Clinical practice patterns in the management of dry eye disease: A TFOS international survey 2023-4

James S. Wolffsohn, David Semp, Debarun Dutta, Lyndon Jones, Jennifer P. Craig

Research output: Contribution to journalArticlepeer-review

Abstract

Aims
To understand current clinical management of dry eye disease (DED), based on its perceived severity and subtype by practitioners across the world.

Methods
The content of the anonymous survey was chosen to reflect the DED management strategies reported by the Tear Film and Ocular Surface Society (TFOS) 2nd Dry Eye Workshop (DEWS II). Questions were designed to ascertain practitioner treatment choice, depending on the subtype and severity of DED. It was first created in English and then translated/back-translated into 14 languages for online completion.

Results
Completed surveys were received from 905 eye care practitioners (52% optometrists and 42% ophthalmologists) from across the globe. Many treatment strategies for DED were observed to be utilised by respondents, independent of severity and subtype, the most common being advice (82%), low (82%) and high (81%) viscosity unpreserved lubricants and lid wipes/scrubs (79%). Several treatments were prescribed across all severity levels (scaled from 1 mild to 10 severe), such as advice (median 4.5, range 4.8), artificial tears (median 5.1, range 4.6) and nutritional supplements (median 5.3, range 4.2). Others were prescribed more frequently with increasing disease severity, for instance, biologics (median 8.2, range 2.8) and surgical approaches (median 8.1, range 2.2). While a similar number of practitioners reported prescribing advice, artificial tears and anti-inflammatories regardless of DED subtype, the majority reported approaches for aqueous deficient DED were punctal occlusion, therapeutic contact lenses and secretagogues, while the use of oral essential fatty acids, topical lipid-containing products, lid hygiene and lid warming were the preferred management choices for evaporative DED.

Conclusions
There remains great variability in clinical approaches to DED management and until research-evidence definitively informs improved guidance, data from this survey can be used by clinicians to benchmark their practice.
Original languageEnglish
JournalOcular Surface
Early online date30 Dec 2024
DOIs
Publication statusE-pub ahead of print - 30 Dec 2024

Bibliographical note

Copyright © 2024 Published by Elsevier Ltd. This accepted manuscript version is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International https://creativecommons.org/licenses/by-nc-nd/4.0/.

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