Cargando…

Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists

Dry eye disease (DED) is a multifactorial disorder characterized by loss of tear film homeostasis with an estimated worldwide prevalence of 5% to 50%. In DED, dysfunction of the ocular structures that create and regulate the tear film components—including the lacrimal glands, meibomian glands, corne...

Descripción completa

Detalles Bibliográficos
Autores principales: Sheppard, John, Shen Lee, Bridgitte, Periman, Laura M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809411/
https://www.ncbi.nlm.nih.gov/pubmed/36576348
http://dx.doi.org/10.1080/07853890.2022.2157477
_version_ 1784863118647623680
author Sheppard, John
Shen Lee, Bridgitte
Periman, Laura M.
author_facet Sheppard, John
Shen Lee, Bridgitte
Periman, Laura M.
author_sort Sheppard, John
collection PubMed
description Dry eye disease (DED) is a multifactorial disorder characterized by loss of tear film homeostasis with an estimated worldwide prevalence of 5% to 50%. In DED, dysfunction of the ocular structures that create and regulate the tear film components—including the lacrimal glands, meibomian glands, cornea, and conjunctiva—causes a qualitative and/or quantitative tear deficiency with resultant tear film instability and hyperosmolarity. This initiates a vicious cycle of ocular surface inflammation and damage that may ultimately impair the quality of life and vision of affected patients. Many factors can contribute to the development of DED, including ocular and systemic diseases, topical and systemic medications, and environmental conditions. Because DED is a chronic disorder, treatment is most often long term and may utilize both pharmacologic and nonpharmacologic interventions to address all etiologic components. The long-term management of DED can be challenging and most often should involve eye care specialist referral. However, primary care clinicians (PCCs) are often the first points of contact for patients with DED and importantly provide initial diagnosis and preliminary patient education about the disease process. Consideration of DED is also vital for the practice of various specialties due to the large number of comorbidities and medications that can contribute to DED pathogenesis and progression. Therefore, it is important that PCCs and clinical specialists be aware of the etiology of DED and its available therapeutic options. This manuscript provides an overview of DED pathophysiology and treatment and discusses specific considerations regarding DED management for PCCs and clinical specialists. KEY MESSAGES: Successful management of dry eye disease often requires the use of various pharmacologic and/or nonpharmacologic therapies, as well as environmental and lifestyle modifications, to mitigate the underlying etiologies and restore tear film homeostasis. Primary care clinicians play an essential role in dry eye disease management by establishing a diagnosis, educating patients about the disorder, and providing referrals to eye care specialists for initiation of specialized treatment and long-term follow-up. Primary care clinicians and clinical specialists should consider prescribing medications with fewer ocular surface effects whenever possible in patients at risk for or with existing dry eye disease.
format Online
Article
Text
id pubmed-9809411
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Taylor & Francis
record_format MEDLINE/PubMed
spelling pubmed-98094112023-01-04 Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists Sheppard, John Shen Lee, Bridgitte Periman, Laura M. Ann Med Ophthalmology Dry eye disease (DED) is a multifactorial disorder characterized by loss of tear film homeostasis with an estimated worldwide prevalence of 5% to 50%. In DED, dysfunction of the ocular structures that create and regulate the tear film components—including the lacrimal glands, meibomian glands, cornea, and conjunctiva—causes a qualitative and/or quantitative tear deficiency with resultant tear film instability and hyperosmolarity. This initiates a vicious cycle of ocular surface inflammation and damage that may ultimately impair the quality of life and vision of affected patients. Many factors can contribute to the development of DED, including ocular and systemic diseases, topical and systemic medications, and environmental conditions. Because DED is a chronic disorder, treatment is most often long term and may utilize both pharmacologic and nonpharmacologic interventions to address all etiologic components. The long-term management of DED can be challenging and most often should involve eye care specialist referral. However, primary care clinicians (PCCs) are often the first points of contact for patients with DED and importantly provide initial diagnosis and preliminary patient education about the disease process. Consideration of DED is also vital for the practice of various specialties due to the large number of comorbidities and medications that can contribute to DED pathogenesis and progression. Therefore, it is important that PCCs and clinical specialists be aware of the etiology of DED and its available therapeutic options. This manuscript provides an overview of DED pathophysiology and treatment and discusses specific considerations regarding DED management for PCCs and clinical specialists. KEY MESSAGES: Successful management of dry eye disease often requires the use of various pharmacologic and/or nonpharmacologic therapies, as well as environmental and lifestyle modifications, to mitigate the underlying etiologies and restore tear film homeostasis. Primary care clinicians play an essential role in dry eye disease management by establishing a diagnosis, educating patients about the disorder, and providing referrals to eye care specialists for initiation of specialized treatment and long-term follow-up. Primary care clinicians and clinical specialists should consider prescribing medications with fewer ocular surface effects whenever possible in patients at risk for or with existing dry eye disease. Taylor & Francis 2022-12-28 /pmc/articles/PMC9809411/ /pubmed/36576348 http://dx.doi.org/10.1080/07853890.2022.2157477 Text en © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Ophthalmology
Sheppard, John
Shen Lee, Bridgitte
Periman, Laura M.
Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title_full Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title_fullStr Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title_full_unstemmed Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title_short Dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
title_sort dry eye disease: identification and therapeutic strategies for primary care clinicians and clinical specialists
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9809411/
https://www.ncbi.nlm.nih.gov/pubmed/36576348
http://dx.doi.org/10.1080/07853890.2022.2157477
work_keys_str_mv AT sheppardjohn dryeyediseaseidentificationandtherapeuticstrategiesforprimarycarecliniciansandclinicalspecialists
AT shenleebridgitte dryeyediseaseidentificationandtherapeuticstrategiesforprimarycarecliniciansandclinicalspecialists
AT perimanlauram dryeyediseaseidentificationandtherapeuticstrategiesforprimarycarecliniciansandclinicalspecialists