Personalized Management of Dry Eye Disease: Beyond Artificial Tears

Abstract

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.

Ameliorative effects of Tagetes erecta Linn. flower against desiccation stress-induced dry eye symptoms in the mice model

“… 2 Artificial tears improve the signs and symptoms of aqueous-deficient DED and evaporative DED by replacing some of the aqueous tear fluid. 3 However, topical artificial tear substitutes only compensate for a proportion of the fluid lost on account of dry eye and need to be administered several times a day. 4 In several randomized trials, short-term topical corticosteroid use was found to significantly improve the symptoms of DED; however, the potential adverse effects of corticosteroids, including cataracts, glaucoma, and infection, limit their long-term use.…”

Management of Dry Eye Syndrome Through Ayurvedic Interventions: An In-Depth Analysis

“…Artificial tears are a common first-line medicinal therapy for DES that aims to supplement the tear film but they are of short-duration action and do not address the underlying causes of DES. Also, a proportion of patients have been found to show limited or no improvement with artificial tears [6] .…”