Clinical Scorecard: Prescribing for Dry Eye Disease

At a Glance

Key Highlights

• DED has 10 different drivers categorized into 3 main groups.
• A targeted approach based on etiology is recommended for treatment.
• Common therapies include artificial tears, lid hygiene, and nutraceuticals.
• Ocular surface regenerators and tear conservation devices are also utilized.
• Lifestyle factors significantly impact DED management.
• Addressing overlapping causes is crucial for effective treatment.

Guideline-Based Recommendations

Diagnosis

• Assess case history, Ocular Surface Disease Index-6 score, symptoms, clinical signs, and diagnostic findings.

Management

• Utilize a combination of therapies targeting the main causes of DED, including specific treatments for each identified driver.

Monitoring & Follow-up

• Regular follow-up to assess treatment efficacy and adjust therapies as needed.

Risks

• Inadequate treatment may lead to worsening symptoms and ocular surface damage.

Patient & Prescribing Data

Individuals diagnosed with Dry Eye Disease, including those with concurrent conditions like ocular rosacea.

Combination therapies are often necessary, with a focus on the primary driver of DED.

Clinical Best Practices

• Educate patients on lifestyle modifications that can alleviate DED symptoms.
• Consider surgical interventions for severe anatomical misalignments, such as ectropion repair or pterygium excision.
• Implement in-office procedures for meibomian gland dysfunction, including thermal pulsation or meibomian gland probing, as needed.

References

• TFOS DEWS III Management and Therapy Report
• Multi-frequency RF combined with intense pulsed light improves signs and symptoms of dry eye disease due to meibomian gland dysfunction
• Review of literature on intraductal meibomian gland probing