The Definition and Classification of Dry Eye Disease: Report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007)

The ocular surface (Impact Factor: 3.34). 03/2007; 5(2):75-92. DOI: 10.1016/S1542-0124(12)70081-2


The aim of the DEWs Definition and Classification Subcommittee was to provide a contemporary definition of dry eye disease, supported within a comprehensive classification framework. A new definition of dry eye was developed to reflect current understanding of the disease, and the committee recommended a three-part classification system. The first part is etiopathogenic and illustrates the multiple causes of dry eye. The second is mechanistic and shows how each cause of dry eye may act through a common pathway. It is stressed that any form of dry eye can interact with and exacerbate other forms of dry eye, as part of a vicious circle. Finally, a scheme is presented, based on the severity of the dry eye disease, which is expected to provide a rational basis for therapy. these guidelines are not intended to override the clinical assessment and judgment of an expert clinician in individual cases, but they should prove helpful in the conduct of clinical practice and research.

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    • "Approximately 135 million people wear contact lens worldwide , and among them, approximately 50% complain of dry eyes, particularly at the end of the day [1]. The primary reasons for contact lens intolerance, resulting in 25% of wearers discontinuing use and 26% decreasing the frequency and duration of use, are irritation, discomfort and dryness [2]. The causes of dryness and discomfort during contact lens wear are complex, multi-factorial, and remain to be fully appreciated. "
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    Tribology International 09/2015; 89:27-33. DOI:10.1016/j.triboint.2014.11.022 · 1.94 Impact Factor
    • "A properly functioning tear film maintains a critical balance between tear secretion and loss within each blink cycle. Malfunction or deficiency of the tear film causes a collection of problems that are believed to comprise DES (Lemp, 2007). DES symptoms include, but are not limited to, blurred vision, burning, foreign body † Present address: Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180, USA. "
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    ABSTRACT: The concentration of ions, or osmolarity, in the tear film is a key variable in understanding dry eye symptoms and disease. In this manuscript, we derive a mathematical model that couples osmolarity (treated as a single solute) and fluid dynamics within the tear film on a 2D eye-shaped domain. The model includes the physical effects of evaporation, surface tension, viscosity, ocular surface wettability, osmolarity, osmosis and tear fluid supply and drainage. The governing system of coupled non-linear partial differential equations is solved using the Overture computational framework, together with a hybrid time-stepping scheme, using a variable step backward differentiation formula and a Runge-Kutta-Chebyshev method that were added to the framework. The results of our numerical simulations provide new insight into the osmolarity distribution over the ocular surface during the interblink. © The Authors 2015. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.
    Mathematical Medicine and Biology 04/2015; DOI:10.1093/imammb/dqv013 · 1.66 Impact Factor
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    • "In the clinical setting, the administration of rebamipide ophthalmic suspension ameliorates SPK associated with dry eye syndrome (Itakura et al., 2013; Kashima et al., 2012, 2014; Kinoshita et al., 2014, 2013). SPK is thus a major sign of dry eye syndrome and is caused by various different factors (Lemp et al., 2007). Although several local treatmentsdsuch as artificial tears, hyaluronan eyedrops, diquafosol eyedrops, and rebamipide suspensiondimprove the microenvironment of the corneal surface and thereby ameliorate SPK and dry eye, new drugs that target the function of corneal epithelial cells would be expected to provide a better option for such treatment. "
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    ABSTRACT: The condition of the corneal epithelium is a critical determinant of corneal transparency and clear vision. The corneal epithelium serves as a barrier to protect the eye from external insults, with its smooth surface being essential for its optical properties. Disorders of the corneal epithelium include superficial punctate keratopathy, corneal erosion, and persistent epithelial defects (PEDs). The prompt resolution of these disorders is important for minimization of further damage to the cornea. Currently available treatment modalities for corneal epithelial disorders are based on protection of the ocular surface in order to allow natural healing to proceed. PEDs remain among the most difficult corneal conditions to treat, however. On the basis of characterization of the pathobiology of PEDs at the cell and molecular biological levels, we have strived to develop new modes of treatment for these defects. These treatments rely on two key concepts: provision of a substrate, such as the adhesive glycoprotein fibronectin, for the attachment and migration of corneal epithelial cells, and activation of these cells by biological agents such as the combination of substance P and insulin-like growth factor–1 (IGF-1). Central to both approaches is the role of the fibronectin-integrin system in corneal epithelial wound healing. Determination of the minimum amino acid sequences required for the promotion of corneal epithelial wound closure by fibronectin (PHSRN) and by substance P (FGLM-amide) plus IGF-1 (SSSR) has led to the development of peptide eyedrops for the treatment of PEDs that are free of adverse effects of the parent molecules.
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