Dry eye or keratoconjunctivitis sicca (KCS) was re-defined in the Tear Film Ocular Society’s comprehensive DEWS II Report in July 2017 as follows:
“Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”
Dry eye is one of the most frequently encountered eye diseases. Twenty–five (25%) percent of all patients who visit ophthalmic clinics report symptoms of dry eye, making it the number one reason people see their eye care practitioner outside of vision correction. Largely because dry eye is associated with aging, it continues to be a growing public health problem severely impacting patients and in certain cases patients quality of life. Dry eye affects an estimated 30 million people in the US today. Its prevalence is about 9% of the total US population but upwards of 33%+ in people over 65. Interestingly, its prevalence is 33%+ among total populations in certain Pacific Rim countries including China, Japan and Taiwan. According to several market research reports, dry eye represents one of the fastest growing pharmaceutical product categories in the ophthalmology market today. MarketScope (2017) estimates the worldwide market at $4.6 billion in 2018, projected to grow to $6.2 billion by 2023.
Dry Eye is chronic and has no cure. It is caused by either the reduction in tear aqueous production/volume over time or the degeneration of tear lipid (oil layer) components, or both. It is typically associated with aging. Therapies today focus largely on treating symptoms (e.g., burning, gritty, itchy, foreign body sensations, and blurred vision) versus causes since there is no cure. Major therapies to date are 1) OTC artificial tears/lubricants/wetting drops; 2) cyclosporine (Restasis®/Allergan), lifitegrast (Xiidra®/Santen) and/or corticosteroids drugs to treat inflammation, just one of numerous contributors or aggravators of dry eye; 3) punctal plugs to help increase tear film volume; and finally, 4) autologous serum. While autologous serum have been well documented in the literature for over 30 years for dry eye and numerous other corneal diseases and conditions, they remain today a niche/end stage/failed meds therapy due to inherent limitations unrelated to safety and/or efficacy. For more information about autologous serum, click here.
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