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# Dry eye and ocular surface agents

Eye drops that calm inflammation of the eye surface (ciclosporin, lifitegrast) or help a damaged cornea heal (cenegermin), beyond artificial tears.

Updated Nov 12, 2026

## What they are

Dry eye happens when the eyes make too few tears or tears that evaporate too fast. Mild dry eye is managed with artificial tears, gels and ointments and with changes such as avoiding smoke and wind, limiting screen time and using a humidifier. When inflammation keeps the problem going, anti-inflammatory drops are added: ciclosporin eye drops (see the ciclosporin page) and lifitegrast. Punctal plugs keep tears on the eye longer. Cenegermin, a nerve growth factor, is grouped here as an ocular surface treatment for neurotrophic keratitis, a different disease in which damaged corneal nerves stop the surface from healing.

## Mechanism of action

Ciclosporin eye drops are an immunomodulator: by blocking calcineurin in T cells they reduce the inflammation that suppresses tear production, so tear production can increase. Lifitegrast blocks the binding of LFA-1 on T cells to ICAM-1 on the ocular surface, reducing T-cell-driven inflammation. Cenegermin supplies nerve growth factor, which acts on TrkA receptors in the cornea and supports healing of the epithelium.

Target: T-cell activation on the ocular surface (calcineurin, LFA-1) and corneal nerve support (TrkA)

## Key points

- Risk factors for dry eye include age over 50, female sex, contact lenses and autoimmune disease such as Sjögren disease.
- Ciclosporin and lifitegrast treat inflammation; they are added to artificial tears, not instead of a full assessment.
- Lifitegrast often causes stinging and an odd taste right after the drop.
- Ciclosporin drops are separated from other eye drops, and contact lenses are removed before use.
- Cenegermin is for neurotrophic keratitis, not ordinary dry eye.

## Drugs in this class

- [**Lifitegrast** Anti-inflammatory eye drops for dry eye disease that block the T-cell protein LFA-1. An odd taste after the drop is… Lymphocyte function-associated antigen 1 (LFA-1, integrin alpha-L/beta-2)](https://durgical.com/en/pharmacology/lifitegrast/)
- [**Cenegermin** Eye drops of recombinant human nerve growth factor that help the cornea heal in neurotrophic keratitis, where corneal… TrkA receptor (nerve growth factor receptor)](https://durgical.com/en/pharmacology/cenegermin/)

## Others in the class

- Ciclosporin eye drops (emulsion or solution)
- Artificial tears, gels and ointments
- Hypertonic sodium chloride drops (corneal oedema)
- Diquafosol

## Test yourself

Think of the answer, then tap the question to see it.

## Which two anti-inflammatory eye drops are used for dry eye disease?

Ciclosporin eye drops and lifitegrast.

## How do ciclosporin eye drops increase tear production?

They calm the immune-driven inflammation of the ocular surface that suppresses tear production.

## What disease is cenegermin used for?

Neurotrophic keratitis, where damaged corneal nerves stop the corneal surface from healing.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Dry Eye | National Eye Institute](https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye) (National Eye Institute (NIH), 2026); [Cyclosporine Ophthalmic: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a604009.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Lifitegrast Ophthalmic: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a616039.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=S01XA) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/classes/dry-eye-and-ocular-surface-agents/