The Tear Film and Ocular Surface Society Dry Eye Workshop II report recommends a comprehensive, multistage management algorithm for the disease that is both evidence-based and personalized.
Education and lifestyle modifications
Based on patient symptomatology or clinical signs of DED, the first step is to educate the patient on the severity and chronic nature of the disease. It is believed that patient compliance improves once the patient is better educated about his or her disease.2
Once patients understand why the management of DED is key to preventing its progression, and to improve overall patient comfort, the report recommends suggesting environmental, and lifestyle changes. This may include introducing essential fatty acid oral supplements to patients’ diets, and modifying environmental humidity. It also can include dependency on contact lenses, screen time/computer usage, and sun exposure.
Medications may also need to be modified, with the potential elimination of DED-inducing drugs such as antihistamines and decongestants. This may include other medications that may cause, contribute to, or aggravate DED. It also could include hormone therapy drugs, antihypertensives, anticholinergics, antineoplastics, and some analgesics.
The patient should be prescribed artificial tears. If present, signs of meibomian gland dysfunction (MGD) should be addressed with warm compresses and lid scrubs.
1. Craig JP, Nelson JD, Azar DT, et al. TFOS DEWS II Report Executive Summary. Ocul Surf. 2017;15(4):802-12.
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