Dry eye disease (DED) is a complex but ubiquitous condition with an estimated global prevalence of 5% to 50%.¹ Fortunately, we know more than ever about the underlying causes of DED and how to better diagnose and treat it.

In this issue, we have assembled some of the leading voices in dry eye care to share their pearls and perspectives. Whether you’re a comprehensive ophthalmologist or a “dry eye sub-specialist,” you’ll learn something by reading this issue of Ophthalmology Management — I certainly did!

OUR DRY EYE EXPERTS WEIGH IN

As we know, a savvy diagnosis can go a long way to tailored dry eye therapy and better outcomes. Even so, it may not be practical from a workflow or resource perspective for every practice to invest in every diagnostic technology. Dr. Yuna Rapoport explains her approach to diagnosing DED and its subtypes, utilizing symptom questionnaires, examination, tests and imaging (page 39). In addition, Dr. Rapoport shares what really works and how to deploy these resources while providing a smooth patient experience.

Next, Dr. Neel Pasricha and Ethan Lindgren examine lifestyle and pharmaceutical management of dry eye, from topical immunomodulators to scleral contact lenses and beyond (page 20). This article updates us on “what’s new” for dry eye in 2023 and what we can look forward to in the pharmaceutical pipeline. Most importantly, the authors share their approach to selecting amongst these varied therapies in accordance with a patient’s specific DED diagnosis.

This last decade has seen a dramatic expansion of DED procedural offerings, including vectored thermal pulsation, intense pulsed light, microblepheroexfoliation and more. Drs. Anthony Tang, Nandini Venkateswaran and Kourtney Houser summarize the landscape of procedural and surgical interventions for dry eye (page 28). This article will help clinicians discern which patients may be the best candidates for each of these treatments and discuss how these procedures may fit into existing clinical algorithms.

Finally, in their articles, Dr. Ashley Brissette, David Rabinovitch (page 15) and Dr. Zeba Syed (page 42) cover the practical business management of effective, high-quality dry eye care that is focused on the patient experience. The authors explore trends in dry eye care, including ophthalmology-optometry co-management, the importance of peri-operative ocular surface optimization and the rise of dry eye centers of excellence.

THE FUTURE IS BRIGHT FOR DED

Vision scientists have begun to unravel the complexities of DED, while societies such as the Tear Film Ocular Society² and the ASCRS³ have been instrumental in the translation of bench data to clinical knowledge. The robust DED drug and device pipeline has continued to grow due to ongoing collaboration with industry partners. Thanks to the evolution of dry eye care, we, as ophthalmologists, are more capable than ever of helping our patients who suffer from this condition.

We’re proud to offer this collection of articles on DED and hope you’ll enjoy reading as much as we did putting them together! OM

Special thanks to Lakshman Mulpuri, MD, for his assistance with this editorial.

REFERENCES

1. Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334-365.
2. Craig JP, Nelson JD, Azar DT, et al. TFOS DEWS II Report Executive Summary. Ocul Surf. 2017;15(4):802-812.
3. Starr CE, Gupta PK, Farid M, et al. An algorithm for the preoperative diagnosis and treatment of ocular surface disorders. J Cataract Refract Surg. 2019;45(5):669-684.

Rahul Tonk, MD, MBA, is a cornea, cataract and refractive surgeon located in Miami. He serves as associate medical director and cornea fellowship co-director at the Bascom Palmer Eye Institute.