FAQs

• MIEBO is a prescription eye drop used to treat the signs and symptoms of dry eye disease. It’s the first and only prescription eye drop that directly targets too much tear evaporation—the #1 cause of rough, gritty dry eye.

• MIEBO is used for the treatment of the signs and symptoms of dry eye disease.
• “Signs” refer to the damage to the surface of your eye that your doctor can see. “Symptoms” refer to the feeling of eye dryness experienced, such as dry, rough, or gritty.

• MIEBO is used for the treatment of the signs and symptoms of dry eye disease.
• If you’ve tried other treatments and are still looking for relief, it’s time to try something different. Consider asking your doctor about MIEBO.
• Other eye drops may add tears or increase the number of tears you make. But for about 9 out of 10 people with dry eye, a leading cause is too much tear evaporation.
• Everyone’s tears evaporate. But when you have excessive tear evaporation, your tears escape too quickly and the quality of new tears is not as good. This can lead to actual damage on the surface of the eye over time and cause symptoms to get worse.
• MIEBO is the only prescription eye drop that directly targets too much tear evaporation.
• You can also take the quiz to find out if MIEBO may be right for you.

• No, there is no FDA-approved generic available for MIEBO. MIEBO is the only prescription dry eye drop that directly targets too much tear evaporation—the #1 cause of dry eye. MIEBO contains only one ingredient, perfluorohexyloctane, and was approved by the FDA in 2023 as a prescription treatment for the signs and symptoms of dry eye disease.

• Dry eye is more than just the symptoms that you feel. It’s an underlying condition that can be caused by different things. There are 2 types of dry eye. The first type involves your eyes not producing enough tears. This is called aqueous-deficient dry eye. The second type is when your tears evaporate too quickly. This is called evaporative dry eye. Too much tear evaporation is a leading cause of dry eye in about 9 out of 10 people with dry eye. In both types, these conditions can potentially result in symptoms that make your eyes feel tired, scratchy, gritty, rough, or dry. Evaporative dry eye can be driven by factors in our modern lifestyle, like screen time. Sometimes, you can have a combination of both types. MIEBO is the only prescription dry eye drop that directly targets too much tear evaporation to treat dry eye disease. No other water-based or water-free drops directly target tear evaporation.

• No, not all dry eye is the same. There are 2 types of dry eye:
  • Evaporative, or “too much tear evaporation,” which contributes to dry eye in about 9 out of 10 people with dry eye.
  • Aqueous deficient, or “not making enough tears,” which is a less common type of dry eye.
  • Some people may have a combination of both types.

• Everyone’s tears evaporate. But when you have evaporative dry eye, your tears escape too quickly—more than what’s considered normal. Too much tear evaporation is the #1 cause of dry eye and can leave eyes feeling symptoms such as tiredness, scratchiness, grittiness, roughness, or dryness.

• Dry eye may make your eyes feel one or more of the following: tired, scratchy, gritty, stinging, painful, heavy, sensitive to light, burning, rough, itchy, watery, or irritated. It’s also common to experience the need to clear your vision by blinking and vision that fluctuates throughout the day.

• Meibomian (my-bo-mee-an) gland dysfunction, also called MGD, is the leading cause of too much tear evaporation. Little glands called meibomian glands make an oily layer, or lipids, on the surface of the eye. The oily layer prevents the tears beneath from evaporating and helps protect the surface of the eye. In evaporative dry eye, the meibomian glands don’t work as they should, and the oily layer becomes damaged. This damage leads to too much tear evaporation.

• Several factors can contribute to evaporative dry eye. These may include increased screen time and device usage, air conditioning or fans, dry or windy environments, smoke exposure, and wearing contact lenses. Certain medications such as antihistamines, decongestants, acne medication, antidepressants, and heart medication may also contribute to evaporative dry eye. Dry eye can also be a natural part of aging.

