Treatment Guideline Chart

Dry eye syndrome is a clinical condition wherein the patient experiences ocular and conjunctival irritation due to decreased tear production and/or excessive tear evaporation.
It is associated with increased osmolarity of the tear film and inflammation of the ocular surface.

Goals of treatment are to relieve symptoms of patients, to improve visual acuity and quality of life of patients, to restore ocular surface and tear film to normal homeostatic state and to correct the underlying defect.

Dry Eye Syndrome References

  1. Fiscella RG. Understanding dry eye disease: a managed care perspective. Am J Manag Care. 2011 Dec;17(Suppl 16):S432-A439. https://secure.pharmacytimes.com/lessons/pdf/201112-02.pdf.Accessed. Accessed 23 Jan 2012. PMID: 22435675
  2. Jackson WB. Management of dysfunctional tear syndrome: a Canadian consensus. Can J Ophthamol. 2009 Aug;44(4):385-394. http://www.eyesite.ca/CJO/4404/i09-015.pdf. Accessed 23 Jan 2012. PMID: 19606158
  3. International Dry Eye Committee. 2007 report of the International Dry Eye Workshop (DEWS). Ocul Surf. 2007 Apr;5(2):75-92. http://www.tearfilm.org/dewsreport/pdfs/TOS-0502-DEWS-noAds.pdf. Accessed 23 Jan 2012. PMID: 17508116
  4. Perry HD. Dry eye disease: pathophysiology, classification, and diagnosis. Am J Manag Care. 2008 Apr;14(3 Suppl):S79-S87. PMID: 18452371
  5. American Academy of Ophthalmology Cornea/External Disease Panel. Preferred practice pattern guidelines. Dry eye syndrome. San Francisco, CA: American Academy of Ophthalmology. http://one.aao.org/. 2013. Accessed 23 Jan 2012.
  6. Nam K, Kim HJ, Yoo A. Efficacy and safety of topical 3% diquafosol ophthalmic solution for the treatment of multifactorial dry eye disease: meta-analysis of randomized clinical trials. Ophthalmic Res. 2019 Jan;61(4):188-198. doi: 10.1159/000492896. Accessed 29 Jun 2021. PMID: 30654362
  7. Akpek EK, Amescua G, Farid M, et al; American Academy of Ophthalmology Preferred Practice Pattern Cornea and External Disease Panel. Dry eye syndrome Preferred Practice Pattern®. Ophthalmology. 2019 Jan;126(1):P286-P334. doi: 10.1016/j.ophtha.2018.10.023. PMID: 30366798
  8. Aragona P, Giannaccare G, Mencucci R, et al. Modern approach to the treatment of dry eye, a complex multifactorial disease: a P.I.C.A.S.S.O. board review. Br J Ophthalmol. 2021 Apr;105(4):446-453. doi: 10.1136/bjophthalmol-2019-315747. PMID: 32703782
  9. ClinicalKey. Clinical overview: dry eye. ClinicalKey. https://www.clinicalkey.com. 07 Nov 2020.
  10. Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and classification report. Ocul Surf. 2017 Jul;15(3):276-283. doi: 10.1016/j.jtos.2017.05.008. PMID: 28736335
  11. Giannaccare G, Carnevali A, Senni C, et al. Umbilical cord blood and serum for the treatment of ocular diseases: a comprehensive review. Ophthalmol Ther. 2020 Jun;9(2):235-248. doi: 10.1007/s40123-020-00239-9. PMID: 32107737
  12. Jones L, Downie LE, Korb D, et al. TFOS DEWS II management and therapy report. Ocul Surf. 2017 Jul;15(3):575-628. doi: 10.1016/j.jtos.2017.05.006. PMID: 28736343
  13. Karakus S, Baer AN, Akpek EK. Clinical correlations of novel autoantibodies in patients with dry eye. J Immunol Res. 2019 Jan;2019:7935451. doi: 10.1155/2019/7935451. PMID: 30766890
  14. Liu Y, Kam WR, Ding J, et al. Can tetracycline antibiotics duplicate the ability of azithromycin to stimulate human meibomian gland epithelial cell differentiation. Cornea. 2015 Mar;34(3):342-346. doi: 10.1097/ICO.0000000000000351. PMID: 25611398
  15. Margo CE, Harman LE. Dry eye syndrome. In: Kellerman RD, Rakel D, eds. Conn's Current Therapy 2021. Philadelphia: Elsevier; 2021. 493-495. Accessed 22 Jun 2021:493-495.
  16. Nelson JD, Craig JP, Akpek EK, et al. TFOS DEWS II Introduction. Ocul Surf. 2017 Jul;15(3):269-275. doi: 10.1016/j.jtos.2017.05.005. PMID: 28736334
  17. U.S. Food and Drug Administration. Xiindra. US FDA. http://www.fda.gov. 2016.
  18. Wei Y, Troger A, Spahiu V, et al. The role of SKQ1 (Visomitin) in inflammation and wound healing of the ocular surface. Ophthalmol Ther. 2019 Mar;8(1):63-73. doi: 10.1007/s40123-018-0158-2. PMID: 30565203
  19. Akpek EK, Smith R. Current treatment strategies for age-related ocular conditions. Am J Manag Care. 2013 May;19(Suppl 5):S76-S84. http://www.ajmc.com. PMID: 23725499
  20. Barlett J, Karpecki P, Melton R, et al. Diagnostic & treatment algorithms for ocular surface disease states - updated edition. Dry eye - new paradigms in the understanding of dry eye. Review of Optometry. 2011 Oct:001-11. http://www.reviewofoptometry.com.
  21. Baudoiun C, Aragona P, Van Setten G, et al. Diagnosing the severity of dry eye: a clear and practical algorithm. Br J Ophthalmol. 2014 Sep;98(9):1168-1176. doi: 10.1136/bjophthalmol-2013-304619. PMID: 24627252
  22. Colligris B, Alzoki H, Pintor J. Recent development on dry eye disease treatment compounds. Saudi Journal of Ophthalmology. 2014;28:19-30. http://dx.doi.org/10.1016/j.sjopt.2013.12.003.
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