Attention to the subtypes of dry eye disease may better equip clinicians to diagnose and treat cases, according to a review article recently published in the New England Journal of Medicine

Janine A. Clayton, M.D., from the National Institutes of Health in Bethesda, Md., conducted a literature review to describe current knowledge of the causes and treatment of dry eye, ongoing research, and future directions for advancing knowledge and treatment of the condition.

Dry eye is a common disorder of the ocular surface that affects millions of people worldwide, with varying severity. At a minimum, dry eye causes discomfort, but it can also cause disabling pain and fluctuating vision, substantially affecting the vision-related quality of life by limiting such activities as driving and reading, as well as recreation.

Dry eye also influences productivity in the workplace by making it more difficult to use a computer or read for extended periods, decreasing tolerance for certain environments, and reducing work time.

Causes and treatment of dry eye

As the population ages, the prevalence of dry eye is likely to increase, yet the condition is often underrecognized and undertreated. This review describes current knowledge of the causes and treatment of dry eye, ongoing research, and future directions for advancing knowledge and treatment of the condition.

Clayton explains that dry eye has many causes. It can occur with other conditions, as a consequence of environmental triggers, or as a side effect of medications, such as over-the-counter antihistamines. Dry eye can be caused or exacerbated by ocular surgery, computer use, contact-lens use, or low-humidity conditions.

Initial diagnosis can be complicated by subjective symptoms, variable presentation, and few objective signs that can be assessed in the primary care setting.

"By thinking in terms of the subtypes of dry eye, classified on the basis of risk factors and pathophysiological features, clinicians will be better equipped to diagnose and treat cases," Clayton writes.