• On the outside of your eye, there is something called the “tear film.” It’s made up of 3 layers: a layer of oil on top, a watery layer of tears, and an inner layer of mucus. In healthy eyes, the oily layer helps to keep the tears from drying out. With evaporative dry eye, the oil layer isn’t as effective, and it causes too many tears to evaporate. Over time, this can lead to damage on the surface of the eye and symptoms like dryness, grittiness, and irritation. The damage can also cause inflammation. This can create a vicious cycle of worsening dry eye signs and symptoms.

• Everyone’s tears evaporate. But when you have evaporative dry eye, your tears escape too quickly—more than what’s considered normal. Too much tear evaporation is the leading cause of dry eye and contributes to dry eye in about 9 out of 10 people with dry eye.
• A common cause of too much tear evaporation is called meibomian gland dysfunction (MGD). Meibomian glands create a layer of oil on the surface of the eye called meibum. Meibum helps to keep the tears on your eyes from drying out, which helps protect the surface of your eyes. When these glands don’t work properly, the meibum becomes damaged and allows too much tear evaporation.

• Our goal is to make MIEBO affordable and accessible to patients as quickly as possible. The price of MIEBO will vary from person to person based on insurance coverage.

• MIEBO is covered broadly on both commercial and Medicare Part D plans, qualifying as best-in-class coverage. About 75% of commercial plans cover MIEBO, and about 65% of Medicare Part D plans cover MIEBO.
• Eligible commercially insured patients may pay as little as a $0 copay. Eligible Medicare Part D patients may be able to receive a product trial through the digital pharmacy service BlinkRx while they await coverage decisions for MIEBO.

• Yes, the Bausch + Lomb Patient Assistance Program helps patients who have limited assets, have limited or no prescription coverage, or are on government insurance. To find out if you are eligible, please fill out the patient assistance questionnaire or call 1-855-770-0424.

• A MIEBO prescription can be sent to traditional pharmacies or to BlinkRx, a digital pharmacy alternative.
• If you are picking up MIEBO from a traditional pharmacy, the MySavings Program may be able to help you save on your copay. With our MIEBO Copay Card, eligible commercially insured patients may pay as little as a $0 copay for new prescriptions and refills. Please visit the My Savings Program website to learn more. Terms and conditions apply.

• BlinkRx offers a digital alternative to traditional pharmacies. BlinkRx will work with your insurance to find out if you are eligible and apply savings to your MIEBO prescription if so. Through BlinkRx, you are able to pay for your prescription online or over the phone and receive free delivery of your MIEBO prescription. The BlinkRx team has pharmacists available to help answer your questions and help with refills and reminders. They can be reached by phone at 1-833-914-3856 or by email at support@blinkrx.com.
• BlinkRx is not a traditional pharmacy. If you would like your prescription sent to your home by BlinkRx, your eye doctor will need to search for the virtual or mail order pharmacy “BlinkRx” in Boise, Idaho.

• The MySavings Program may be able to help you save on your copay for MIEBO. With our MIEBO Copay Card, eligible commercially insured patients may pay as little as a $0 copay for new prescriptions and refills. The program/card is not valid for patients whose prescriptions are reimbursed by any federal or state healthcare program, including Medicaid, Medicare, TRICARE, or any other federal or state healthcare program. Please visit the My Savings Program website to learn more. Terms and conditions apply.

• Eligible commercially insured patients may pay as little as a $0 copay for MIEBO through the MySavings Program. Savings and coverage may vary depending on your insurance plan. MIEBO may also be available through BlinkRx, a digital pharmacy service that will work with your insurance to find out if you are eligible and apply savings to your MIEBO prescription if so.
• Patients with limited or no prescription coverage may also qualify for the Bausch + Lomb Patient Assistance Program. To find out if you are eligible, please fill out the patient assistance questionnaire or call 1-855-770-0424.
• To learn more about savings options and eligibility, visit our Savings page.

