DEWS II further explores sex, gender and hormones

BALTIMORE — Experts here gave a glimpse into the Tear Film Ocular Surface Dry Eye Workshop II report.

“One goal from the Tear Film Ocular Surface Dry Eye Workshop II was to create an evidence-based classification system and definition for dry eye to help guide clinical management and future research,” Jennifer P. Craig, PhD, MSc, BSc, MCOptom, FBCLA, DEWS II vice chair, said at the Association for Research in Vision and Ophthalmology annual meeting.

The changes in the definition for dry eye make it more simplified and will help to resolve confusion between diagnostic vs. pathophysiological features, she said.

The new report defines dry eye as “a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms in which tear film instability and hyperosmolarity, ocular surface inflammation, and damage and neurosensory abnormalities play etiological roles.”

The DEWS II report is the result of 150 members from 23 countries, organized into leadership, steering committees and subcommittees, according to J. Daniel Nelson, MD, DEWS II chair.

Furthermore, the report includes an option for a diagnosis of normal and addresses the misperception of mutual exclusivity, Craig said.

“Hormones are an important factor in dry eye but not the sole cause,” according to David A. Sullivan, PhD, FARVO, who chaired the Sex, Hormones and Gender Subcommittee.

Researchers have studied sex-related eye problems since Hippocrates, he said, and the report includes a large section on gender and health.

Dry eye is more prevalent in female and Asian patients, with greater symptoms reported by female patients and youths, Sullivan said.

Symptomatic dry eye rates in women are 1.3 to 1.7 times higher, with symptoms higher across all age groups, as well.

The researchers also found that women are more likely to seek preventive care screenings.

In addition, “women tend to focus more on health maintenance than illness and typically have more proactive attitudes toward vision correction,” Sullivan said.

The committee recommends using the terms “sex” and “gender” correctly across scientific disciplines of ocular surface issues and considering how they both contribute to sex-related differences in dry eye.

The researchers also sought to assess whether diagnostic testing should be different in men and women.

“Communicate clearly about the role of sex and gender influences in these areas,” Sullivan added.

The final report is 400 to 500 pages in length and will be published around July 1. It also will feature videos available online for best techniques and practices. – by Abigail Sutton

Reference:

Sullivan DA, et al. Conclusions and recommendations from the TFOS Dry Eye Workshop II. Presented at: Association for Research in Vision and Ophthalmology annual meeting; May 7-11, 2017; Baltimore.

Disclosure: Sullivan reports financial disclosures with Allergan, Cempra, Lµbris, Laboratoires Thea, MG Therapeutics and Santen. Please see the study for all other authors’ relevant financial disclosures.