe Dry Eye Syndrome and Vernal Keratoconjunctivitis
The unavailability of cyclosporine is causing significant health concerns for individuals suffering from moderate to severe dry eye syndrome and vernal keratoconjunctivitis, an allergic eye condition. According to La Presse, this is due to the permanent ocular and visual discomfort that these individuals endure on a daily basis. These pathologies significantly affect the eyes, threatening the cornea and, consequently, vision. Cyclosporine is the only treatment recommended to quickly alleviate the pain and discomfort of these patients and allow them to resume a normal life. However, this treatment remains unavailable due to the lack of a clean room to guarantee its preparation.
Severe Dry Eye and Vernal Keratoconjunctivitis
Cyclosporine is defined as an "ophthalmic treatment in the form of eye drops, used to treat chronic and moderate to severe dry eye, vernal keratoconjunctivitis (an allergic eye condition), and to prevent corneal transplant rejection." It is a "topical immunosuppressant and anti-inflammatory that reduces inflammation at the source of dry eye, improves tear production, and relieves symptoms." For individuals with severe dry eye syndrome, related to certain autoimmune diseases such as lupus or Sjögren's syndrome, dry eye is a frequent discomfort due to the chronic nature of the disease. Dry eye is characterized by a reduction in tear production, which is affected by moderate dryness in some cases and severe dryness in others.
Without tears, constant and unbearable ocular discomfort persists until tear production resumes. Although artificial tears in the form of eye drops are available, in cases of severe dry eye, this treatment is ineffective. Regarding the allergic eye condition, which also affects children, cyclosporine is the most suitable treatment. "Allergic eye conditions, especially in children, risk causing lesions or corneal deformation if left untreated. In this case, the daily life, schooling, and ocular well-being of these children will be affected," says Dr. Afef Zarrad, an ophthalmologist, to La Presse.
Risk of Visual Impairment and Blindness
Without cyclosporine, severe consequences may occur for individuals suffering from severe dry eye syndrome. "Without tears, the eye risks perforation, leading to visual impairment or blindness," adds Dr. Zarrad. She emphasizes that it is a great sadness and frustration to have to prescribe substitute treatments that do not provide the required effect. The unavailability of cyclosporine is not due to a lack of the molecule but rather the absence of a clean room to produce the pharmaceutical preparation according to standards. Despite the demand, cases of severe dry eye syndrome and allergic eye conditions are numerous, and patients are simply seeking access to treatment.
No Equivalent Treatment Available
It is worth noting that there are no equivalent treatments available in Tunisia that are accessible to patients. The treatment Restasis, used to treat dry eye and marketed abroad, is expensive. "Equivalents to cyclosporine cost around 2,000 dinars, which is sufficient for a two-month treatment. However, severe dry eye syndrome is a chronic disease. Opting for such an expensive treatment is illogical," adds Dr. Zarrad. To access treatment, patients with severe dry eye syndrome have submitted requests to the Minister of Health and the director of the Hédi-Raïs Institute of Ophthalmology, hoping to find a solution to the problem and save their vision. The installation of a clean room is urgent to guarantee cyclosporine to patients and respond to a public health need.