• MIEBO is an FDA-approved prescription eye drop that's been studied in over 600 people. In clinical studies, MIEBO was shown to significantly reduce the signs—damage on the surface of the eye—and symptoms of dry eye. With continued use of MIEBO, doctors saw significant improvement in the damage on the surface of the eye. People in the studies felt their eye dryness significantly improved.
• In the studies, doctors checked the signs and symptoms of dry eye after 2 weeks, and again after 8 weeks. Patients saw significant improvement at both checkpoints, as those improvements continued and were maintained with continued use of MIEBO.
• In these studies (GOBI and MOJAVE), MIEBO was studied against saline in 2 clinical trials of more than 1200 patients. A total of 208 patients from the GOBI study went on to enroll in an open-label extension study, KALAHARI, that evaluated the long-term safety and efficacy of MIEBO for an additional 52 weeks.

• MIEBO was studied against saline in 2 clinical trials of more than 1200 patients.

• The studies took place from 2019 to 2022. GOBI lasted from December 2019 until March 2021. MOJAVE lasted from November 2020 until August 2021. KALAHARI then evaluated the long-term safety and efficacy of MIEBO for an additional 52 weeks.

• Yes, 1 person out of 614 people in the studies stopped using MIEBO due to side effects, specifically eye irritation.

• In the United States, the main ingredient in MIEBO had never been approved by the FDA before. So the FDA required it to be approved as a prescription first to ensure its safety and effectiveness.

• Clinical studies showed that patients experienced relief from the signs and symptoms of dry eye disease from the first evaluation (Week 2) through the last evaluation (Week 8). It’s important to note that everyone’s experience is different.

• MIEBO is the only prescription eye drop that directly targets the #1 cause of dry eye: too much tear evaporation. If you’ve tried other treatments and are still looking for relief, it’s time to try something different. Consider asking your doctor about MIEBO.

• Yes, MIEBO can provide lasting relief when used consistently, as directed. In pivotal studies, doctors checked the signs and symptoms of dry eye after 2 weeks and again after 8 weeks. Patients saw significant improvement at both checkpoints while they were continuing to use MIEBO.

• MIEBO is a different type of eye drop for dry eye. It’s the first and only prescription dry eye drop that directly targets too much tear evaporation. When you place a drop of MIEBO in your eye, it spreads evenly and quickly to form a protective layer on the surface of your eye. This reduces evaporation so that you can keep more of your own tears. Don’t feel it? Don’t worry. Because of the unique properties of MIEBO, you may not feel the drop or it may not make you blink when applied.^*

• MIEBO is the first and only prescription eye drop that directly targets tear evaporation. A bottle of MIEBO contains 100% MIEBO—1 ingredient, nothing else. It’s preservative-free, which means it’s gentle on the eyes. It also contains no additives or water, which means it’s a smaller drop. Typical drops that contain water, like some artificial tears, are 3-5x larger than a drop of MIEBO.
• MIEBO also helps form a lasting barrier that fights tear evaporation to improve the signs and symptoms of dry eye with continued use. It mimics the way the protective outer layer of your own tear film prevents evaporation. MIEBO may reduce friction to help relieve that rough, gritty, dry feeling. And it can help the surface of the eye heal itself with continued use as directed.^{* †}

*The exact way MIEBO works is not known.

^†In clinical studies, with continued use of MIEBO, doctors saw improvements in the damage on the surface of the eye.

• No, MIEBO is not an artificial tear. MIEBO is a prescription treatment for the signs and symptoms of dry eye disease.
• You can only get MIEBO from your eye doctor. If you don’t have an eye doctor, you can go to the Find a Doctor tab on our website to locate one near you.

• Prescription drugs in the US demand a significantly higher level of scrutiny and oversight than over-the-counter products, so the safety and effectiveness of MIEBO were evaluated in rigorous clinical studies. Over-the-counter eye drops, like artificial tears, may provide temporary relief by adding moisture to your eyes. But for people with dry eye disease, this may not be enough. MIEBO specifically targets too much tear evaporation.

• A bottle of MIEBO contains only 1 ingredient: 100% MIEBO—and nothing else. It’s preservative-free, which means it’s gentle on the eyes, it contains no additives or water, and it’s a smaller drop. Typical drops that contain water, like some artificial tears, are 3-5x larger than a drop of MIEBO. This means you may not need as much as you’re used to. Because of its unique properties, you may not feel the drop, or it may not make you blink.

