Hemoderivative Eye Drops

Autologous serum tears are made from the clear liquid portion of your blood after it clots — the “serum” layer — and contain a broad, dilute profile of growth factors, vitamins, and immunoglobulins. ePRP is made by centrifuging your blood to concentrate the platelet-rich fraction, which carries a denser mix of regenerative growth factors (PDGF, VEGF, EGF, TGF-β, IGF). AS is the long-established workhorse for severe dry eye and autoimmune disease; ePRP is more recent and tends to be chosen when corneal epithelial healing is the primary goal. Your clinical picture guides the choice — in some cases we use them in sequence.

Hemoderivatives are autologous biological products — made from your blood, for you alone — and they’re regulated accordingly. Production requires a licensed facility with the right centrifugation, sterile processing, and storage infrastructure. In Canada, that means a small number of specialised compounding pharmacies, which are concentrated in a few cities. For a patient in significant discomfort, being told “we can prescribe this, but you’ll need to find a pharmacy that makes it” is often the end of the conversation — which is exactly why we brought production in-house at UDEI.

Through the conventional specialist-plus-external-pharmacy pathway, patients typically wait two to four weeks between the decision to start biologic drops and actually dispensing them — accounting for the specialist appointment, the pharmacy consultation, scheduling a separate blood draw, production time, and pickup logistics. At UDEI, because the assessment, blood draw, processing, and dispensing happen at the same location, most patients complete the pathway within a week or two of the initial decision. We’ll give you a realistic timeline based on your appointment date and which of our three producing sites is handling your preparation.

Because the drops are made from your own blood, the risks of allergic reaction, immune response, or disease transmission that exist with donor-derived products are essentially absent. That said, no treatment is risk-free. The blood draw carries the usual minor risks of bruising and, very rarely, infection. The drops themselves, if not handled, stored, or dispensed correctly, can become contaminated — which is why we produce under sterile conditions and give you specific instructions for storage and hygiene at home. We screen every patient for a small set of standard blood-borne conditions before starting, and we decline treatment when it isn’t the right fit. Most patients tolerate biologic drops extremely well — better, in fact, than many prescription dry-eye drops that cause stinging or preservative irritation.

A typical dispensing gives you a refrigerated daily-use supply — usually enough for one to two weeks of active drops — plus a frozen reserve for longer-term storage. Once a bottle is open and in daily use, it stays in the refrigerator and is used within its assigned date. Frozen aliquots are thawed as needed, one bottle at a time. We walk you through exactly how to handle, thaw, and use each bottle, including travel logistics if you’re away from a fridge for a day or two. Most patients find the storage routine straightforward after the first few days.

OHIP does not cover the cost of producing autologous serum or ePRP drops, and neither do most provincial drug plans. Some private extended health insurance plans cover a portion of the cost — especially for severe disease such as Sjögren’s syndrome or post-surgical dry eye — often requiring an itemised invoice and sometimes prior authorisation. Your initial ocular-surface assessment may be covered by OHIP when medically indicated. We’ll provide a clear written cost breakdown before any production begins, so there are no surprises. For patients where cost is a barrier, we’ll always discuss the full range of alternatives honestly rather than pushing the most expensive option.

It depends on why you’re on them. Patients with post-surgical dry eye or a persistent epithelial defect often use hemoderivatives as a bridge therapy — intensively for weeks to months while the surface heals, then tapered off. Patients with Sjögren’s syndrome, graft-versus-host disease, or severe permanent aqueous deficiency often use them indefinitely as part of long-term maintenance. Somewhere between those two ends sits the majority: patients who use them for several months to a year, then transition to a reduced frequency or stop entirely once the surface is stable. We reassess periodically and adjust the plan rather than leaving you indefinitely on a treatment that’s doing its job quietly in the background.

Most patients who need hemoderivatives have a surface that isn’t well-suited to ongoing contact lens wear — which is often why they ended up in our office. We typically ask patients to pause lens wear during the initial healing phase, then reassess candidacy as the surface stabilises. For patients who still want contact lenses long-term, our colleagues at U Optical can discuss specialty lens options, including scleral lenses, which are often the right fit for a severe dry eye patient who can’t tolerate conventional soft lenses.

Quite possibly. Severe post-surgical dry eye — particularly after refractive surgery — is one of the most common reasons patients end up on hemoderivatives. The corneal nerves damaged during laser surgery or cataract incisions can take months to recover, and during that time your surface loses its normal trophic signals. Biologic drops replace those signals while the nerves regenerate, often dramatically improving comfort and accelerating recovery. A proper assessment will tell us whether hemoderivatives are the right tool, or whether another intervention — UltraView DEL™, LipiFlow, punctal plugs, or addressing an underlying MGD component — is the better place to start.

We welcome referrals for patients with severe refractory dry eye, Sjögren’s or other autoimmune ocular surface disease, persistent epithelial defects, neurotrophic keratopathy, GVHD, or post-surgical dry eye that isn’t improving on conventional therapy. The key advantage for your patient is that we handle the assessment, blood draw, production, and dispensing in-house — no separate pharmacy referral, no logistics for them to solve on their own. Fax referrals to 416-292-0331, or contact our referral desk at 416-292-0334 or info@udei.ca. A consult letter with findings and plan will be returned within one week of the patient’s visit. To formally join the UVG Professional Relations network — for co-management updates, CE opportunities, and streamlined referral pathways — sign up at uptowneye.ca/referring-doctors.