Elsevier

The Ocular Surface

Volume 5, Issue 2, April 2007, Pages 163-178
The Ocular Surface

DEWS Management and Therapy
Management and Therapy of Dry Eye Disease: Report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007)

https://doi.org/10.1016/S1542-0124(12)70085-XGet rights and content

Abstract

The members of the Management and Therapy Subcommittee assessed current dry eye therapies. Each member wrote a succinct evidence-based review on an assigned aspect of the topic, and the final report was written after review by and with consensus of all subcommittee members and the entire Dry eye WorkShop membership. In addition to its own review of the literature, the Subcommittee reviewed the Dry Eye Preferred Practice Patterns of the American Academy of Ophthalmology and the International Task Force (ITF) Delphi Panel on Dry Eye. The Subcommittee favored the approach taken by the ITF, whose recommended treatments were based on level of disease severity. The recommendations of the Subcommittee are based on a modification of the ITF severity grading scheme, and suggested treatments were chosen from a menu of therapies for which evidence of therapeutic effect had been presented.

References (186)

  • MA Di Pascuale et al.

    Sequential changes of lipid tear film after the instillation of a single drop of a new emulsion eye drop in dry eye patients

    Ophthalmology

    (2004)
  • AW Tuberville et al.

    Punctal occlusion in tear deficiency syndromes

    Ophthalmology

    (1982)
  • RM Willis et al.

    The treatment of aqueous-deficient dry eye with removable punctal plugs. A clinical and impression-cytological study

    Ophthalmology

    (1987)
  • M Balaram et al.

    Efficacy and tolerability outcomes after punctal occlusion with silicone plugs in dry eye syndrome

    Am J Ophthalmol

    (2001)
  • SA Baxter et al.

    Punctal plugs in the management of dry eyes

    Ocul Surf

    (2004)
  • TC Huang et al.

    Punctal occlusion and topical medications for glaucoma

    Am J Ophthalmol

    (1989)
  • H Gerding et al.

    Symptomatic cicatrizial occlusion of canaliculi after insertion of Herrick lacrimal plugs

    Am J Ophthalmol

    (2003)
  • MT Yen et al.

    The effect of punctal occlusion on tear production, tear clearance, and ocular surface sensation in normal subjects

    Am J Ophthalmol

    (2001)
  • K Tsubota

    The effect of wearing spectacles on the humidity of the eye

    Am J Ophthalmol

    (1989)
  • T Romero-Rangel et al.

    Gas-permeable scleral contact lens therapy in ocular surface disease

    Am J Ophthalmol

    (2000)
  • P Rosenthal et al.

    Treatment of persistent corneal epithelial defect with extended wear of a fluid-ventilated gas-permeable scleral contact lens

    Am J Ophthalmol

    (2000)
  • DQ Li et al.

    Regulation of MMP-9 in human corneal epithelial cells

    Exp Eye Res

    (2001)
  • M Nakamura et al.

    Gefarnate stimulates secretion of mucin-like glycoproteins by corneal epithelium in vitro and protects corneal epithelium from desiccation in vivo

    Exp Eye Res

    (1997)
  • JP Gilbard

    Human tear film electrolyte concentrations in health and dry-eye disease

    Int Ophthalmol Clin

    (1994)
  • O Schein et al.

    Relation between signs and symptoms of dry eye in the elderly

    Ophthalmology

    (1997)
  • JD Nelson et al.

    Topical fibronectin in the treatment of keratoconjunctivitis sicca. Chiron Keratoconjunctivitis Sicca Study Group

    Am J Ophthalmol

    (1992)
  • JD Nelson

    Impression cytology

    Cornea

    (1988)
  • J Ubels et al.

    Effects of preservative-free artificial tear solutions on corneal epithelial structure and function

    Arch Ophthalmol

    (1995)
  • K Green et al.

    Tear potassium contributes to maintenance of corneal thickness

    Ophthalmic Res

    (1992)
  • F Holly et al.