• MIEBO has been studied extensively in clinical trials. The results demonstrate that MIEBO effectively targets too much tear evaporation. From lab studies, we know that MIEBO mimics the way the natural lipids, or oily layer, of a healthy tear film prevent evaporation. The exact way MIEBO works is unknown.

• This is a common statement that the FDA includes in the package insert for many drugs. It is used when there is understanding of a drug’s therapeutic effects but the complete mechanisms by which it works are not entirely known. This statement is included in the package inserts for most dry eye medications.

• The unique, single ingredient used in MIEBO, perfluorohexyloctane, is produced by a Japanese pharmaceutical company. Bausch + Lomb takes the ingredient from the Japanese manufacturer to package MIEBO in the United States, ensuring that FDA health and safety standards are met.

• MIEBO targets the #1 cause of dry eye: too much tear evaporation. MIEBO is for the treatment of the signs and symptoms of dry eye disease. MIEBO may help heal the surface of the eye with continued use, which, in turn, may help interrupt the cycle of damage and inflammation that results in the signs and symptoms of dry eye.

• Xiidra works differently than MIEBO. Both are prescription treatments used to treat the signs and symptoms of dry eye disease but do so by targeting different characteristics of the problem. Xiidra works by targeting a source of inflammation while MIEBO addresses too much tear evaporation. You should consult with your eye doctor to learn about the treatment approach that may be right for you.

• MIEBO is the only prescription drop that directly targets the #1 cause of dry eye: too much tear evaporation. VEVYE works by increasing the amount of tears that are made—it does not address tear evaporation directly.
• Both MIEBO and VEVYE are water-free products, but MIEBO is just one ingredient while VEVYE is made of multiple ingredients. None of the ingredients in VEVYE are the same as MIEBO.

• MIEBO does not treat the meibomian glands. It treats the signs and symptoms of dry eye disease. MIEBO treats dry eye disease associated with meibomian gland dysfunction (MGD). In clinical studies of MIEBO, all patients had MGD, the reason for too much tear evaporation. MGD is a cause of dry eye for about 9 out of 10 people with dry eye.

• MIEBO treats the signs and symptoms of dry eye disease and can protect and help heal the surface of the eye with continued use over time.

• MIEBO is approved to treat the signs and symptoms of dry eye disease.^‡ Some people with dry eye may experience blurry or fluctuating vision related to too much tear evaporation, leading to an unstable tear film. MIEBO forms a protective layer to reduce tear evaporation and help maintain a stable tear film. Please note the exact way MIEBO works is not known.
  ^‡MIEBO was studied against saline in 2 clinical trials of more than 1200 people who were treated 4 times per day.

• MIEBO is a prescription eye drop approved by the FDA. Since prescription drugs in the US demand a significantly higher level of scrutiny and oversight than over-the-counter products, the safety and effectiveness of MIEBO were evaluated in rigorous clinical studies. These included 2 clinical trials where MIEBO was studied in over 600 people for 57 days (the 2 clinical trials were named GOBI and MOJAVE). No serious side effects were seen in either study. The following data is an average of the studies:
  • 0 serious side effects. No one treated with MIEBO experienced serious side effects.
  • 0.2% of people studied stopped using MIEBO due to side effects. That means that of the 614 people studied, only 1 person, in the GOBI study, stopped using MIEBO because of side effects.
  • 0.5% of people studied felt burning or stinging when putting in MIEBO. This was 3 people in the GOBI study.
  • And 2.1% of people studied reported blurred vision, which usually resolved within minutes. This was 9 people in the GOBI study and 4 people in the MOJAVE study. 0.8% also experienced eye redness.
  • Do not use if you are allergic to MIEBO.

• Yes, we have long-term data from a clinical study called KALAHARI. Because MIEBO is a prescription, it was studied in depth in patients, unlike over-the-counter artificial tears. This included the long-term safety study KALAHARI, which demonstrated no additional safety concerns, confirming the safety data from the previous studies GOBI and MOJAVE. Detailed safety data from the studies can be found on our Results with MIEBO page.

