INNOVATION |
DRY EYE MANAGEMENT
New Treatments Emerge in Dry Eye Disease by Andrew Sweeney
O
f all of the maladies affecting the eye, dry eye disease (DED) is among the most common.
It’s characterized by a loss of homeostasis in the tear film and is accompanied by ocular symptoms; tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities all play etiological roles in DED. The stinging, redness and sensitivity to light caused by DED can be extremely unpleasant for patients, and in severe cases restriction of daily activities, pain, decreased wellness, and impairment of general health can occur.1 And for physicians, it can be difficult to manage. According to Current Management of Dry Eye Disease,1 the management of DED is highly complicated because of its multifactorial etiology which is
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associated with many mechanisms. Therefore, clinicians should clearly determine the underlying etiology and differentiate between the two forms of DED: aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE). This classification is often used to diagnose and identify the treatment modality.
No more tears Traditional dry eye treatments have generally been limited to overthe-counter artificial tears, warm compresses, and lid hygiene with baby shampoo. And according to Advances in Dry Eye Disease Treatment,2 even though topical cyclosporine (CsA) has a long track record in dry eye treatment, questions still surround its use. These include: optimal concentration/dose, necessary length of treatment, and which patients are most likely to benefit from its use. The same study
| February 2021
has welcomed the increase in the development of therapies that target meibomian gland dysfunction (MGD) and DED, and the use of biologic and biologically derived products (i.e., blood serum and plasma, amniotic membranes and naturally occurring glycoproteins). Clearly there is a groundswell of development in the study and treatment of DED, a development that should be welcome as both beneficial for patients and fascinating for study. At the American Academy of Ophthalmology (AAO 2020 Virtual) meeting held in November, DED was one of the main conditions given center stage for study and discussion. One of the standout presentations on this subject was Step-by-Step Management of Dry Eye Disease, which was still available to view on the AAO 2020 Virtual portal at the time of writing.
