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Annals of Medicine Dec 2023Dry eye disease (DED) is a multifactorial disorder characterized by loss of tear film homeostasis with an estimated worldwide prevalence of 5% to 50%. In DED,... (Review)
Review
Dry eye disease (DED) is a multifactorial disorder characterized by loss of tear film homeostasis with an estimated worldwide prevalence of 5% to 50%. In DED, dysfunction of the ocular structures that create and regulate the tear film components-including the lacrimal glands, meibomian glands, cornea, and conjunctiva-causes a qualitative and/or quantitative tear deficiency with resultant tear film instability and hyperosmolarity. This initiates a vicious cycle of ocular surface inflammation and damage that may ultimately impair the quality of life and vision of affected patients. Many factors can contribute to the development of DED, including ocular and systemic diseases, topical and systemic medications, and environmental conditions. Because DED is a chronic disorder, treatment is most often long term and may utilize both pharmacologic and nonpharmacologic interventions to address all etiologic components. The long-term management of DED can be challenging and most often should involve eye care specialist referral. However, primary care clinicians (PCCs) are often the first points of contact for patients with DED and importantly provide initial diagnosis and preliminary patient education about the disease process. Consideration of DED is also vital for the practice of various specialties due to the large number of comorbidities and medications that can contribute to DED pathogenesis and progression. Therefore, it is important that PCCs and clinical specialists be aware of the etiology of DED and its available therapeutic options. This manuscript provides an overview of DED pathophysiology and treatment and discusses specific considerations regarding DED management for PCCs and clinical specialists.Key messagesSuccessful management of dry eye disease often requires the use of various pharmacologic and/or nonpharmacologic therapies, as well as environmental and lifestyle modifications, to mitigate the underlying etiologies and restore tear film homeostasis.Primary care clinicians play an essential role in dry eye disease management by establishing a diagnosis, educating patients about the disorder, and providing referrals to eye care specialists for initiation of specialized treatment and long-term follow-up.Primary care clinicians and clinical specialists should consider prescribing medications with fewer ocular surface effects whenever possible in patients at risk for or with existing dry eye disease.
Topics: Humans; Quality of Life; Dry Eye Syndromes; Conjunctiva; Tears; Primary Health Care
PubMed: 36576348
DOI: 10.1080/07853890.2022.2157477 -
Survey of Ophthalmology 2023Chalazia are localized cysts of chronic lipogranulomatous inflammation arising from the obstruction of sebaceous glands of the eyelid tarsal plate, including the...
Chalazia are localized cysts of chronic lipogranulomatous inflammation arising from the obstruction of sebaceous glands of the eyelid tarsal plate, including the Meibomian gland (deep chalazion) or Zeis gland (superficial chalazion). This disease entity is differentiated from the hordeolum (stye), an acute purulent localized swelling of the eyelid often associated with an eyelash follicle, Zeis gland, or Moll gland obstruction and infection. Ambiguously, the chalazion, hordeolum, and blepharitis are commonly categorized and described on a continuum in the literature. While it is one of the most common eyelid disorders across all age demographics, the chalazion remains largely understudied and pathophysiological, epidemiological, and therapeutic findings exist fragmented in the literature. We discuss current understandings of the chalazion and provide current best practice guidelines supported by clinical anecdotal evidence.
Topics: Humans; Chalazion; Hordeolum; Eyelid Diseases; Meibomian Glands; Cysts; Inflammation
PubMed: 36395826
DOI: 10.1016/j.survophthal.2022.11.002 -
American Journal of Ophthalmology Aug 2023To evaluate the efficacy and safety of NOV03 (perfluorohexyloctane) ophthalmic drop for the treatment of signs and symptoms of dry eye disease (DED) associated with... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
To evaluate the efficacy and safety of NOV03 (perfluorohexyloctane) ophthalmic drop for the treatment of signs and symptoms of dry eye disease (DED) associated with meibomian gland dysfunction (MGD).
DESIGN
Randomized, double-masked, controlled trial.
METHODS
Patients ≥18 years of age with a history of DED and signs of MGD were randomly assigned 1:1 to treatment with NOV03 or hypotonic saline (0.6%) 4 times daily for 8 weeks. The primary sign and symptom endpoints were change from baseline to week 8 in total corneal fluorescein staining (tCFS; National Eye Institute scale) and eye dryness score (0-100 visual analog scale), respectively.
RESULTS
A total of 620 patients (NOV03, n = 311; saline, n = 309) were randomized and treated. Least-squares (LS) mean change from baseline to week 8 was statistically significantly greater for NOV03 compared with saline for both tCFS (-2.3 vs -1.1; LS mean treatment difference, -1.2 [95% confidence interval -1.7 to -0.8]; P < .001) and visual analog scale dryness score (-29.4 vs -19.2; LS mean treatment difference, -10.2 [95% CI -14.4 to -6.1]; P < .001), with statistically significant between-group differences observed as early as week 2. The incidence of ocular adverse events was similar for NOV03 (12.9%) and saline (12.3%). There were no serious adverse events and no adverse events leading to treatment discontinuation.
CONCLUSIONS
In this randomized controlled trial of patients with DED associated with MGD, NOV03 significantly reduced both signs and symptoms of DED compared with hypotonic saline control. NOV03 was well tolerated, with an adverse event profile similar to that of saline.
Topics: Humans; Infant, Newborn; Meibomian Gland Dysfunction; Fluorescein; Ophthalmic Solutions; Dry Eye Syndromes; Administration, Ophthalmic; Meibomian Glands; Tears
PubMed: 36948372
DOI: 10.1016/j.ajo.2023.03.008 -
Skinmed 2023Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease that affects the sebaceous tissues of the body. The meibomian glands of the eyelids are... (Review)
Review
Seborrheic dermatitis (SD) is a common, chronic inflammatory skin disease that affects the sebaceous tissues of the body. The meibomian glands of the eyelids are modified sebaceous glands. Involvement of the meibomian glands and their dysfunctioning are significant in SD; however, the ophthalmic features of SD have been poorly described in the literature. The ophthalmic manifestations of SD and the significance of ocular examinations in SD patients are discussed in this review.
Topics: Humans; Dermatitis, Seborrheic; Sebaceous Glands; Meibomian Glands; Skin; Dermatitis
PubMed: 38051236
DOI: No ID Found -
Japanese Journal of Ophthalmology Jul 2023
Topics: Humans; Meibomian Gland Dysfunction; Dry Eye Syndromes; Tears; Meibomian Glands; Eyelid Diseases
PubMed: 37351738
DOI: 10.1007/s10384-023-00995-8