Prescribing for Dry Eye Disease
The Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) III report, which was recently released, includes an updated prescribing algorithm based on DED etiology or pathogenic drivers.
Clinical Scorecard: Prescribing for Dry Eye Disease
At a Glance
Category Detail
Condition Key Mechanisms Multifactorial etiology including tear film deficiencies (e.g., aqueous deficiency, lipid deficiency), eyelid abnormalities (e.g., ectropion, entropion), and ocular surface abnormalities (e.g., conjunctivochalasis). Target Population Care Setting
Key Highlights
DED has 10 different drivers categorized into 3 main groups. A targeted approach based on etiology is recommended for treatment. Common therapies include artificial tears, lid hygiene, and nutraceuticals. Ocular surface regenerators and tear conservation devices are also utilized. Lifestyle factors significantly impact DED management. Addressing overlapping causes is crucial for effective treatment. Guideline-Based Recommendations
Diagnosis
Assess case history, Ocular Surface Disease Index-6 score, symptoms, clinical signs, and diagnostic findings. Management
Utilize a combination of therapies targeting the main causes of DED, including specific treatments for each identified driver. Monitoring & Follow-up
Regular follow-up to assess treatment efficacy and adjust therapies as needed. Risks
Inadequate treatment may lead to worsening symptoms and ocular surface damage. Patient & Prescribing Data
Individuals diagnosed with Dry Eye Disease, including those with concurrent conditions like ocular rosacea.
Combination therapies are often necessary, with a focus on the primary driver of DED.
Clinical Best Practices
Educate patients on lifestyle modifications that can alleviate DED symptoms. Consider surgical interventions for severe anatomical misalignments, such as ectropion repair or pterygium excision. Implement in-office procedures for meibomian gland dysfunction, including thermal pulsation or meibomian gland probing, as needed. References
