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The potential clinical benefits of nasolacrimal occlusion (NLO) and eyelid closure (ELC) for 5 minutes have been recognized for many years. 1.9 Following the ocular instillation of drugs prepared in solutions, suspensions, and ointments, the pharmacologically active chemicals within these vehicles are pumped from the periocular area by the eyelids down the nasolacrimal outflow paths to the nasal mucosa. 10 This results in less intraocular drug absorption. In addition, the vascular nasal mucosa can readily absorb the drugs delivered in these vehicles, resulting in measurable systemic blood levels, which can be associated with significant systemic toxicity. 11 Therefore, the rapid passage of eye drops into the nasolacrimal outflow system effectively minimizes therapeutic effect and maximizes systemic toxicity of topically applied medications. 1 .

Proposed Mandate for Instructions and Labeling Regarding the Use of Eye Drops