    Surface chemistry of the tear film: Implications for dry eye syndromes, contact lenses, and ophthalmic polymers

    Contact Lens Soc Am J

    (1971)
  • Perrigan DM, Morgan A, Quintero S, et al. Comparison of osmolarity values of selected ocular lubricants. ARVO 2004...
  • J Albietz et al.

    The conjunctival epithelium in dry eye subtypes: Effect of preserved and nonpreserved topical treatments

    Curr Eye Res

    (2001)
  • N Burstein

    The effects of topical drugs and preservatives on the tears and corneal epithelium in dry eye

    Trans Ophthalmol Soc UK

    (1985)
  • L Smith et al.

    Comparative effects of preservative free tear substitutes on the rabbit cornea: a scanning electron microscopic evaluation (ARVO abstract)

    Invest Ophthalmol Vis Sci

    (1991)
  • JP Gilbard et al.

    Osmolarity of tear microvolumes in keratoconjunctivitis sicca

    Arch Ophthalmol

    (1978)
  • D Lopez Bernal et al.

    Quantitative evaluation of the corneal epithelial barrier: effect of artificial tears and preservatives

    Curr Eye Res

    (1991)
  • DL Bernal et al.

    Artificial tear composition and promotion of recovery of the damaged corneal epithelium

    Cornea

    (1993)
  • R Noecker

    Effects of common ophthalmic preservatives on ocular health

    Adv Ther

    (2001)
  • BJ Tripathi et al.

    Cytotoxicity of ophthalmic preservatives on human corneal epithelium

    Lens Eye Toxicity Res

    (1992)
  • J Herrema et al.

    Retardation of wound healing in the corneal epithelium by lanolin

    Am J Ophthalmol

    (1950)
  • J Nelson et al.

    Evaluation of physiologic tear substitute in patients with keratoconjunctivitis sicca

    Adv Exp Med Biol

    (1994)
  • LM Lenton et al.

    Effect of carmellose-based artificial tears on the ocular surface in eyes after laser in situ keratomileusis

    J Refract Surg

    (1999)
  • BL Slomiany et al.

    Role of mucus in gastric mucosal protection

    J Physiol Pharmacol

    (1991)
  • JP Gilbard

    Tear film osmolarity and keratoconjunctivitis sicca

    CLAO J

    (1985)
  • J Gilbard

    Tear film osmolarity and keratoconjuncitivitis sicca

    (1986)
  • L Luo et al.

    Hyperosmolar saline is a proinflammatory stress on the mouse ocular surface

    Eye Contact Lens

    (2005)
  • F Holly et al.

    Colloid osmotic pressure of artificial tears

    J Ocul Pharmacol

    (1985)
  • PH Yancey

    Organic osmolytes as compatible, metabolic and counteracting cryoprotectants in high osmolarity and other stresses

    J Exp Biol

    (2005)
  • A Hawi et al.

    A quantitiative comparison of artificial tear clearance rates in humans using gamma scintigraphy (ARVO abstract)

    Invest Ophthalmol Vis Sci

    (1990)
  • P Argueso et al.

    Mucin characteristics of human corneal-limbal epithelial cells that exclude the rose bengal anionic dye

    Invest Ophthalmol Vis Sci

    (2006)
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    Management and Therapy Subcommittee members: Stephen C. Pflugfelder, MD (Chair); Gerd Geerling, MD; Shigero Kinoshita, MD; Michael A. Lemp, MD; James McCulley, MD; Daniel Nelson, MD; Gary N. Novack, PhD; Jun Shimazaki, MD; Clive Wilson, PhD.

    Proprietary interests of Subcommittee members are disclosed on pages 202 and 204.

    Reprints are not available. Articles can be accessed at: www.tearfilm.org.

    Correspondence in regard to the this chapter should be addressed to Stephen C. Pflugfelder MD, Ophthalmology-Ocular Surf Ctr, Cullen Eye Institute, 6565 Fannin Street NC 205, Houston, TX 77030. Tel: 713-798-4732. Fax: 713-798-1457. Email: [email protected]

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