EnVision Summit 2026: Dry eye case studies with Dr Cathleen McCabe

Cathleen McCabe, MD, a cataract and refractive surgeon in Sarasota, Florida, discussed her approach to diagnosing and managing dry eye disease, especially in the perioperative cataract population at the Envision Summit 2026 in Puerto Rico. She presented alongside P. Dee Stephenson, MD, FACS, in a product theater titled "Know Your Dry Eye: Navigating the Challenges of Real-World Dry Eye Cases."

She illustrated her philosophy with 2 real patient cases. The first is a woman in her 40s, a photographer with clear meibomian gland dysfunction and visually significant fluctuation throughout the day. Examination showed thick, inspissated meibum and gland issues. Treatment with perfluorohexyloctane (Miebo) drops, warm compresses, and a nutraceutical led to symptom relief and better visual stability, highlighting the value of fast-onset, low–side effect therapies that improve comfort and encourage compliance.

The second case, Sybil, a 57-year-old with Sjögren disease and multiple autoimmune conditions, had severe, inflammatory dry eye with photophobia, requiring sunglasses indoors. For her, an immunomodulatory approach was prioritized, using lifitegrast (Xiidra) twice daily plus short-term steroids to achieve early efficacy. This case underscores tailoring therapy to the inflammatory component and the importance of setting realistic expectations and reinforcing adherence.

McCabe emphasized communication and education as central to success, particularly for cataract patients who may not recognize that tearing and visual fluctuation stem from dryness. She uses objective tools such as tear osmolarity and the EyeTrace dry eye module to demonstrate disease to patients, creating “aha” moments that drive buy-in.

She also shared her own experience as a dry eye patient and admits to being noncompliant at times, using this to normalize the up-and-down nature of adherence. She frames dry eye as a lifelong journey taken together with the patient: there may be an intensive initial phase, followed by refinement to the simplest, least intrusive maintenance regimen that still preserves ocular surface homeostasis. Patients are encouraged to recognize early signs of worsening, resume their regimen proactively, and return periodically for reassessment.