A Multi-Country Assessment Of Eye Care Professionals’ Perspectives On The Conjunctival Hyperaemia Treatment Landscape

Conjunctival hyperaemia (CH) is a common sign of acute anterior inflammation, which can occur following ocular surgery as well as in response to a range of environmental or infectious conditions. While existing treatments – including ocular vasoconstrictors and antihistamines – can provide temporary relief from CH, continued use has been associated with tachyphylaxis and adverse events. This study explored eye care professionals’ (ECPs’) experience of treating CH.

Interviews were conducted with ECPs in Spain (n=4), Portugal (n=4), France (n=4) and the US (n=4) who were ophthalmologists experienced in treating CH with a range of approaches, including brimonidine tartrate (0.25 mg/ml; BTOS), an ophthalmic decongestant available over the counter (OTC) in the US but currently only available via prescription in Europe.

A semi-structured interview guide was developed based on a targeted literature review. Interview topics included CH pathology, treatment decisions, unmet needs and treatment satisfaction. Interviews were recorded, transcribed verbatim and analysed using content analysis. This study received ethical review exemption from the Western-Copernicus GroupInstitutional Review Board.

ECPs had 14–25 years’ experience treating CH and treated 40–100 CH patients in the month leading up to the interviews. ECPs reported limitations with existing treatments, such as eye sensitivity and rebound redness. BTOS was reported to be fast-acting and to cause fewer adverse events. ECPs emphasised the importance of determining and treating the cause of CH but noted BTOS was a well-tolerated adjunctive option. In Europe, it was suggested that while prescription-only status reduces accessibility, it helps ensure ECPs monitor the cause of CH and ensure treatment is appropriate and targeted to the underlying case of CH. Conversely, US ECPs stated that while OTC availability increased accessibility, it was harder to monitor patient usage. 

BTOS provides an effective and well-tolerated solution which addresses the aesthetic needs of patients with CH, including post-surgical CH. ECPs highlight the need to identify and treat the underlying cause of CH, but report BTOS can be used as an adjunctive treatment.