Why Treat The Eye Through The Nose?

According to Jeffrey Nau, Ph.D., president and CEO of Oyster Point Pharma, people have a cognitive dissonance when it comes to treating the human eye with therapeutics that are not delivered to the organ directly. In fact, one of the first questions he usually gets is, “How do you treat the eye through the nose?” But if you think about the fundamental concept of dry eye disease (DED), it’s not hard to think of that harnessing the body’s own natural tear film is the best way to treat DED. “Our whole concept was to look at the different ways the tears are produced, either stimulation of the ocular surface, emotions, or via the nasal cavity,” the CEO scientist begins.

One is stimulus to the cornea. “You might have experienced this walking outside in the winter; your eyes start watering when hit with a blast of cold air.” Another is through the emotional centers in the brain (i.e., tears when you cry or laugh). The third, which is responsible for about 34% of our basal tear film secretion, is due to the inhalation of air across the nasal cavity. “Interestingly, the nerve endings in the nose stimulate tear film secretion and keep your eyes lubricated,” Nau explains. You have probably experienced this when waking up with a cold or sinusitis where your nasal passages have been blocked all night and your eyes feel dry. “It’s because you are not bringing air across those mucous membranes in the nose.” We also know that if someone gets nasal surgery, or has a severed trigeminal nerve (the largest and most complex of the 12 cranial nerves that supplies sensations to the face, mucous membranes and other structures of the head), they will develop a dry eye type condition. “For Oyster Point, developing a nasal spray as the method of delivery may provide a novel way to stimulate tear film without making them emotional or treating the traditional route on the ocular surface.” Nau believes stimulating natural tear film production is an important pathway reestablish homeostasis on the ocular surface and potentially treat the disease. “And you’re not doing it in a manner where you’re putting something with preservatives or compounds onto the ocular surface,” he contends.

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