Dry eye disease has become a public health issue, with increasing prevalence in the United States, where more than 16 million people are affected.
While dry eye is a common and often chronic problem, particularly in older adults, younger populations are also being affected because of the increasing and constant use of digital devices.
Related: Surfing the dry eye pipeline
According to Audrey R. Talley Rostov, MD, the increased diagnosis of dry eye disease among younger patients is increasing at an alarming rate, and parents should beware.
“We are seeing dry eye disease developing in the pediatric population,” said Dr. Talley Rostov, who is in private practice at Northwest Eye Surgeons, Seattle.
With this in mind, it is more important than ever to establish effective treatments.
“The goals of therapeutic intervention are normalization of the tear film, decrease lacrimal gland and ocular surface inflammation, stimulate epithelial healing, and restore the normal neural feedback mechanism to the lacrimal glands,” Dr. Talley Rostov pointed out.
The treatment categories address blepharitis and meibomian gland dysfunction, aqueous deficiency, evaporative goblet cell and mucin deficiency, exposure keratopathy, and co-conspirators. In dysfunctional tear syndrome all of these are not mutually exclusive and there often is overlapping.
What’s new in treatments?
Lid hygiene to treat anterior blepharitis is not new, but the addition of hypochlorous solutions used as lid scrubs is and they are beneficial. New topical antiparasitic drugs are available to treat Demodex. The in-office process of mechanical lid debridement has been improved with the introduction of an automated toothbrush-like device. In addition, more attention is being directed to the products used to remove make-up and the choice of cosmetics.
The treatment of posterior blepharitis, topical anti-inflammatory drugs, such as the off-label use of azithromycin, cyclosporine, and lifitegrast (Xiidra, Novartis); microwavable lid masks. Newer technologies such as thermal pulsation and intense pulsed light (IPL) are available, according Dr. Talley Rostov.