Eyeworld

78 | EYEWORLD | SPRING 2026 C ORNEA I 'm fairly certain recurrent corneal erosions are the bane of any corneal spe- cialist's existence. Patients are unhappy, they are in pain, and they keep coming back again and again. As Winston Chamberlain, MD, PhD, points out in this issue's excellent article on the subject—conservative measures fail >50% of the time, and even with interventions, there's no silver bullet. The same can be said for ocular surface disease, which torments an untold number of patients and nearly every ophthalmologist worldwide. In reality, these conditions are likely a combination of multiple different diseases, all with overlapping symptoms and presentations. The therapies we have today seem like they don't work all the time, and worse yet, we can't predict when they will help and when they will fail to make a difference. This isn't because our options today are ineffective or weak—it's because we lack the capacity to truly discrim- inate between the underlying conditions that are lumped together into the catch-all bucket of ocular surface disease. The answer to this is the development of both better diagnostics but also individualized medicine. Anat Galor, MD, hints at this in our article on biologics in the cornea. There are markers that can predict the patient's response to anti-TNFα therapies for ocular surface dis- ease. Early forays into this—looking at matrix metalloproteinase-9 levels on the ocular sur- face—were helpful but not discriminative. As we advance in medicine, the next frontier will be getting a true picture of the state of the patient—genetics, environment, and lifestyle— and using this to find the correct diagnosis and treatment. Fully personalized, individualized medi- cine will help to take the pain points of patient care—the dry eye, the recurrent erosions—and fit them with a treatment that will work. This will ultimately benefit not only patients, but also the physicians who have been frustrated with the trial-and-error approach that these condi- tions sometimes need. As always, the growth and direction of our field continue onward and upward, and I remain in awe of the future potential. by Julie Schallhorn, MD Cornea Editor Growth and upward direction in the cornea field William Trattler, MD, EyeWorld Refractive Editorial Board member, shared what he is looking forward to at the 2026 ASCRS Annual Meeting: "One of the highlights of the meeting for me is the scientific paper sessions. It is wonderful to see all of the hard work performed to help uncover new insights on how to best care for patients. The paper sessions are always a fantastic place to learn from our colleagues." Fully personalized, individualized medicine will help to take the pain points of patient care— the dry eye, the recurrent erosions—and fit them with a treatment that will work.

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