Advance in Undertanding and Managing Dry Eye Dieae Original Reearch Article

Purpoe To preent evidence from the literature and cientific meeting to upport fundamental change in concept regarding the prevalence, pathogenei, definition, diagnoi, management of dry eye dieae (DED) and the propect for the development of new therapie. Deign Analyi and clinical perpective of the literature and recent preentation. Method Review and interpretation of literature. Reult The tear film and ocular urface form an integrated phyiologic unit linking the urface epithelia and ecretory gland via a neural network. Thi enory-driven network regulate ecretory activity in quantity and compoition, upporting the homeotai of the ytem. The tear film form a metatable covering between blink, uberving clear viion, and maintain the health and turnover of the ocular urface cell. Diturbance of intrinic factor uch a increaing age; hormonal balance; ytemic or local autoimmune dieae, or both; ytemic drug or extrinic factor including topical medication; environmental tre; contact len wear; or refractive urgery reult in a final common pathway of event at the tear film and ocular urface, reulting in DED. Diagnoi of DED and the deign of clinical trial for new drug have been hampered by a lack of correlation between ign and ymptom and flawed endpoint; ucceful new drug application likely will require new approache, uch a the ue of objective biomarker for dieae everity. Concluion Recent advance in our knowledge of the cauation of DED open opportunitie for improving diagnoi and dieae management and for developing new, more effective therapie to manage thi widely prevalent and debilitating dieae tate.