Journal ArticleDOI
TFOS DEWS II Definition and Classification Report
Jennifer P. Craig,Kelly K. Nichols,Esen K. Akpek,Barbara Caffery,Harminder S Dua,Choun Ki Joo,Zuguo Liu,J. Daniel Nelson,J. Daniel Nelson,Jason J. Nichols,Kazuo Tsubota,Fiona Stapleton +11 more
TLDR
The new definition recognizes the multifactorial nature of dry eye as a disease where loss of homeostasis of the tear film is the central pathophysiological concept and central to the scheme is a positive diagnosis of DED with signs and symptoms, and this is directed towards management to restore homeostosis.Abstract:
The goals of the TFOS DEWS II Definition and Classification Subcommittee were to create an evidence-based definition and a contemporary classification system for dry eye disease (DED). The new definition recognizes the multifactorial nature of dry eye as a disease where loss of homeostasis of the tear film is the central pathophysiological concept. Ocular symptoms, as a broader term that encompasses reports of discomfort or visual disturbance, feature in the definition and the key etiologies of tear film instability, hyperosmolarity, and ocular surface inflammation and damage were determined to be important for inclusion in the definition. In the light of new data, neurosensory abnormalities were also included in the definition for the first time. In the classification of DED, recent evidence supports a scheme based on the pathophysiology where aqueous deficient and evaporative dry eye exist as a continuum, such that elements of each are considered in diagnosis and management. Central to the scheme is a positive diagnosis of DED with signs and symptoms, and this is directed towards management to restore homeostasis. The scheme also allows consideration of various related manifestations, such as non-obvious disease involving ocular surface signs without related symptoms, including neurotrophic conditions where dysfunctional sensation exists, and cases where symptoms exist without demonstrable ocular surface signs, including neuropathic pain. This approach is not intended to override clinical assessment and judgment but should prove helpful in guiding clinical management and research.read more
Citations
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Journal ArticleDOI
TFOS DEWS II Epidemiology Report.
Fiona Stapleton,Monica Alves,Vatinee Y Bunya,Isabelle Jalbert,Kaevalin Lekhanont,Florence Malet,Kyung Sun Na,Debra A. Schaumberg,Miki Uchino,Jelle Vehof,Eloy Viso,Susan Vitale,Lyndon Jones +12 more
TL;DR: The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease and confirmed that prevalence increases with age, however signs showed a greater increase per decade than symptoms.
Journal ArticleDOI
TFOS DEWS II Diagnostic Methodology report
James S. Wolffsohn,Reiko Arita,Robin L. Chalmers,Ali R. Djalilian,Murat Dogru,Kathy Dumbleton,Preeya K. Gupta,Paul M. Karpecki,Sihem Lazreg,Heiko Pult,Benjamin Sullivan,Alan Tomlinson,Louis Tong,Edoardo Villani,Kyung Chul Yoon,Lyndon Jones,Jennifer P. Craig +16 more
TL;DR: The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was to identify tests used to diagnose and monitor dry eye disease (DED) to identify those most appropriate to fulfil the definition of DED and its sub-classifications.
Journal ArticleDOI
TFOS DEWS II pathophysiology report
Anthony J. Bron,Anthony J. Bron,Cintia S. de Paiva,Sunil K. Chauhan,Stefano Bonini,Eric E. Gabison,Sandeep Jain,Erich Knop,Maria Markoulli,Yoko Ogawa,Victor L. Perez,Yuichi Uchino,Norihiko Yokoi,Driss Zoukhri,David A. Sullivan +14 more
TL;DR: The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease, finding the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation to be important.
Journal ArticleDOI
TFOS DEWS II Management and Therapy Report
Lyndon Jones,Laura E Downie,Donald R. Korb,Jose M. Benitez-del-Castillo,Reza Dana,Sophie X. Deng,Pham N. Dong,Gerd Geerling,Richard Y Hida,Yang Liu,Kyoung Yul Seo,Joseph Tauber,Tais Hitomi Wakamatsu,Jianjiang Xu,James S. Wolffsohn,Jennifer P. Craig +15 more
TL;DR: It became clear that many of the treatments available for the management of dry eye disease lack the necessary Level 1 evidence to support their recommendation, often due to a lack of appropriate masking, randomization or controls and in some cases due to issues with selection bias or inadequate sample size.
