Miebo (Perfluorohexyloctane)

Miebo (perfluorohexyloctane ophthalmic solution) is a prescription eye drop for treating signs and symptoms of dry eye disease. Unlike other dry eye medications, it works by directly preventing tear evaporation, making it particularly useful for evaporative dry eye.

How It Works

Miebo takes a unique approach to dry eye:

• Creates a protective layer on the eye surface
• Prevents tears from evaporating
• Supplements or mimics the natural lipid (oil) layer
• Particularly helpful when meibomian glands aren't producing enough oil

Unlike cyclosporine or lifitegrast, it doesn't reduce inflammation—it physically prevents tear evaporation.

Common Uses

• Evaporative dry eye disease
• Meibomian gland dysfunction (MGD)
• Dry eye with good tear production but rapid evaporation
• May be used with or without anti-inflammatory drops

How to Use

• Dosing: One drop in each eye four times daily
• Contact lenses: Can be used without removing contacts
• Instillation: Standard technique—clean hands, tilt head back, apply drop
• Multi-dose bottle: Can be used for up to 90 days after opening
• Storage: Room temperature

What to Expect

Timeline

• May notice improvement relatively quickly
• Full benefit with consistent use
• Continue as directed even when feeling better

Unique Features

• Can be used with contact lenses in place
• Different mechanism allows combination with other dry eye treatments
• Not an anti-inflammatory—complementary approach

Side Effects

Common

• Blurred vision (temporary, especially right after instillation)
• Eye redness
• Eye pain or discomfort
• Eye irritation
• Foreign body sensation

Notes on Side Effects

• Blurred vision is usually brief
• Most side effects are mild and transient
• No systemic (body-wide) effects expected

Precautions

• Don't use if eye is infected
• Keep tip clean—don't touch to eye or other surfaces
• Pregnancy/breastfeeding: Discuss with doctor
• Multi-dose bottle: Good for 90 days after opening

How Miebo Differs from Other Dry Eye Treatments

Treatment	How It Works	Best For
Miebo	Prevents evaporation	Evaporative dry eye, MGD
Restasis/Cequa	Reduces inflammation	Inflammatory dry eye
Xiidra	Reduces inflammation	Inflammatory dry eye
Artificial tears	Temporary lubrication	All types (symptom relief)

Using Miebo with Other Treatments

Miebo can be used alongside:

• Anti-inflammatory drops (Restasis, Cequa, Xiidra)
• Artificial tears
• Warm compresses for MGD
• Omega-3 supplements

This combination approach addresses multiple aspects of dry eye.

Frequently Asked Questions

Can I use Miebo with my contact lenses?

Yes, Miebo can be used without removing contact lenses, which is unique among prescription dry eye drops.

Is Miebo better than Restasis or Xiidra?

They work differently. Miebo prevents evaporation; Restasis, Cequa, and Xiidra reduce inflammation. Miebo may be better for purely evaporative dry eye, while inflammatory dry eye may need the other medications. Some patients benefit from combining approaches.

Why is Miebo dosed four times daily?

The protective layer it creates needs to be replenished regularly throughout the day for optimal effect.

Will my vision be blurry after using Miebo?

Some temporary blur right after instillation can occur. It typically clears quickly.

Can I use artificial tears with Miebo?

Yes, artificial tears can be used alongside Miebo. If using multiple drops, wait a few minutes between them.

How do I know if I have evaporative dry eye?

Your eye doctor can determine if your dry eye is primarily evaporative (often from meibomian gland dysfunction) or from reduced tear production. Signs include rapid tear break-up time and meibomian gland changes.