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Subspecialties Cornea/Ocular Surface

Treating OSD Then and Now

At a Glance

  • Modern risk factors are creating dry eye in younger patients
  • Optimizing the ocular surface to eliminate inflammation increases positive outcomes
  • Nutraceuticals and healthy diet can regenerate the ocular surface naturally
  • The modern epidemic of dry eye requires proactive care

Even though we now have a greater knowledge of the etiology of ocular surface disease (OSD), as well as better diagnostics and a growing array of therapeutics than ever before, there still seems to be a tendency to try to pigeonhole this disease into one of two specific categories – evaporative dry eye or aqueous-deficient dry eye. We need to stop trying to post these problems into one box or the other. We need to start thinking about the patient. Ask: what symptoms are present? What risk factors are creating or exacerbating the problem? The patient’s medical history, medications, habits, profession, diet, and lifestyle will all affect what happens on the ocular surface. Ultimately, it doesn’t matter if the patient’s particular case of dry eye is evaporative or aqueous-deficient, or if everything in combination is leading to the breakdown of the lacrimal function unit. The stressor leads to dysfunction and imbalance of tear film, which creates inflammation and perpetuates this cycle (Figure 1) – and that’s what needs to be addressed. If the stressors can be reduced or eliminated, the cycle can be controlled, and in certain cases, broken.

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About the Author

Elizabeth Yeu

Elizabeth Yeu is Assistant Professor at Eastern Virginia Medical School and Cornea, Cataract and Refractive Surgeon with Virginia Eye Consultants, VA, USA

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