Advances in the diagnosis and treatment of dry eye

Takashi Kojima, Murat Dogru, Motoko Kawashima, Shigeru Nakamura, Kazuo Tsubota

Research output: Contribution to journalReview article

Abstract

The core mechanism of dry eye is the tear film instability. Tear film-oriented diagnosis (TFOD) is a concept to clarify the cause of tear film instability by tear film, and tear film-oriented treatment (TFOT) is a concept to treat dry eye disease by replacing the lacking components of the tear film layer based on the TFOD. In TFOD, the fluorescein breakup pattern of the tear film is important, and the subtype of dry eye can be judged to some extent from the breakup patterns. Current noninvasive devices related to the dynamic analysis of the tear film and visual acuity enabled the diagnosis of dry eye, subtype analysis, and the extent of severity. In Asian countries, secretagogues represent the main treatment in TFOT. Since meibomian gland dysfunction is a factor that greatly affects the tear breakup time, its treatment is also essential in the dry eye treatment strategy. A newly discovered dry eye subtype is the short breakup time-type (BUT) of dry eye. The only abnormal finding in this disease is the short BUT, suggesting a relationship with ocular neuropathic pain and eye strain. Recently, data from many studies have accumulated which show that dry eye is a life-style disease. In addition to the treatment of dry eyes, it is becoming possible to prevent the onset by intervening with the daily habits, diet, exercise and sleep, etc. It has been pointed out that oxidative stress is also involved in the pathology of dry eye, and intervention is being carried out by improving diet and taking supplements. Future research will be needed to link clinical findings to the molecular biological findings in the tear film.

Original languageEnglish
Article number100842
JournalProgress in Retinal and Eye Research
DOIs
Publication statusAccepted/In press - 2020 Jan 1

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Keywords

  • Dry eye disease
  • Life style
  • Oxidative stress
  • Tear film-oriented diagnosis
  • Tear film-oriented treatment
  • Visual function

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

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