Management of dry eye disease

Am J Manag Care. 2008 Apr;14(3 Suppl):S88-101.

Abstract

The management of dry eye disease (DED) encompasses both pharmacologic and nonpharmacologic approaches, including avoidance of exacerbating factors, eyelid hygiene, tear supplementation, tear retention, tear stimulation, and anti-inflammatory agents. Artificial tears are the mainstay of DED therapy but, although they improve symptoms and objective findings, there is no evidence that they can resolve the underlying inflammation in DED. Topical corticosteroids are effective anti-inflammatory agents, but are not recommended for long-term use because of their adverse-effect profiles. Topical cyclosporine--currently the only pharmacologic treatment approved by the US Food and Drug Administration specifically for DED--is safe for long-term use and is disease-modifying rather than merely palliative. Treatment selection is guided primarily by DED severity. Recently published guidelines propose a severity classification based on clinical signs and symptoms, with treatment recommendations according to severity level.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Inflammatory Agents / administration & dosage
  • Cyclosporine / administration & dosage
  • Dry Eye Syndromes / drug therapy
  • Dry Eye Syndromes / therapy*
  • Fatty Acids / administration & dosage
  • Humans
  • Hygiene
  • Immunosuppressive Agents / administration & dosage
  • Ophthalmic Solutions / therapeutic use
  • Randomized Controlled Trials as Topic
  • Tetracycline / administration & dosage
  • Vitamin A / administration & dosage

Substances

  • Adrenal Cortex Hormones
  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • Fatty Acids
  • Immunosuppressive Agents
  • Ophthalmic Solutions
  • Vitamin A
  • Cyclosporine
  • Tetracycline