Eyeworld

Supported by unrestricted educational grants from Shire, TearLab, and TearScience So who has dry eyes? According to data, 3.23 million women, 1.68 million men, and 4.91 million Americans age 50 or older have dry eye. The CEDARS Dys- functional Tear Syndrome Algorithm: Diagnos- tic-Based Approach was published in January 2017 and takes a slightly different approach to the definition of dysfunction- al tear syndrome. This algorithm is not described by severity (mild, moder- ate, or severe) but rather by what type of dry eye a patient has. Based on the different diagnoses, it will predict and define what to use to treat this type of dry eye. The CEDARS algorithm also went through an encyclopedic review of dry eye treat- ment options to look at everything that has been described and to put in their review what might/ might not be effective (Figure 1). The algorithm tries to be encyclopedic in terms of all the diag- nostic tests as well as all the therapies that are out there. As for the next algo- rithm, the Tear Film & Ocular Surface Society (TFOS) DEWS II report was created throughout a 2-year process as a fol- low-up to the first DEWS review in 2007. This Figure 3. The ASCRS Cornea Clinical Committee: Preop Cataract and Refractive Surgery Algorithm focuses on surgical patients, including how to evaluate and prepare patients coming in for surgery. Source: Chris Starr, MD continued on page 4 Figure 2: The Tear Film & Ocular Surface Society (TFOS) DEWS II report was created through a 2-year process as a follow up to the first DEWS review in 2007. Source: Francis Mah, MD in thinking they have another condition, so it's important for clini- cians to decipher if the problem is fluctuation in vision, constant blurring of vision, or distortion of vision. vision, and photophobia/ itching/redness. However, dry eye symptoms may not correlate with clini- cal signs. Fluctuation in vision is one of the key signs of dry eye disease. A lot of these patients come Dry eye can cause fluc- tuation in vision because of the role of the tear film, which is the most im- portant refractive system in the eye. The cornea is responsible for two-thirds of the optical power. 1 3

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