American Academy of Optometry
American Academy of Optometry
November 07, 2018
2 min read

Most dry eye patients may be undertreated

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SAN ANTONIO – A majority of patients with dry eye disease do not have a record of a prescribed treatment, according to research from Csaba Siffel presented here at the American Academy of Optometry annual meeting.

Siffel and colleagues assessed the treatment patterns of patients with dry eye disease using data from the American Academy of Ophthalmology IRIS Registry.

They organized patients by age and category of dry eye disease treatment and then grouped them into four levels of intensity, based on the treatment algorithm described in the Dry Eye Workshop (DEWS II) Tear Film report.

Patients who were prescribed treatments in groups 1 through 4 were considered to have mild, moderate, moderate-severe or severe disease, respectively.

Of the nearly 2.8 million patients with dry eye disease identified in the IRIS registry in 2017, 47.7% had a record of at least one specific dry eye disease prescribed treatment or procedure/surgery, Siffel said in her presentation. The remaining patients were untreated or may have used over-the-counter eye drops, gels or ointments.

Women were more likely than men to receive treatment for dry eye disease, according to Siffel.

Researchers classified treated patients into the following groups: Group 1 – topical and systemic omega-3 fatty acids, 4.7%; group 2 – ocular anti-inflammatory agents, Xiidra (lifitegrast ophthalmic solution 5%, Shire) and Restasis (cyclosporine ophthalmic emulsion 0.05%, Allergan), 16.7%; group 3 – topical corticosteroids, non-thermal or collagen punctal plug occlusions, 56.6%; and group 4 – tetracyclines, cholinergic agonists, anti-inflammatory agents, mucolytic agents, punctal occlusion by thermocauterization, ligation or laser surgery or tarsorrhaphy, 22.1%.

The most intense treatments were more often prescribed to older patients, according to the study – 14.9% of those 18 to 29 years old; 15.6% of those 30 to 39 years, 17.8% of those 40 to 49 years, 20.6% of those 50 to 59 years, 23.3% of those 60 to 69 years, 23.8% of those 70 to 79 years and 21.5% of those 80 years old and older.

Siffel said the majority of patients with dry eye disease had no record of a prescribed dry eye treatment and may be undertreated for their dry eye disease symptoms.

“What surprised us, among those identified with dry eye disease (DED), over 50% of patients were untreated with prescriptions,” he said.

“Our data showed that DED impacts a substantial portion of eye care patients, especially women; that prevalence increases with age; and comorbidities like cataract, glaucoma and meibomian gland dysfunction are highly prevalent in patients with DED, at over 20%,” Siffel added. – by Abigail Sutton


Siffel C. Treatment patterns of patients with dry eye disease: An analysis of the AAO IRIS Registry. Presented at: American Academy of Optometry annual meeting; San Antonio; November 7 – 10, 2018.

Disclosures: Siffel is employed by Shire. Please see the full paper for all remaining authors’ financial disclosures.