Journal ArticleDOI
TFOS DEWS II Sex, Gender, and Hormones Report
David A. Sullivan,Eduardo Rocha,Pasquale Aragona,Janine A. Clayton,Juan Ding,Blanka Golebiowski,Ulrike Hampel,Alison M. McDermott,Debra A. Schaumberg,Debra A. Schaumberg,Sruthi Srinivasan,Piera Versura,Mark D. P. Willcox +12 more
TLDR
Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men.Abstract:
One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.read more
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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 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.
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.
Journal ArticleDOI
TFOS DEWS II iatrogenic report.
José Álvaro Pereira Gomes,Dimitri T. Azar,Christophe Baudouin,Nathan Efron,Masatoshi Hirayama,Jutta Horwath-Winter,Terry Kim,Jodhbir S. Mehta,Elisabeth M. Messmer,Jay S. Pepose,Virender S Sangwan,Alan L. Weiner,Steven E. Wilson,James S. Wolffsohn +13 more
TL;DR: This report presents future directions to address iatrogenic DED, including the need for more in-depth epidemiological studies about the risk factors, development of less toxic medications and preservatives, as well as new techniques for less invasive eye surgeries.
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