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
TLDR
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.Abstract:
The members of the Management and Therapy Subcommittee undertook an evidence-based review of current dry eye therapies and management options. Management options reviewed in detail included treatments for tear insufficiency and lid abnormalities, as well as anti-inflammatory medications, surgical approaches, dietary modifications, environmental considerations and complementary therapies. Following this extensive review 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. Reflecting on all available evidence, a staged management algorithm was derived that presents a step-wise approach to implementing the various management and therapeutic options according to disease severity. While this exercise indicated that differentiating between aqueous-deficient and evaporative dry eye disease was critical in selecting the most appropriate management strategy, it also highlighted challenges, based on the limited evidence currently available, in predicting relative benefits of specific management options, in managing the two dry eye disease subtypes. Further evidence is required to support the introduction, and continued use, of many of the treatment options currently available to manage dry eye disease, as well as to inform appropriate treatment starting points and understand treatment specificity in relation to dry eye disease subtype.read more
Citations
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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
TL;DR: 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.
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 Tear Film Report
Mark D. P. Willcox,Pablo Argüeso,Georgi As. Georgiev,Juha M. Holopainen,Gordon W. Laurie,Tom J. Millar,Eric B. Papas,Jannick P. Rolland,Tannin A. Schmidt,Ulrike Stahl,Tatiana Suarez,Lakshman N. Subbaraman,Ömür Ö. Uçakhan,Lyndon Jones +13 more
TL;DR: The members of the Tear Film Subcommittee reviewed the role of the tear film in dry eye disease (DED), biophysical and biochemical aspects of tears and how these change in DED and recommended areas for future research.
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