As I think back to my days of medical school and residency and recall what we learned about dry eye, I can’t help but be amazed at how far we have come. As a second year medical student, our entire dry eye section consisted of being told that wetting the eyes is not like brushing your teeth — they don’t need regular maintenance, and if they are irritated, they produce their own reflex tears. Also, we could add artificial tears if needed.

Now, in 2020, dry eye disease has become one of the most commonly addressed problems by the eye-care professional. Not only do we have three approved medications for dry eye treatment, we also have numerous devices aimed at both diagnosis and treatment as well as multiple new treatment algorithms outlining various approaches to these patients.

LANDMARK ALGORITHMS

This month, we focus on the current landscape of dry eye management in the United States. Drs. Christopher Starr and Mark Milner discuss the three new landmark algorithms that were recently published: TFOS DEWS II, CEDARS DTS and ASCRS Cornea Committee algorithm (page 34). TFOS DEWS II is the all-encompassing encyclopedia of dry eye disease. The CEDARS algorithm is a practical approach in an at-your-fingertips format for management of these patients. The ASCRS algorithm focuses specifically on how to get dry eye patients ready for surgery.

AND THERE’S MORE

Dr. Alice Epitropoulos shares her approach to managing dry eye patients specifically around the time of cataract and refractive surgery, which has its own unusual components (page 18). Dr. Marguerite McDonald introduces the various diagnostic devices used to help identify and grade severity of dry eye (page 23). Drs. Jodi Luchs, Elizabeth Yeu, John Hovanesian and Parag Majmudar elaborate on their methods to treat these patients (page 28). Finally, Dr. Nicole Lemanski summarizes her approach to building a dry eye-focused practice (page 41).

INCREASING DRY EYE AWARENESS

I am honored to be the guest editor of this month’s issue. I believe we have assembled an incredible roster of dry eye experts to help unwind this complex disease.

While many dry eye innovations have changed the way we practice, their greatest impact may be how they help to raise awareness of the disease and its impact on patients. Physicians are now looking for it, and patients are now asking about it. This newfound attention will lead to further innovation and improved patient outcomes. OM

Kenneth Beckman, MD, FACS, is the director of Corneal Services at Comprehensive EyeCare of Central Ohio in Westerville, Ohio, and clinical assistant professor of Ophthalmology at The Ohio State University in Columbus, Ohio.

Dr. Beckman disclosed relationships with Alcon, Allergan, Bausch + Lomb, Bruder, Eyevance, Holbar Medical, Johnson & Johnson Vision, Novartis, RPS, Sun Pharma and TearLab.