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Managing Dry Eye Disease and Facilitating Realistic Patient Expectations: A Review and Appraisal of Current Therapies

Authors Shen Lee B, Kabat AG, Bacharach J, Karpecki P, Luchs J

Received 29 August 2019

Accepted for publication 26 November 2019

Published 14 January 2020 Volume 2020:14 Pages 119—126


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Bridgitte Shen Lee, 1 Alan G Kabat, 2 Jason Bacharach, 3 Paul Karpecki, 4 Jodi Luchs 5

1Vision Optique, Houston, TX, USA; 2Pennsylvania College of Optometry, Elkins Park, PA, USA; 3Florida Eye Microsurgical Institute, Boynton Beach, FL, USA; 4Kentucky Eye Institute, Lexington, KY, USA; 5Florida Vision Institute, West Palm Beach, FL, USA

Correspondence: Bridgitte Shen Lee
Vision Optique, 5158 Buffalo Speedway, Houston, TX 77005, USA
Tel +1 713-838-2020

Abstract: Dry eye disease (DED) is a multifactorial disease of the ocular surface characterized by loss of homeostasis of the tear film and accompanied by ocular signs and symptoms such as corneal and conjunctival damage, patient discomfort, and visual disturbance. The prevalence of DED ranges from 5%− 33%. Patients with DED may have a reduced quality of life due to their discomfort and visual disturbances. The multifactorial nature of DED requires a multi-targeted treatment approach to address the signs and symptoms. Treatment for DED should follow a step-wise approach beginning with education, dietary modification, and lid and lash hygiene, and progressing to pharmacologic and nonpharmacologic interventions. Ocular lubricants, a mainstay of DED therapy, provide temporary symptomatic relief for the patient, but do not address the underlying pathophysiology. Some currently available pharmacologic treatments that address the underlying pathophysiology of DED may have a delay of 3− 6 months in the onset of therapeutic effect; however, these treatment options may also have tolerability issues. These challenges highlight the need for newer pharmacologic treatments with an earlier onset of observable clinical effect and the potential for improved tolerability profile. Patient education is vital to DED management and should convey the complex and chronic nature of DED. It is important for the eye care practitioner to set realistic expectations with the patient when managing DED to help improve treatment success. This helps the patient understand the need for ongoing treatment and that results will likely not be seen immediately. This review covers the current management of DED, focusing on pharmacologic management, and offers recommendations for the practitioner to help facilitate realistic patient expectations for the treatment of DED.

Keywords: OTX-101, dry eye disease, nanomicelles, drug delivery

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