• In 2 clinical trials that lasted 57 days, no one treated with MIEBO experienced serious side effects. Out of everyone MIEBO was studied in:
  • 0.2% of people studied stopped using MIEBO due to side effects. That means that of the 614 people studied, only 1 person stopped using MIEBO because of side effects.
  • 0.5% of people studied felt burning or stinging when putting in MIEBO.
  • And 2.1% of people studied reported blurred vision, which usually resolved within minutes. 0.8% also experienced eye redness.
• The safety of MIEBO was also demonstrated in a long-term study, KALAHARI, which reinforced the safety data from the previous studies, GOBI and MOJAVE.

• Data suggests that MIEBO is not metabolized in humans. That means it exits your body as waste, with the chemical structure unchanged from when it was put in.

• MIEBO is excreted from the body as waste. A small amount of it also evaporates from the surface of the eye over time.

• No. The recalls and warnings do not apply or relate to any Bausch + Lomb products. The health and safety of anyone who uses our products is a top priority at Bausch + Lomb. We take great pride in supporting and serving our customers, patients, and consumers every day by offering only products that meet high standards of safety and quality.
• This is why it’s important to only use products containing perfluorohexyloctane (the active ingredient in MIEBO) that are prescribed within the US and therefore manufactured by Bausch + Lomb. Bausch + Lomb cannot stand behind the quality of illegally imported products in the US manufactured by other companies.

• Yes, you can continue wearing your contact lenses while using MIEBO, but you should not put the drops in while your lenses are in your eyes. Be sure to remove your contact lenses before using MIEBO, and wait at least 30 minutes after applying the drops before putting your lenses back in.

• Dry eye disease is a chronic condition where there is damage to the surface of the eye that can result in dry eye symptoms. There is no known cure for dry eye disease. Since MIEBO can help heal the eye’s surface with continued use, if you stop using it your dry eye symptoms are likely to return. There is no study data to show exactly how long that may take, but the vicious cycle of damage associated with the condition could progress.

• To use MIEBO, it’s important to know that this different kind of drop means a different way of using the bottle too. Each bottle of MIEBO has all you need for a full month of treatment (about 270 drops). To make sure you only get 1 drop of MIEBO each time, you’ll need to prime the bottle.
• To make sure you only get 1 drop of MIEBO each time you squeeze the bottle, follow these simple steps:
  • Step 1: Get ready. Unscrew and remove the cap from the bottle. If wearing contact lenses, remove them before using MIEBO and wait at least 30 minutes before putting them back in.
  • Step 2: Get set. Prime the bottle before you use it: Squeeze the bottle while upright. Turn it upside down (so the tip points down) while squeezing. Release the pressure.
  • Step 3: Go with MIEBO. With the bottle upside down, move it above your eye and squeeze it again to release 1 drop.
  • Repeat all of Step 2 to prime the bottle and release 1 drop in your other eye.
  • For step-by-step instructions and a video example, please visit our How to use MIEBO page.

• The first squeeze while the bottle is upright will help make sure you only use 1 drop of MIEBO each time. Each bottle of MIEBO has all you need for a month.

• Because you may not feel the drop go in, using a mirror is a great way to make sure it did in fact go in.

• MIEBO spreads quickly to form a silky-smooth feeling protective layer right on the surface of your eye. Don’t feel it? Don’t worry. MIEBO is a comfortable drop. Because of its unique properties, you may not feel the drop, or it may not make you blink when applied.

• Each bottle of MIEBO has what you need for a full month of treatment (about 270 drops). MIEBO has no additives or water, which means it’s a smaller drop than other, water-based drops, which are 3-5x larger. To make sure you only get one drop of MIEBO each time you squeeze the bottle, check out our step-by-step video.
• MIEBO was studied in people using 1 drop per eye 4 times a day, so make sure to use MIEBO as directed by your doctor.

• Always follow the dosing instructions provided by your eye doctor. MIEBO was studied in people using a dosage of 4 drops per day.

• MIEBO is not known to have any reactions to other eye drops. If you are using other drops in addition to MIEBO, you may want to use MIEBO last because other drops may wash it away if used after it. Always check with your doctor before starting new medications or combining medications.

