Compounded Bioidentical Hormone Therapy: A Prescriber's Guide to Working with a Compounding Pharmacy

For people living with severe dry eye disease, the daily discomfort can feel relentless — burning, stinging, light sensitivity, and blurred vision that interferes with work and quality of life. Artificial tears and prescription drops help many patients, but for those with more advanced disease, something more may be needed. Autologous serum eye drops are a specialized treatment that may offer significant relief when other options have not been enough. What Are Autologous Serum Eye Drops? Autologous serum eye drops are made by taking a sample of your own blood, separating the serum from the red blood cells, and diluting it with a sterile solution. The resulting drops contain many of the same growth factors, vitamins, and proteins naturally found in healthy tears — components that commercial artificial tears simply cannot replicate. Because they come from your own body, the risk of rejection or allergic reaction is essentially zero. Who Can Benefit? Autologous serum drops are typically considered for patients with moderate to severe dry eye disease who have not found adequate relief from standard treatments. They are frequently used in conditions such as Sjogren's syndrome-related dry eye, ocular graft-versus-host disease, neurotrophic keratopathy, severe aqueous-deficient dry eye, and significant ocular surface damage from chronic contact lens use. Your eye doctor will determine whether you are a candidate based on your specific diagnosis and history. What Is the Process? Your doctor will write a prescription for autologous serum eye drops. A blood draw is then required — this can be done at a lab or through a coordinating service. Once the blood is received by the compounding pharmacy, the serum is separated, diluted to the appropriate concentration (commonly 20% or 50%), and dispensed in sterile vials. The drops are kept frozen to preserve their potency and are thawed as needed. How Are They Used? Autologous serum drops are typically used multiple times per day, as directed by your eye doctor. They should be stored in the freezer — you thaw one vial at a time for daily use while the rest remain frozen. Most preparations have a beyond-use date established by th compounding pharmacy, and your prescriber will schedule regular follow-up to monitor your response to treatment. Is This Covered by Insurance? Coverage varies by insurance plan and diagnosis. Your prescribing provider can assist with prior authorization documentation if needed. Kearney Park Pharmacy can help answer questions about the prescription process and shipping logistics. Available Across Texas from Kearney Park Pharmacy Kearney Park Pharmacy prepares autologous serum eye drops as a sterile compounded preparation under USP 797 standards. We ship across Texas in appropriate frozen packaging to ensure integrity during transit. If your eye doctor has recommended autologous serum drops, ask them to send the prescription to Kearney Park Pharmacy. Call us at 972-329-1168 or fax to 972-329-1436 and we will guide you through the process.

For patients with aqueous-deficient dry eye disease unresponsive to conventional therapy, autologous serum eye drops remain one of the strongest evidence-based options in the ophthalmologist's armamentarium. Multiple controlled trials and case series have demonstrated improvements in corneal staining, OSDI scores, and symptom burden in patients with Sjogren's syndrome, GVHD, neurotrophic keratopathy, and other severe ocular surface conditions. The clinical barrier to prescribing is largely logistical — and a well-organized compounding pharmacy relationship resolves most of it. Why Autologous Serum Works Serum contains growth factors (EGF, TGF-beta, fibronectin), vitamins, and immunoglobulins that closely replicate the biochemical composition of healthy human tears. These components support corneal epithelial healing, reduce inflammation, and maintain surface integrity in a way that no currently available commercial formulation can match. Commercial cyclosporine and lifitegrast address the inflammatory component, but do not provide the structural and growth factor support that serum delivers — making these treatments potentially complementary rather than competitive. Concentration and Formulation The two most studied concentrations are 20% and 50% serum diluted in sterile 0.9% sodium chloride. The 20% concentration is commonly used as a starting point. The 50% concentration is preferred in patients with more severe disease, GVHD, or inadequate response to 20%. Some protocols use higher concentrations in refractory cases. Kearney Park Pharmacy can prepare autologous serum at the concentration you specify. We recommend clearly stating the concentration, quantity of vials, and refill authorization on the prescription to streamline processing. Blood Collection and Chain of Custody Blood draw coordination is a common workflow question. Patients typically have blood drawn at a local lab and arrange shipping to the compounding pharmacy via overnight service. Kearney Park Pharmacy can provide the collection kit instructions and shipping requirements to your office so that patients are properly prepared. A clear chain of custody from draw to preparation is maintained in our documentation. Sterile Compounding and Frozen Shipping We prepare autologous serum drops aseptically under USP 797 conditions in our ISO-classified cleanroom. Vials are dispensed in unit-dose format and shipped frozen using validated cold-chain packaging to maintain product integrity during transit. We ship across Texas, making this therapy accessible to your patients regardless of proximity to our Mesquite location. Coordinating Refills for Your Patients For patients on chronic autologous serum therapy, we can coordinate refill scheduling to minimize lapses. We recommend establishing a refill rhythm tied to the patient's remaining vial supply and scheduling the next blood draw accordingly. Your office can be notified when a new prescription or refill authorization is needed. Establish a Prescriber Relationship If you are treating patients with ocular surface disease and want a reliable sterile compounding source for autologous serum, we would welcome the opportunity to work with your practice. Contact Kearney Park Pharmacy at 972-329-1168 or fax to 972-329-1436.