“I can’t be dilated, I have to get back to work,” is a common patient re-frain in many primary care optometric offices. What’s more, ODs are always on the lookout to provide safe, effective, and convenient interventions for their patients. Enter phentolamine ophthalmic solution 0.75% (Ryzumvi), from Viatris.
Safety and efficacy
Ryzumvi is FDA approved for the treatment of pharmacologically induced mydriasis produced by adrenergic agonists or parasympatholytic agents.
In terms of safety, the drop is not recommended for patients who have active ocular inflammation (e.g., iritis), and contact lens wearers should wait 10 minutes before reinserting their lenses after use.
Additionally, the most common adverse events reported have been instillation site discomfort (16%), conjunctival hyperemia (12%), and dysgeusia (6%).
Josh Johnston, OD, FAAO, who practices at Georgia Eye Partners, a multilocation OD/MD practice in Georgia, says the most common patient population he offers the drop to are patients preparing for adjustable lens cataract surgery, as this procedure requires frequent visits and dilation.
Regarding efficacy, Ryzumvi typically works in 30 minutes. In two clinical trials, 49% and 58% of patients who instilled two drops of Ryzumvi, respectively, returned to ≤ 0.2 mm of their baseline pupil diameter vs. 7% and 6% of patients who instilled a placebo, respectively.
Patient convenience
Walter Whitley, OD, who practices at Virginia Eye Consultants, a multilocation OD/MD practice in Virginia, says many of his patients, especially those who need to get back to work or have a busy lifestyle, give a resounding “yes” when asked whether they’d like to utilize the not-covered dilation-reversal drop. This is because of the convenience it offers patients.
Keep in mind that dilation can last anywhere from four to 24 hours, requiring patients to restrict their activities until their eyes return to normal, so they see the value in paying out-of-pocket for it.
“I think the key to bringing the product on is to understand that it’s a way to increase the patient experience with the practice,” points out Shane R. Kannarr, OD, who practices at Kannarr Eye Care, a multilocation practice in Kansas. “Offering cutting-edge technologies ensures practitioners are providing the highest level of care to patients, which creates patient loyalty to a practice.”
To facilitate the dissemination of Ryzumvi, he says he provided staff a patient script on its benefits, and related paperwork to give to patients, such as an acknowledgment of dilation (complete with an introduction to Ryzumvi), and an Advance Beneficiary Notice of Noncoverage. (ODs typically charge between $15 and $40 for the drop, according to Viatris.)
The patient script: “We have a drop that will speed up the reversal of most of the effects of your dilation. You may still have near blur up close. We’ve had great response from our patients who report feeling comfortable driving and having near work restored within one to two hours. Is that something you’re interested in?”
A welcomed side effect
Dr. Kannar says he experiences less pushback on dilation because of Ryzumvi, which comes packaged as individual non-preserved vials with a 30-day expiration date.
“As optometrists, we know all too well that dilation is an important component of a comprehensive exam,” he says. OM
