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While dry eye has only recently been recognized as a widespread problem affecting millions of people, it has been a recurring problem for decades. LEWIS WILLIAMS traces his story to show his progress from the perceived disruption to the overall health issue.
Since the relatively recent acceptance of the seemingly increasing prevalence of dry eye, researchers with the necessary interest and qualifications have begun in-depth studies
Research has not been conducted. has begun seriously only probably over the last 20-30 years and has reached its peak in the last 10-15 years. The results of these studies and the predictable creation of a new instrumentation, or the evolution of existing instrumentation, to meet the clinical and laboratory needs of these researchers have resulted in the creation of 39 a growing industry dedicated to the equipment of dry people. Some of these same results have also resulted in novel or advanced in-eye preparations to treat at least the symptoms of the disease.
Many solutions, literally and figuratively, have been published by companies that already had similar products. an add-on treatment for contact lens wearers, or who had the manufacturing capabilities to enter the evolving dry eye market. Some start-ups have also entered the fray, and the current situation boils down to an established and expanding "dry eye" industry populated by many old faces and several new ones.
An important step was the TFOS (Tear Film and Ocular Surface Company). DEWS I (Dry Eye WorkShop I) reports that, perhaps more than any other "event", has put a dry eye on the map of ophthalmic professions. While DEWS II (2017) has dealt with much of what has happened since the groundwork of the 2007 milestone and answered several of the perceived shortcomings of the original, it seems that the professions involved the perceive almost as an anti-climax
. The greatest contribution of the DEWS II is to admit that the dry eye is a multifactorial disease and that the dry eye itself represents a continuum between two extremes previously considered distinct: the watery dry eye deficient and evaporative dry eye. The central physiopathological concept is now a loss of tear film homeostasis.
Importantly, the concept of ocular symptoms has been expanded to encompass ocular discomfort or visual disturbance. In the new definition, all aspects of dry eye are now related to the key etiologies of tear film instability, hyperosmolality, ocular surface inflammation and damage that result. New data has also resulted in neurosensory abnormalities, including neurotrophic conditions (eg, neurotrophic keratitis) included in the definition for the first time.
Although the prevalence has not been confirmed, there are good reasons to believe that it for example, the graying of the population of the western world, the widespread invasion of digital devices in the work and leisure life of people of all ages, but especially those under 40, the greater awareness of the people and professions concerned, and the activities of all branches of the industry of dry eye.
The success of the latter can be measured by the release of graduated palliative solutions in the eye for the spectrum of the severity of the dry eye; the release of a few, and the search for numerous therapeutic treatments for dry eyes, including devices for treating contributors to the disease, e.g. MGD; and our ability to evaluate and quantify aspects of the dry eye, especially the osmolality of the tear film, although often expensive.
The ability to assess factors that may indicate the presence of dry eye can mean early detection of the disease. the condition will come sooner rather than later. The confusion between the signs and symptoms is disconcerting: some have little or no signs but significant symptoms, while others show obvious signs but few symptoms.
To date, no diagnostic factor for dry eye has been identified. – the closest parameter to set the dry eye is the osmolality of the tear film, but it is fallible. On the contrary, a set of signs and / or symptoms can collectively result in a "diagnosis" of dry eye, which agrees well with the acceptance of a multifactorial definition and etiology complex
while in the past the dry eye was considered DEWS II also confirmed that dry eye is present in the under 40 years, affects more frequently Asians, but whose prevalence is difficult to determine reliably (figures range from 5 to 50%). but can reach 75% in some populations). Few reliable epidemiological studies, even in the last 10 years, have surfaced, hence the actual prevalence still unknown.
Given the current level of dry eye activity in academic and clinical circles, and quasipharmaceutical conglomerates are already involved, it is unlikely that the dry eye will become a passing fad – it is rather more likely to become an expanding pursuit and increasingly influential by many entities.
Image courtesy of Flickr | Kamil Porembinski
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