Journal ArticleDOI
TFOS DEWS II Report Executive Summary
Jennifer P. Craig,J. Daniel Nelson,J. Daniel Nelson,Dimitri T. Azar,Carlos Belmonte,Anthony J. Bron,Anthony J. Bron,Sunil K. Chauhan,Cintia S. de Paiva,José Álvaro Pereira Gomes,Katherine M. Hammitt,Lyndon Jones,Jason J. Nichols,Kelly K. Nichols,Gary D. Novack,Gary D. Novack,Fiona Stapleton,Mark D. P. Willcox,James S. Wolffsohn,David A. Sullivan +19 more
TL;DR: This article presents an Executive Summary of the conclusions and recommendations of the 10-chapter TFOS DEWS II report.
References
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Journal Article
Report of the National Eye Institute/Industry workshop on Clinical Trials in Dry Eyes.
Journal ArticleDOI
TFOS DEWS II Epidemiology Report.
Fiona Stapleton,Monica Alves,Vatinee Y Bunya,Isabelle Jalbert,Kaevalin Lekhanont,Florence Malet,Kyung Sun Na,Debra A. Schaumberg,Miki Uchino,Jelle Vehof,Eloy Viso,Susan Vitale,Lyndon Jones +12 more
TL;DR: The subcommittee reviewed the prevalence, incidence, risk factors, natural history, morbidity and questionnaires reported in epidemiological studies of dry eye disease and confirmed that prevalence increases with age, however signs showed a greater increase per decade than symptoms.
Journal ArticleDOI
TFOS DEWS II Diagnostic Methodology report
James S. Wolffsohn,Reiko Arita,Robin L. Chalmers,Ali R. Djalilian,Murat Dogru,Kathy Dumbleton,Preeya K. Gupta,Paul M. Karpecki,Sihem Lazreg,Heiko Pult,Benjamin Sullivan,Alan Tomlinson,Louis Tong,Edoardo Villani,Kyung Chul Yoon,Lyndon Jones,Jennifer P. Craig +16 more
TL;DR: The role of the Tear Film and Ocular Surface Society (TFOS) Dry Eye Workshop (DEWS) II Diagnostic Methodology Subcommittee was to identify tests used to diagnose and monitor dry eye disease (DED) to identify those most appropriate to fulfil the definition of DED and its sub-classifications.
Journal ArticleDOI
TFOS DEWS II pathophysiology report
Anthony J. Bron,Anthony J. Bron,Cintia S. de Paiva,Sunil K. Chauhan,Stefano Bonini,Eric E. Gabison,Sandeep Jain,Erich Knop,Maria Markoulli,Yoko Ogawa,Victor L. Perez,Yuichi Uchino,Norihiko Yokoi,Driss Zoukhri,David A. Sullivan +14 more
TL;DR: The TFOS DEWS II Pathophysiology Subcommittee reviewed the mechanisms involved in the initiation and perpetuation of dry eye disease, finding the targeting of the terminal duct in meibomian gland disease and the influence of gaze dynamics and the closed eye state on tear stability and ocular surface inflammation to be important.
Journal ArticleDOI
TFOS DEWS II Management and Therapy Report
Lyndon Jones,Laura E Downie,Donald R. Korb,Jose M. Benitez-del-Castillo,Reza Dana,Sophie X. Deng,Pham N. Dong,Gerd Geerling,Richard Y Hida,Yang Liu,Kyoung Yul Seo,Joseph Tauber,Tais Hitomi Wakamatsu,Jianjiang Xu,James S. Wolffsohn,Jennifer P. Craig +15 more
TL;DR: It became clear that many of the treatments available for the management of dry eye disease lack the necessary Level 1 evidence to support their recommendation, often due to a lack of appropriate masking, randomization or controls and in some cases due to issues with selection bias or inadequate sample size.