Miebo

Miebo is a prescription eye drop for adults with dry eye disease. It contains perfluorohexyloctane, a water-free liquid that helps treat both the signs (like corneal staining) and symptoms (like dryness or burning) of dry eye. The usual dose is 1 drop in each affected eye four times a day. The most common side effect reported in studies was brief blurred vision. 1

In large randomized trials (GOBI and MOJAVE), patients using perfluorohexyloctane showed meaningful improvements compared with saline control. 2

How it works: Instead of adding water to the eye, Miebo spreads across the tear surface to form a thin layer that reduces tear evaporation. It forms a monolayer at the air–liquid interface of the tear film, which slows evaporation. 3 This makes it a direct option for evaporative dry eye, often linked to meibomian gland dysfunction (MGD).

Where it fits: Dry eye care is stepwise and may include:

• Artificial tears
• Eyelid hygiene and warm compresses
• Omega-3s
• Prescription anti-inflammatory drops
• In-office meibomian gland treatments
• Punctal plugs
• Moisture goggles

Miebo can be used on its own or with these therapies, depending on your doctor’s plan. 4

Good candidates: Adults with dry eye, especially those with MGD or tear evaporation. Symptoms like burning, grittiness, fluctuating vision, or quick tear break-up may benefit. Miebo is dosed 4 times daily and should not be used with contact lenses; remove lenses and wait 30 minutes before reinserting. 5

Who may not be a fit: Children, pregnant/nursing patients without full risk-benefit review, or those with other causes of irritation (allergies, blepharitis, infection) that need separate treatment. 6

Miebo is a brand-name medication typically dispensed as a multi-dose bottle. Most patients use 1 drop in each eye 4 times daily, so a bottle often lasts about a month. 7

Ways to plan for cost:

• Call your insurance to check tier, prior authorization, and supply limits (often 30 days).
• Ask about samples or 90-day supply options once stable.
• Use FSA/HSA funds when eligible.
• If costs are high, combine with lower-cost options (warm compresses, lid hygiene, artificial tears).
• Compare prices across pharmacies; your care team can help.

Effective treatment may reduce hidden costs like missed work and productivity loss. 8

Benefits: Two large randomized studies showed improvement in corneal staining and reduced dryness symptoms compared with saline. Improvements appeared within 2 weeks for many patients. 9 Additional trials confirmed outcomes in patients with MGD-related dry eye. 10

Limitations & side effects: Not all patients respond. Most common is temporary blurred vision. Contact lenses must be removed and kept out for 30 minutes. Some patients may still need additional treatments for inflammation or eyelid health.

Recovery: No downtime. Use 1 drop in each affected eye 4 times daily. Technique tips:

• Wash hands
• Tilt head back
• Pull lower lid to make a pocket
• Let drop fall without touching the bottle tip

If using other drops, space them several minutes apart. Remove contacts and keep them out for 30 minutes. 11

Supportive habits: Warm compresses, lid hygiene, artificial tears, screen breaks, and humidifiers help keep the tear film stable. 12

Research updates: A pooled analysis of the GOBI and MOJAVE trials confirmed consistent benefits across patient subgroups. 13

The FDA requires postmarketing studies to assess corneal endothelial health over at least 12 months, ensuring safety as use expands. 14

If your eyes feel dry, gritty, or vision fluctuates, start with a complete exam. Ask if evaporative dry eye or MGD is part of your diagnosis and if Miebo could help. 15

Best specialists: Cornea/External Disease Ophthalmologists or optometrists with ocular surface expertise. Kerbside can connect you with the right specialist for educational consults (not a physician–patient relationship). 16