Dry Eye Syndrome

Publication Date: February 11, 2024
Last Updated: February 16, 2024

HIGHLIGHTED FINDINGS AND RECOMMENDATIONS FOR CARE

Dry eye syndrome is a common ocular condition that has a substantial impact on the quality of life of afflicted individuals owing to discomfort and visual disability. Dry eye may compromise results of cataract, corneal, and keratorefractive surgery. (, , )
569
Clinical examination is the gold standard for diagnosing dry eye syndrome (also known as dry eye disease or keratoconjunctivitis sicca). No single test is adequate for establishing the diagnosis of dry eye syndrome. The constellation of findings from multiple tests can add to the clinician's understanding of the patient's condition. (, , )
569
Pharmacological and procedural treatments are associated with improvements in patient symptoms and clinical signs; although these are rarely curative, long-term treatment is typically necessary. (, , )
569
US. Food and Drug Administration (FDA)-approved treatments for dry eye syndrome include topical loteprednol 0.25%, lifitegrast 0.5%, cyclosporine 0.05% and 0.09%, varenicline nasal spray, and perflurohexyloctane ophthalmic solution. They may lead to improvements of patient symptoms and/or signs but non has been proven more effective than the other in head-to-head trials. No direct comparison in a prospective clinical trial is available in the literature. (, , )
569
Patients with dry eye syndrome considering keratorefractive and lens-based surgery should be cautioned that the dry eye symptoms could become worse after surgery. If pre-existing factors contributing to dry eye syndrome can be improved preoperatively, the chance of worsened dry eye syndrome can be reduced. Dry eye symptoms are common in the first few months after keratorefractive and lens-based surgery and often subside with time. (, , )
569
Dry eye syndrome is one of the main reasons for patient dissatisfaction following intraocular refractive and/or cataract surgery. Dry eye symptoms that continue beyond the normal postoperative period of 3 months are seen in about one third of individuals. Baseline ocular surface and tear film parameters predict the patients at risk. Therefore, all patients undergoing lens-based surgery should be evaluated and managed for dry eye preoperatively and postoperatively. (, , )
569
Approximately 10% of patients with clinically aqueous tear deficiency dry eye have underlying Sjӧgren’s syndrome. A meta-analysis found that, among autoimmune diseases, primary Sjӧgren’s syndrome is the most strongly associated with lymphoid proliferative malignancy. (, , )
569

Recommendation Grading

Overview

Title

Dry Eye Syndrome

Authoring Organization

Publication Month/Year

February 11, 2024

Last Updated Month/Year

February 19, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

Establish the diagnosis of dry eye and differentiate it from other causes of ocular irritation and redness that may complicate both patient care and research on tear deficiency. Identify the local and systemic causes of dry eye disease. Recommend appropriate therapy, relieve discomfort, prevent worsening of symptoms and clinical findings, and educate and involve the patient in the management of this disease

 

Inclusion Criteria

Female, Male, Adolescent, Adult, Child, Infant, Older adult

Health Care Settings

Ambulatory, Emergency care, Outpatient

Intended Users

Optometrist, optician, nurse, nurse practitioner, physician, physician assistant

Scope

Counseling, Diagnosis, Management

Diseases/Conditions (MeSH)

D015352 - Dry Eye Syndromes

Keywords

dry eye, red eyes, ocular irritation, mucus discharge, fluctuating vision

Source Citation

Amescua G, Ahmad S, Cheung AY, Choi DS, Jhanji V, Lin A, Mian SI, Rhee MK, Viriya ET, Mah FS, Varu DM; American Academy of Ophthalmology Preferred Practice Pattern Cornea/External Disease Panel. Dry Eye Syndrome Preferred Practice Pattern®. Ophthalmology. 2024 Feb 12:S0161-6420(24)00012-5. doi: 10.1016/j.ophtha.2023.12.041. Epub ahead of print. PMID: 38349301.

Supplemental Methodology Resources

Data Supplement

Methodology

Number of Source Documents
265
Literature Search Start Date
March 3, 2022
Literature Search End Date
June 7, 2023