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Clinical Reviews in Allergy & Immunology

, Volume 49, Issue 3, pp 288–297 | Cite as

Current Approach to Dry Eye Disease

  • Valéria ValimEmail author
  • Virginia Fernandes Moça Trevisani
  • Jacqueline Martins de Sousa
  • Verônica Silva Vilela
  • Rubens BelfortJr
Article

Abstract

Dry eye disease (DED) is a multifactorial disease of the tears and ocular surface that causes tear film instability with potential damage to the ocular surface. The prevalence of dry eye in the world population ranges from 6 to 34 %. It is more common in those aged over 50, and affects mainly women. Since the introduction of the Schirmer’s test in 1903, other tests have been developed to evaluate dry eye, such as biomicroscopy, the tear film breakup time (BUT), vital dyes (lissamine green and rose bengal), fluorescein, leaf fern test, corneal sensitivity test, conjunctiva impression cytology, optical coherence tomography (OCT), and tear osmolarity measurement. Although there is no gold standard, it is advisable to combine at least two tests. Strategies for treating DED have recently been modified and include patient education, tear substitute, corticosteroids, secretagogues, fatty acids, immunomodulators, occlusion of lacrimal puncta surgery and, tarsorrhaphy. Biological therapy and new topical immunomodulators such as tacrolimus, tofacitinib and IL-1 receptor inhibitor are being tested. In this review, the evaluation tests for dry eye are compared and the main studies on treatment are presented, with emphasis on studies in patients with Sjögren’s syndrome. The authors propose an approach for the management of dry eye.

Keywords

Dry eye disease Sjögren’s syndrome Cornea Ocular surface 

Notes

Conflict of interest

The authors declare that they have no conflicts of interest concerning this article.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Valéria Valim
    • 1
    • 6
    Email author
  • Virginia Fernandes Moça Trevisani
    • 2
    • 3
    • 6
  • Jacqueline Martins de Sousa
    • 4
  • Verônica Silva Vilela
    • 5
    • 6
  • Rubens BelfortJr
    • 4
  1. 1.Centro de Referência de Doenças Reumáticas, Serviço de ReumatologiaUniversidade Federal do Espírito Santo, Hospital Universitário Cassiano Antonio de MoraesVitóriaBrazil
  2. 2.Disciplina de Medicina de Urgência e Medicina Baseada em EvidênciasUniversidade Federal de São PauloSão PauloBrazil
  3. 3.Universidade de Santo AmaroSão PauloBrazil
  4. 4.Escola Paulista de Medicina (EPM), Departamento de Oftalmologia e Ciências VisuaisSão PauloBrazil
  5. 5.Disciplina de ReumatologiaUniversidade do Estado do Rio de JaneiroRio de JaneiroBrazil
  6. 6.Scientific Committee on Sjögren’s SyndromeBrazilian Society of RheumatologySão PauloBrazil

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