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Tear dysfunction influences corneal epithelial function, speaker says
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 Stephen C. Pflugfelder |
ORLANDO, Fla. — Ongoing research is yielding new insights into the causes, symptoms and potential treatments of tear dysfunction and debilitating corneal disease, a guest speaker said.
Stephen C. Pflugfelder, MD, a researcher and ophthalmologist, discussed new developments while giving the Jackson Memorial Lecture during the opening ceremony of the American Academy of Ophthalmology meeting here.
"Tears are essential for maintaining corneal clarity and optimal performance," Dr. Pflugfelder said. "Tear dysfunction is a pervasive clinical problem that causes superficial epithelial corneal disease by a variety of mechanisms. Irritation and blurred vision from corneal epithelial disease greatly impact quality of life . . . Disease-relevant therapeutic targets have been identified."
The tear-corneal epithelial complex accounts for 65% of the optical power of the eye. The eye is open 92% of the time and the blink rate is 15 times per minute. The corneal epithelium needs constant protection and must maintain its clarity between eye blinks, Dr. Pflugfelder said.
Pathologic changes resulting from tear dysfunction include corneal barrier disruption and apoptosis.
Dr. Pflugfelder quoted studies showing that the effects of tear dysfunction on the corneal epithelium have a significant impact on quality of life and daily activities such as work, reading, TV watching and driving. Symptoms include pain and photophobia, he said.
Treatments in development include contact lenses and pharmacologic therapies that use inflammatory mediators, Dr. Pflugfelder said.
- Disclosure: Dr. Pflugfelder has financial relationships with Allergan, Bausch + Lomb and Inspire Pharmaceuticals Inc.
It is well accepted that dry eye has an impact on the ocular surface, which can lead to significant changes in a patient’s lifestyle. For some patients, having dry eye takes over his/her life — always adding drops, avoiding situations that might exacerbate symptoms, inability to wear contact lenses comfortably, to name a few.
Asking patients about avoidance activities may provide the practitioner with some insight as to the severity and quality of life impact of the disease for a patient.
– Kelly K. Nichols, OD, MPH, PhD
Foundation for Education and Research in Vision professor, Houston
Disclosure: Dr. Nichols is a paid consultant to Alcon, Allergan, Celtic, Eleven
Biotherapeutics, InSite, Ista, SarCode, and Tearlab.