• Always check with your doctor before starting a new medication or combining medications.

• You should store MIEBO at around room temperature, anywhere from 59°F-77°F (15°C-25°C). After opening, MIEBO can be used until the expiration date on the bottle.

• MIEBO is a comfortable drop. Because of its unique properties, you may not feel the drop or it may not make you blink when applied. For detailed usage instructions, visit our How to use MIEBO page.

• Clinical studies showed that patients experienced relief from the signs and symptoms of dry eye disease from the first evaluation (Week 2) through the last evaluation (Week 8). It’s important to note that everyone’s experience is different.

• Yes, you can continue wearing your contact lenses while using MIEBO, but you should not put the drops in while your lenses are in your eyes. Be sure to remove your contact lenses before using MIEBO, and wait at least 30 minutes after applying the drops before putting your lenses back in.

• MIEBO is unique because it contains only 1 ingredient: 100% MIEBO—and nothing else. The ingredient, perfluorohexyloctane, helps form a lasting barrier to fight tear evaporation. It’s preservative-free, which means it’s gentle on the eyes, and it contains no additives or water, which means it’s a smaller drop. Because of its unique properties, you may not feel the drop or it may not make you blink. MIEBO directly targets too much tear evaporation, and with continued use can help heal the surface of the eye.

• PFAS stands for perfluoroalkyl and polyfluoroalkyl substances, and is a broad term for many different compounds. The term PFAS does not indicate whether a substance is harmful or not.
• Perfluorohexyloctane, which is the only ingredient in MIEBO, has also been safely used in ophthalmic surgery, and other PFAS have been used in contact lenses for 5 decades with no safety concerns.
• MIEBO is non-reactive with other things. It does not change, react with, or bind to other substances.
• MIEBO is NOT metabolized; it leaves the body unchanged. Studies show that MIEBO exits the body naturally by evaporating from the eye, passing through the digestive system, or being exhaled.
• Some other PFAS can stay in the body because they dissolve easily in water and interact with proteins. However, MIEBO does not react with the body and cannot readily dissolve in water.
• Based on thorough testing in both laboratory and clinical studies, the FDA has approved MIEBO as a safe and effective treatment for the signs and symptoms of dry eye disease. It has been commercially available in the US since September 2023 with no serious side effects seen in two 57-day clinical studies.

• Yes, perfluorohexyloctane has been used in other medical applications in eye care.

• No, Bausch + Lomb does not sell MIEBO outside of the US. In some parts of the world, the active ingredient, perfluorohexyloctane, is sold as a medical device. This means that it must be asked for by name at the pharmacy. Perfluorohexyloctane was approved by the FDA in May 2023 as a standalone product in eye care. As it is a new drug in the US, it was approved as a prescription in order to ensure its safety and effectiveness.
• It’s important to understand that it is illegal for pharmacies to import products that are prescriptions in the US from other countries. Since perfluorohexyloctane eye drops from countries outside the US were not manufactured by Bausch + Lomb, they have not been evaluated by the FDA. There is no assurance about their quality, standards of their production, or, very importantly, clinical efficacy and safety.

• Yes, the only way to get MIEBO is with a prescription. Ask your eye doctor if MIEBO may be right for you.

• Because MIEBO is a prescription eye drop, the first step in finding relief is talking with an eye doctor. If you don’t have an eye doctor, you can use the “Find a doctor” tool on our website to search for one by name, location, and specialty. Visit our Find a doctor page to search now.

• MIEBO may be prescribed by regular doctors. Since it is a prescription treatment for dry eye, it’s recommended to meet with an eye care professional to discuss your individual needs and treatment plan.

• Your eye doctor will recommend a follow-up schedule based on your individual needs and treatment plan. In clinical studies, patients using MIEBO were evaluated at 2 weeks and again at 8 weeks, with improvements in the signs and symptoms of dry eye seen at both checkpoints while they were continuing to use MIEBO. Follow-up appointments with your eye doctor help monitor your progress and ensure your treatment questions are addressed.