The Conjunctival Microbiome and Dry Eye: What We Know and Controversies

Abstract

Dry eye disease is a common multifactorial condition that may be idiopathic or associated with autoimmune conditions, such as Sjogren syndrome. Commensal microorganisms modify immune responses, so it is relevant to understand how they modify such immune-mediated diseases. Microbiota in the gut regulate inflammation in the eye, and conversely, severe inflammation of the ocular surface results in alteration of gut microbiome. The conjunctiva microbiome can be analyzed using 16S or shotgun metagenomics. The amount of microbial DNA in ocular surface mucosa relative to human DNA is limited compared with the case of the intestinal microbiome. There are challenges in defining, harvesting, processing, and analyzing the microbiome in the ocular surface mucosa. Recent studies have shown that the conjunctiva microbiome depends on age, presence of local and systemic inflammation, and environmental factors. Microbiome-based therapy, such as the use of oral probiotics to manage dry eye disease, has initial promising results. Further longitudinal studies are required to investigate the alteration of the conjunctival microbiome after local therapy and surgery.

Inflammatory Dry Eye: Nerves, Microbiome, Onset, and New Treatments

“…Recognizing these phenotypes is important to better understand the pathways to ultimately alter the disease course and reduce morbidity.Louis Tong et al review the conjunctival microbiome and its role in dry-eye disease including what is known about the microbial imbalance of the ocular surface in patients with SS and animal models of dry eye. 3 Victor Perez, MD, delivered a lecture on immune mechanisms in ocular GVHD, which is summarized in the review by Quiroga-Garza et al 4 Ocular GVHD is interesting in that it is an ocular surface inflammatory disease of known time of onset. Early intervention might prevent severe dry eye and related complications in this condition that is often refractory to treatment.Continuing in this vein, Sandeep Jain, MD, delivered a lecture on treatment of ocular GVHD.…”

“…Louis Tong et al review the conjunctival microbiome and its role in dry-eye disease including what is known about the microbial imbalance of the ocular surface in patients with SS and animal models of dry eye. 3…”