“…149 Recently, Olympic Ophthalmics, Inc. (Issaquah, WA) has developed a portable sonic external neurostimulation device, the iTEAR, which introduces two variations to the previously mention intranasal therapy, which consists of an external approach and external nasal nerve stimulation, demonstrating significant improvement in the treatment of DED. 150…”
Section: Management Of Dry Eye In Patients With Autoimmune Diseasesmentioning
Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. Methods An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included “dry eye disease” associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. Results Although DED is frequently associated with SAIDs, its diagnosis is commonly delayed or missed, producing significant complications, including corneal ulceration, melting, scleritis, uveitis, and optic neuritis resulting in severe complications detrimental to visual function and quality of life. SAID should be suspected in a woman, 30 to 60 years old with a family history of autoimmunity, presenting with DED symptoms and extraocular manifestations including arthralgias, dry mouth, unexplained weight and hair loss, chronic fatigue, heat or cold intolerance, insomnia, and mood disorders. Conclusions Establishing the correct diagnosis and treatment of DED associated with SAIDs is crucial to avoid its significant burden and severe ocular complications.
“…149 Recently, Olympic Ophthalmics, Inc. (Issaquah, WA) has developed a portable sonic external neurostimulation device, the iTEAR, which introduces two variations to the previously mention intranasal therapy, which consists of an external approach and external nasal nerve stimulation, demonstrating significant improvement in the treatment of DED. 150…”
Section: Management Of Dry Eye In Patients With Autoimmune Diseasesmentioning
Objectives Dry eye disease (DED) is arguably the most frequent ocular disease encountered in ophthalmic clinical practice. DED is frequently an underestimated condition causing a significant impact on visual function and quality of life. Many systemic autoimmune diseases (SAIDs) are related to moderate to severe DED. The main objective of this review is to enhance the awareness among ophthalmologists of the potential association of an underlying SAID in a high-risk patient with DED. Methods An exhaustive literature search was performed in the National Library of Medicine's Pubmed, Scopus, Web of Science, and Google Scholar databases for all English language articles published until November 2021. The main keywords included “dry eye disease” associated with autoimmune, connective tissue, endocrine, gastrointestinal, hematopoietic, vascular, and pulmonary diseases. Case reports, series, letters to the editor, reviews, and original articles were included. Results Although DED is frequently associated with SAIDs, its diagnosis is commonly delayed or missed, producing significant complications, including corneal ulceration, melting, scleritis, uveitis, and optic neuritis resulting in severe complications detrimental to visual function and quality of life. SAID should be suspected in a woman, 30 to 60 years old with a family history of autoimmunity, presenting with DED symptoms and extraocular manifestations including arthralgias, dry mouth, unexplained weight and hair loss, chronic fatigue, heat or cold intolerance, insomnia, and mood disorders. Conclusions Establishing the correct diagnosis and treatment of DED associated with SAIDs is crucial to avoid its significant burden and severe ocular complications.
“…12 Therapies to promote tear production include varenicline solution nasal spray, external neurostimulation, and oral pilocarpine. [95][96][97] Patients with DED may show a mixture of clinical features, including inflammation, MGD, and aqueous deficiency. Therefore, the most prominent clinical feature may need to be considered at the start.…”
Dry eye disease (DED) is a multifactorial disease of the ocular surface that may be accompanied by discomfort and visual disturbances to a level that reduces quality of life. Artificial tears are a common first-line therapy for DED that aim to supplement the tear film but do not address the underlying causes of DED. Because of the complexity and variability of the disease, personalized treatment beyond artificial tears is important for successful management. This review describes artificial tears and the current knowledge in the personalized approach to the management of DED. There is evidence that artificial tears can reduce symptoms and signs of DED; however, a proportion of patients have been found to show limited or no improvement with artificial tears. Furthermore, the effectiveness of artificial tears may depend on patient compliance and type of artificial tear product used. Personalized management of DED with other treatments involves identifying features of the disease, including the subtype of DED, the presence of inflammation, and the coexistence of external and behavioral contributing factors. Various measures exist to characterize DED, including assessments of the tear film lipid layer, the meibomian glands, tear volume, tear osmolarity, and matrix metalloproteinase 9 levels. Because individuals can show variable features, the most prominent clinical findings, comorbidities, triggering events, and treatment history should be considered to determine the best treatment choices for patients.
“…The clinical efficacy of the iTEAR device, however, demonstrates that such an interface between the external nasal and nasociliary nerves and NLR does exist and can result in a robust lacrimal response. 32 …”
Section: Extranasal Neurostimulationmentioning
confidence: 99%
“…Patients are instructed to use the device for 30 seconds at a time, at least twice daily or more, on an as needed basis daily. 32 Figure 2 The commercial iTEAR100 device applies repetitive electromechanical stimulation to the external nasal nerve via an oscillating tip (black arrow). Reproduced from Ji MH, Moshfeghi DM, Periman L, et al Novel Extranasal Tear Stimulation: Pivotal Study Results.…”
Section: Extranasal Neurostimulationmentioning
confidence: 99%
“…The device was well-tolerated with 2–3% incidence of dizziness and headache during the study. 32 , 33…”
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