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Ophthalmology Management

Article

Dry Eye Best Practices Must Surpass Standards of Care

Every doctor who examines the front of the eye should look for DED and treat it.

By: Darrell E. White, MD
Ophthalmology Management May 1, 2025 Vol 29, Issue May 2025 Page(s): 8-9

Clinical Scorecard: Dry Eye Best Practices Must Surpass Standards of Care

At a Glance

CategoryDetail
ConditionDry Eye Disease (DED)
Key MechanismsInvolves tear film instability, inflammation, and damage to the ocular surface.
Target PopulationPatients with symptoms or signs of dry eye, including those undergoing cataract or refractive surgery.
Care SettingComprehensive care, DED specialty care, and cataract/refractive care practices.

Key Highlights

  • Every eye examination should include a check for DED.
  • Utilization of standardized questionnaires is essential for assessing DED severity.
  • Tear osmolarity testing is critical for diagnosing covert DED.
  • Imaging of meibomian glands is necessary for evaluating evaporative DED.
  • Preoperative assessment of DED can prevent post-surgical complications.

Guideline-Based Recommendations

Diagnosis

  • Use standardized questionnaires like SPEED, OSDI, SANDE, or VAS for initial assessment.
  • Perform tear osmolarity testing to identify covert DED.

Management

  • Treat all identified cases of DED, including mild cases, especially in preoperative settings.

Monitoring & Follow-up

  • Regularly assess meibomian gland health and tear osmolarity to track disease progression.

Risks

  • Untreated DED can lead to post-surgical refractive surprises and patient dissatisfaction.

Patient & Prescribing Data

Patients with dry eye symptoms, particularly those undergoing cataract or refractive surgery.

Effective treatment requires understanding the type of DED present, with a focus on both evaporative and aqueous-deficient components.

Clinical Best Practices

  • Incorporate slit lamp examination with specific techniques to evaluate meibomian glands.
  • Use vital dyes for ocular surface assessment.
  • Ensure comprehensive preoperative evaluations for patients considering multifocal or extended depth of focus IOLs.

References