Dry eye disease is a condition that occurs when your eyes do not make enough tears or when your tears dry up too quickly. Tears are essential for keeping the surface of your eyes healthy, comfortable, and clear. Common symptoms of dry eye disease include a scratchy or gritty feeling, stinging, burning, redness, blurry vision, or sensitivity to light.
Many things can cause dry eye symptoms or make them worse. For example, if environmental factors are to blame, changes like avoiding dry air, limiting screen time, and drinking more water may help. Many people also find relief with over-the-counter (OTC) eye drops, also called artificial tears, which help keep the eyes wet. When these basic measures are not enough, your eyes may need help producing more natural tears.
In May 2025, the FDA approved Tryptyr, a new medicine for dry eye disease. This article covers frequently asked questions and answers about Tryptyr for dry eye.
How Does Tryptyr Work for Dry Eyes?
Tryptyr (acoltremon) 0.003% ophthalmic solution is a prescription eye drop for adults with dry eye disease. The medicine works by stimulating your eye’s natural tear production.
The active ingredient in Tryptyr is acoltremon, which activates a protein in your eye called TRPM8. TRPM8 is part of a group of proteins in your eye called thermoreceptors, which detect small changes in temperature due to normal tear evaporation. When TRPM8 is activated, it stimulates nerves in your eye that help increase the amount of tears your eye makes on a daily basis. Making more tears can reduce symptoms of dry eye.
How Was Tryptyr Studied?
Two clinical studies, called COMET-2 and COMET-3, were done to see if Tryptyr was safe and effective for the treatment of dry eye disease in adults. Tryptyr was compared to a placebo eye drop that contained no medicine. In both studies, neither the participants nor the researchers knew if they were getting Tryptyr or the placebo. To be eligible for the studies, participants had to have both signs and symptoms of dry eye disease, confirmed through eye exams and special tests. Symptoms included a Symptom Assessment in Dry Eye (SANDE) score of at least 50 and an Ocular Discomfort Score of at least 50. Signs of disease included a corneal fluorescein staining score between 2 and 15 and a Schirmer tear test score between 2 and 9 mm (without anesthesia).
In total, 931 adults were included across both trials. Participants in these studies were between the ages of 30 and 93, with an average age of 61. Approximately 75% of participants in the study were women. Tryptyr or placebo was dosed twice daily for 90 days. Participants were not allowed to use artificial tears during the study. The effectiveness of Tryptyr was evaluated by a specific test called the Schirmer tear test, which measures the amount of tears produced by the eyes. The Schirmer score ranges from 0 to 35 mm. The main goal of the study was to determine how many patients had an increase in the Schirmer score of 10 mm or more.
In other words, the studies looked at whether people with dry eye disease who used Tryptyr made more tears compared to those who used a placebo. The main goal was to see how many people had a noticeable increase in tear production after two weeks of treatment.
What Are the Main Benefits Based on Studies? (Primary Outcomes)
After 14 days of treatment, more people who used Tryptyr had a Schirmer score increase of 10 mm or more compared to people who used placebo drops. In COMET-2, 42.6% of people using Tryptyr had an increase in tear production, compared to just 8.2% of those using the placebo. In COMET-3, 53.2% of people using Tryptyr had an increase in tear production, compared to just 14.4% of those using the placebo. These improvements with Tryptyr continued throughout the 90-day study.
Your results may differ from what was seen in clinical studies.
How Strong Is the Evidence for Tryptyr?
Based on the COMET-2 and COMET-3 trials, Tryptyr is safe and effective for adults with dry eye disease. Tryptyr is not yet included in clinical practice guidelines for dry eye disease, but it is the first eye medicine that activates certain nerves in the eye to increase tear production.
What Can I Do to Manage Side Effects?
The most common side effect of Tryptyr is a painful sensation when the drops are applied. About 50% of people who use Tryptyr experience this side effect. While this discomfort is usually mild and temporary, there are steps you can take to manage it and continue using the medication.
First, proper drop technique is essential. Wash your hands before using the medicine and avoid touching the tip of the vial to your eye, eyelid, or any surface. When applying the drop, gently pull down your lower eyelid, look upward, and place one drop into the eye without touching the eye itself. After application, gently close your eyes for a few seconds rather than squeezing them shut.
