Autologous Serum Eye Drops (ASEDs)

Autologous Serum Eye Drops (ASEDs) are eye drops made from a patient’s own blood. After drawing a small amount of blood, experts process it so that what remains (the serum) is used to make drops. These drops aim to act more like natural tears than artificial eye drops do. They contain growth factors, vitamins, and proteins that help soothe and heal the surface of the eye. 1 These drops are used especially when regular treatments like over-the-counter artificial tears or ointments do not help enough. 2

Here’s how Autologous Serum Eye Drops are made and what choices are involved:

• Blood draw: A small blood sample is collected from the patient. The sample is screened for infectious diseases to make sure it is safe. 2
• Processing: The blood is allowed to clot, then spun in a centrifuge to separate serum (which contains helpful proteins) from blood cells. The serum is often diluted (commonly around 20%) in sterile saline or another sterile medium.
• Formulation options: Some formulations use higher or lower dilutions depending on severity of disease. Some use full-strength (100%) serum. Also, preservative-free storage is essential to avoid irritation or infection because there usually are no preservatives.
• Storage & use: Because they contain natural proteins that degrade, these drops are usually kept frozen, then thawed and refrigerated for short-term use. They are applied multiple times per day, depending on how bad the eye surface is. 5

ASEDs are usually considered when milder treatments have not worked well enough. Typical candidates include:

• People with severe dry eye disease or chronic dry eye that doesn’t improve with artificial tears or other standard drops. 6
• Patients with ocular surface disease such as persistent corneal epithelial defects (areas of cornea that won’t heal), neurotrophic keratitis, graft-versus-host disease, Stevens–Johnson syndrome, or autoimmune diseases affecting tear production.
• After surgeries or injuries when the eye’s surface is damaged and natural healing is slow.
• Those who can tolerate blood draws, refrigeration/freezing, and frequent use of drops. If someone has difficulty giving blood, has a blood disorder, or very low hemoglobin, it might be harder. 5

Because Autologous Serum Eye Drops are custom-made, the cost can vary quite a lot depending on where you live, how much is needed, and how often you use them. Important points:

• Many insurance plans do **not** cover these drops, since they are not FDA-approved for standard ocular surface disease treatment. 7
• Typical cost might range from **US$250 to US$500** for a 3- to 6-month supply, depending on how diluted the serum is and how often it is used.
• Additional costs may include blood draw fees, lab processing, storage (freezer space), and visits with eye care providers for monitoring. 5

Here are what ASEDs can do well and what possible downsides or limitations are:

• Benefits:
  • They better mimic natural tears. They have growth factors and vitamins that help heal and protect the eye surface.
  • Studies show improvements in symptoms (like dryness, pain, foreign body feeling), tear production tests, tear film stability, and corneal staining (damage on the surface). 6
  • Because they come from your own body, there is much lower risk of allergic reactions.
  • Useful for very bad or hard-to-heal surface defects. ASEDs have been shown to help persistent epithelial defects heal. 1
• Limitations:
  • Standards for dilution, frequency, storage etc. are not the same everywhere, so results can vary.
  • Need to draw blood, which may be hard for some people.
  • No FDA approval specifically for many ocular surface uses, which limits insurance coverage.
  • Requires freezer or cold storage, careful handling to prevent contamination.
  • May be expensive overall, especially for frequent applications. 7

Here’s what to expect after you begin using ASEDs, and how to take care of your eyes long-term:

• Application schedule: Typically, drops are used multiple times per day (for example, 4-10 times), depending on the severity of the eye condition. Your eye doctor will guide the schedule. 6
• Monitoring: Regular check-ups are needed. Eye doctors will look at symptoms, tear film tests (break-up time, tear volume), and signs of corneal healing or damage.
• Storage rules: Keep drops frozen until ready to use. Once thawed, store in a refrigerator and discard leftovers after a short time (often a week or less) to avoid risk of harm.
• Long-term care: For many, using drops long term provides ongoing symptom relief, fewer flare-ups, and better health of the ocular surface. But long-term safety data is limited; need to watch for infection risks and ensure drop quality.
• Adjustments over time: If signs of irritation, infection, or lack of improvement, treatment may need change: either different concentration, more frequent use, or combining with other therapies (ointments, anti-inflammatory drops).

Recent studies are trying to answer questions like how well ASEDs work compared to other treatments, how to make them safer or easier to use, and how to standardize them. Some findings:

• A 2024 meta-analysis of randomized controlled trials showed that ASEDs significantly improve dry eye measurements: more tear production, longer tear stability, less damage to the eye surface, and better symptom scores vs artificial tears.
• A recent study found that autologous platelet-rich plasma (APRP) drops are not inferior to 100% serum drops in moderate-to-severe dry eye disease. 9
• Clinical trials are underway for enhanced serum drops, e.g. combining with insulin, or using improved closed-system processing to reduce risk. 10
• Some researchers are working on standardizing how much dilution, what storage conditions, and what quality controls should be used. This helps different clinics produce more similar results.

If you think ASEDs might help you:

• Talk with an eye care specialist (ophthalmologist or cornea specialist) about whether it’s right for your condition. They can assess your eyes, how severe the damage or dryness is, and whether other treatments have been tried. Only a specialist can prescribe and supervise this treatment.
• Ask your doctor about the protocols at your clinic or pharmacy: what dilution they use, how they store the drops, what follow-ups are scheduled, and costs. Knowing these details helps you get safer, more reliable treatment.
• Make sure you can follow storage requirements (freezer, refrigeration), frequent usage, and safe handling to avoid contamination. If not, alternatives may be better.
• Check whether your insurance or health plan might cover any part of the cost, or whether financial assistance is available. Many people have to pay out of pocket.

You can connect with the right specialist via Kerbside for medical education consults to learn more about whether this is right for you. This is not medical advice and does not replace a visit with a health professional.